Respiratory viruses such as influenza do not typically cause viremia; however, SARS-CoV-2 has been detected in the blood of COVID-19 patients with mild and severe symptoms. Detection of SARS-CoV-2 in blood raises questions about its role in pathogenesis as well as transfusion safety concerns. Blood donor reports of symptoms or a diagnosis of COVID-19 after donation (post-donation information, PDI) preceded or coincided with increased general population COVID-19 mortality. Plasma samples from 2,250 blood donors who reported possible COVID-19–related PDI were tested for the presence of SARS-CoV-2 RNA. Detection of RNAemia peaked at 9%–15% of PDI donors in late 2020 to early 2021 and fell to approximately 4% after implementation of widespread vaccination in the population. RNAemic donors were 1.2- to 1.4-fold more likely to report cough or shortness of breath and 1.8-fold more likely to report change in taste or smell compared with infected donors without detectable RNAemia. No infectious virus was detected in plasma from RNAemic donors; inoculation of permissive cell lines produced less than 0.7–7 plaque-forming units (PFU)/mL and in susceptible mice less than 100 PFU/mL in RNA-positive plasma based on limits of detection in these models. These findings suggest that blood transfusions are highly unlikely to transmit SARS-CoV-2 infection.

中文翻译：

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在症状前受感染的献血者血浆中经常检测到 SARS-CoV-2 RNA，但缺乏传染性


流感等呼吸道病毒通常不会引起病毒血症；然而，在轻度和重度症状的 COVID-19 患者的血液中检测到了 SARS-CoV-2。血液中 SARS-CoV-2 的检测引发了对其在发病机制中的作用以及输血安全问题的质疑。献血者报告症状或献血后诊断出 COVID-19（献血后信息，PDI）先于或同时发生在普通人群 COVID-19 死亡率增加之前。对 2,250 名报告可能与 COVID-19 相关的 PDI 的献血者的血浆样本进行了检测，以确定是否存在 SARS-CoV-2 RNA。 2020 年末至 2021 年初，PDI 捐献者中 RNA 血症的检出率达到峰值，达到 9%–15%，在人群中广泛实施疫苗接种后，这一比例下降至 4% 左右。与未检测到 RNA 血症的受感染捐献者相比，RNA 血症捐献者报告咳嗽或呼吸短促的可能性高出 1.2 至 1.4 倍，报告味觉或嗅觉变化的可能性高出 1.8 倍。在 RNAemic 捐献者的血浆中未检测到传染性病毒；根据这些模型的检测限，接种允许的细胞系产生的噬菌斑形成单位 (PFU)/mL 低于 0.7-7，而在易感小鼠中，RNA 阳性血浆中的噬菌斑形成单位 (PFU) 低于 100 PFU/mL。这些发现表明，输血传播 SARS-CoV-2 感染的可能性极小。