Detectable SARS-CoV-2 RNAemia in Critically Ill Patients, but Not in Mild and Asymptomatic Infections

Enrico Richter; Doaa Al Arashi; Bianca Schulte; Christian Bode; Benjamin Marx; Souhaib Aldabbagh; Celina Schlüter; Beate Mareike Kümmerer; Johannes Oldenburg; Markus B Funk; Christian Putensen; Ricarda Maria Schmithausen; Gunther Hartmann; Anna Eis-Hübinger; Hendrik Streeck

doi:10.1159/000515841

Detectable SARS-CoV-2 RNAemia in Critically Ill Patients, but Not in Mild and Asymptomatic Infections

Transfus Med Hemother. 2021 May;48(3):154-160. doi: 10.1159/000515841. Epub 2021 May 25.

Authors

Affiliations

¹ Institute of Virology, University Hospital, University of Bonn, and German Center for Infection Research (DZIF), partner site Bonn-Cologne, Bonn, Germany.
² Department for Internal Medicine, City Hospital Heinsberg, Heinsberg, Germany.
³ Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany.
⁴ Department of Experimental Hematology and Transfusion Medicine, University Hospital, University of Bonn, Bonn, Germany.
⁵ Department Safety of Drugs and Medical Devices, Paul-Ehrlich-Institut, Langen, Germany.
⁶ Institute for Hygiene and Public Health, University Hospital, University of Bonn, Bonn, Germany.
⁷ Institute of Clinical Chemistry and Clinical Pharmacology, University Hospital, University of Bonn, and German Center for Infection Research (DZIF), partner site Bonn-Cologne, Bonn, Germany.

Abstract

Background: The SARS-CoV-2 pandemic has challenged many of our current routine practices in the treatment and care of patients. Given the critical importance of blood donation and transfusion we analyzed 92 blood samples of individuals infected with SARS-CoV-2 stratified by symptoms.

Study design and methods: We therefore tested blood samples for SARS-CoV-2 via RT-PCR targeting the E gene. In addition, we tested each blood sample for anti-SARS-CoV-2 IgG antibodies via ELISA and performed plaque reduction neutralization tests.

Results: SARS-CoV-2 RNA was absent in the blood of mild to asymptomatic patients (57 individuals) and only detectable in individuals with severe COVID-19 who were admitted to the intensive care unit (35 individuals) (n = 6/92 [6.5%]; p = 0.023 Fisher's exact test). Interestingly, anti-spike IgG antibodies were not significantly higher in intensive care unit patients compared to mild patients, but we found that their neutralizing capacity was disproportionately increased (p < 0.001).

Conclusion: Our observations support the hypothesis that there are no potential hazards from blood or plasma transfusion of SARS-CoV-2-positive individuals with mild flu-like symptoms and more importantly of asymptomatic individuals.

Keywords: Blood donation; Blood safety; Plasma; Virus safety.