Assessment of the impact of pathogen reduction technologies on the neutralizing activity of COVID-19 convalescent plasma

COVID-19 convalescent plasma (CCP) could improve the clinical outcome of COVID-19 patients when high-titer CCP is administered in early stages of disease. However, CCP donors have a risk profile like first-time donors, pathogen reduction treatment (PRT) may mitigate such risk but should not impact CCP quality. The current study aims to assess the impact of PRT-technologies available in Saudi Arabia on the neutralizing activity of CCP. Study Design and Methods: CCP was collected from eligible donors by plasmapheresis. The neutralization titer was determined with an in-house microneutralization assay (MNA) using a local SARS-CoV-2 clinical isolate. Selected units were split and subject to PRT with amotosalen/UVA (AS) or Riboflavin/UVB (RB) (pairwise side-by-side comparison) followed by a second MNA analysis. 51 CCP units were collected, 27 were included in the analysis reaching the minimum MNA titer of 1:40 (4 reached high titer (≥1:250)). 27 CCP units were treated with AS and 14 with RB, the median MNA pre-treatment titer was 1:80 (1:40-640). The impact of AS and RB PRT on CCP neutralizing activity was not significantly different, nor in the total analysis neither in the pairwise comparison (94.6 vs 96.4% retention, p>0.05). No correlation of titer and blood group was observed, but a trend for increasing MNA titer with donor age, choosing donors with an age >45 years would increase the number of high-titer CCP donors. The difference in impact of AS and RB on CCP MNA titer was below the limit of detection of the assay (0.5-fold).

Assessment of the impact of pathogen reduction technologies on the neutralizing activity of COVID-19 convalescent plasma.

COVID-19 convalescent plasma (CCP) could improve the clinical outcome of COVID-19 patients when high-titer CCP is administered in early stages of disease. However, CCP donors have a risk profile like first-time donors, pathogen reduction treatment (PRT) may mitigate such risk but should not impact CCP quality. The current study aims to assess the impact of PRT-technologies available in Saudi Arabia on the neutralizing activity of CCP. STUDY DESIGN: and Methods: CCP was collected from eligible donors by plasmapheresis. The neutralization titer was determined with an in-house microneutralization assay (MNA) using a local SARS-CoV-2 clinical isolate. Selected units were split and subject to PRT with amotosalen/UVA (AS) or Riboflavin/UVB (RB) (pairwise side-by-side comparison) followed by a second MNA analysis. 51 CCP units were collected, 27 were included in the analysis reaching the minimum MNA titer of 1:40 (4 reached high titer (≥1:250)). 27 CCP units were treated with AS and 14 with RB, the median MNA pre-treatment titer was 1:80 (1:40-640). The impact of AS and RB PRT on CCP neutralizing activity was not significantly different, nor in the total analysis neither in the pairwise comparison (94.6 vs 96.4 % retention, p > 0.05). No correlation of titer and blood group was observed, but a trend for increasing MNA titer with donor age, choosing donors with an age > 45 years would increase the number of high-titer CCP donors. The difference in impact of AS and RB on CCP MNA titer was below the limit of detection of the assay (0.5-fold).

Association of blood group with COVID-19 disease susceptibility and severity in Saudi Arabia.

BACKGROUND: Novel SARS-CoV-2 (COVID-19) virus has rapidly spread worldwide and was declared a pandemic, making identifying and prioritizing individuals most at risk a critical challenge. The literature describes an association between blood groups and the susceptibility to various viral infections and their severity. Knowing if a specific blood group has more susceptibility to COVID-19 may help improve understanding the pathogenesis and severity of the disease. We aimed to assess the association between ABO/RhD and COVID-19 susceptibility and severity, and to compare results with similar studies in Saudi Arabia. STUDY DESIGN AND METHODS: This study was conducted between March and October 2021 on 600 patients confirmed positive for COVID-19 infection. Patients' data were collected and analyzed. As a control, 8423 healthy blood donors were enrolled as a sample representative of the population for blood group distribution. RESULTS: More individuals had blood group B in the COVID-19 group in comparison with the control group (24.2% vs. 18%), The opposite was observed among individuals of group O (39.5% vs. 47.3%). The B blood group was predictive of higher risk of mortality. No significant difference in the distribution of RhD was observed between the COVID-19 and the control groups. Neither ABO nor RhD was significantly associated with the severity of COVID-19. DISCUSSION: Although there was no significant association with the disease severity, the B blood group may be associated with a higher risk for COVID-19 infection. Further studies with a larger sample size are necessary to evaluate this correlation.

Perception of blood donation among employees of healthcare organizations during COVID-19 pandemic: A national multicenter cross-sectional study.

BACKGROUND: Maintaining a safe and adequate blood supply during a crisis is a major challenge facing blood banks around the world. With the recent global COVID-19 crisis and the enforced "stay at home" lockdown, access to blood donors was limited. Since employees of healthcare facilities may act as potential blood donors, their perception of blood donation and their willingness to donate during the pandemic period is important to be assessed. STUDY DESIGN AND METHOD: A national cross-sectional study at six centers in Saudi Arabia was conducted using an online-based questionnaire that was distributed to all healthcare employees in these facilities between June and August 2020. RESULTS: Among the total of 1664 participants, 63.2% (n = 1051) did not donate blood during the last 2 years. However, 53% (n = 882) of participants reported they are likely to donate blood during the COVID-19 crisis. Furthermore, 85% (n = 1424) did not donate blood during the current pandemic, with the biggest worries of getting the COVID-19 infection in the donor center. The main concerns of participants were about adherence to physical distancing requirements and the safety of the donation procedure. The majority of health care participants (88.2%) support implementing a hospital policy for a voluntary blood donation by employees during crises. CONCLUSION: Recruitment of more blood donors among health care employees is a feasible solution to improve the blood supply during a crisis. This should be based on efforts throughout the year including regular awareness campaigns and effective communication.

The association between different blood group systems and susceptibility to COVID-19: a single center cross-sectional study from Saudi Arabia.

Background: Since the beginning of COVID-19 pandemic, many associated factors have been investigated to clarify the susceptibility and severity among the affected individuals. Biological markers can play an important role in identification of individual susceptibility to such pandemic. Growing evidence suggest the influence of different blood group systems on susceptibility to COVID-19 virus, with a particular blood type conferring selection advantage. Objectives: The study aimed to determine the association of ABO, Rhesus (D) and P1 blood groups with COVID-19 susceptibility in Taif city, Western Saudi Arabia. Methods: ABO, D and P1 blood antigens were determined in 104 blood samples of COVID-19 patients versus 100 control samples using either automated immunohematology analyser or test tube method. Statistical differences between patients and control samples were calculated based on p-value where results of ≤ 0.05 were considered significant. Results: O+ve blood group constituted the predominant type among the studied samples. Determination of P1 antigen showed significant association where Anti-P1 was positive in 76.9% of patients compared to 61.0% of controls with a P value of 0.01 conferring the susceptibility of P1+ve patients to COVID-19. Conclusion: Although our study showed no significant association between ABO and D, and susceptibility to COVID-19, there was a significant association between P1+ve and COVID-19. P1+ve participants were 2.131 times more associated with the risk of COVID-19 infection than those with Anti P1-ve. Thus, P1 antigen can be used as a biological marker for identification of individuals susceptibility to COVID-19. It is strongly advised that such individuals should consider extra protective measures. Further studies on other contributing factors should also be considered for more scientific clarity.

International Society of Blood Transfusion survey of experiences of blood banks and transfusion services during the COVID-19 pandemic.

BACKGROUND AND OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic has impacted blood systems worldwide. Challenges included maintaining blood supplies and initiating the collection and use of COVID-19 convalescent plasma (CCP). Sharing information on the challenges can help improve blood collection and utilization. MATERIALS AND METHODS: A survey questionnaire was distributed to International Society of Blood Transfusion members in 95 countries. We recorded respondents' demographic information, impacts on the blood supply, CCP collection and use, transfusion demands and operational challenges. RESULTS: Eighty-two responses from 42 countries, including 24 low- and middle-income countries, were analysed. Participants worked in national (26.8%) and regional (26.8%) blood establishments and hospital-based (42.7%) institutions. CCP collection and transfusion were reported by 63% and 36.6% of respondents, respectively. Decreases in blood donations occurred in 70.6% of collecting facilities. Despite safety measures and recruitment strategies, donor fear and refusal of institutions to host blood drives were major contributing factors. Almost half of respondents working at transfusion medicine services were from large hospitals with over 10,000 red cell transfusions per year, and 76.8% of those hospitals experienced blood shortages. Practices varied in accepting donors for blood or CCP donations after a history of COVID-19 infection, CCP transfusion, or vaccination. Operational challenges included loss of staff, increased workloads and delays in reagent supplies. Almost half of the institutions modified their disaster plans during the pandemic. CONCLUSION: The challenges faced by blood systems during the COVID-19 pandemic highlight the need for guidance, harmonization, and strengthening of the preparedness and the capacity of blood systems against future infectious threats.

Impact of COVID-19 on Blood Donation and Supply: A Multicenter Cross-Sectional Study from Saudi Arabia.

BACKGROUND: The coronavirus disease-19 (COVID-19) pandemic caused a major impact on blood donation process and supply globally. A lockdown management procedure was launched nationally in Saudi Arabia to manage this global health crisis. The main aim of this study was to determine the effect of COVID-19 lockdown on blood donation services and supply in different regions of Saudi Arabia. Study Design and Methods. A retrospective cross-sectional study was conducted in the blood bank centers of 5 major cities including Riyadh, Jeddah, Dammam, Hail, and Jizan in Saudi Arabia. Demographic and blood characteristics were retrieved from the first 6 months of 2019 (January-June) and compared to the same period of 2020. RESULTS: Our findings showed variation in the characteristics of blood donation and supply among the centers surveyed, as some of these centers were adversely affected, while others showed an increase in the availability of blood products during the pandemic. For example, Jeddah's center was significantly affected by COVID-19 lockdown whereas Hail's center showed a significant increase in the analyzed characteristics of blood donation services in 2020 compared to 2019. Overall, there was no major difference among the surveyed centers between 2020 and 2019, and this might be due to the effective management of blood supply and transfusion. Discussion. Although blood supply and transfusion practice was slightly affected at various degree among the surveyed centers, the whole process did not show a significant effect on the overall outcome. This is in fact due to the proper preparedness, management of blood requirements and supplies, and efficient response of the surveyed centers in Saudi Arabia.

Awareness about Coronavirus (COVID-19) and challenges for blood services among potential blood donors.

BACKGROUND: The Coronavirus- 19 disease pandemic had a significant impact on the blood supply around the world. Physical distancing measures and many other factors contribute to this impact. Misinformation about methods of disease transmission and lack of knowledge among potential blood donors may contribute to this. AIM: To assess the knowledge and awareness of blood donors about COVID-19 as well as their reasons and fears that prevent them from donating blood during this period. METHODS: This is an exploratory; survey based cross sectional study targeting Saudi population. RESULTS: A total number of 3841 persons responded to the survey; 58 % were between the ages of (31-50) years. Most participants 74.5 % were males. More than 60 % of participants donated blood previously, and many were repeat donors. The majority of participants were concerned about the transmission of the virus during the blood donation process mostly secondary to concerns about contact with other blood donors. CONCLUSION: Fear of contracting COVID-19 during donating blood is an important concern for potential blood donors. Blood collection facilities must take optimum precautionary measures to minimize this risk and are encouraged to communicate these efforts to potential donors for reassurance to maintain an adequate and safe blood supply.

Clinical and hematologic presentations of adults with COVID-19 patients in Jeddah: A case control study.

BACKGROUND: Coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2), is associated with significant morbidity and mortality. The clinical features of COVID-19 were mentioned in previous studies. However, risk factors for COVID-19 are not fully recognized. The aim of this study is to characterize risk factors and clinical features of COVID-19 disease in Jeddah, Saudi Arabia. METHODS: A retrospective, chart-review, case-control study was conducted at King Abdulaziz University, Jeddah, Saudi Arabia. Demographic, clinical, radiological, and laboratory data on patients diagnosed between March 18 and May 18, 2020 were collected and analyzed. RESULTS: We reviewed medical records on 297 suspected cases of COVID-19. Of these, 175 (59%) tested positive for COVID-19 by polymerase chain reaction (PCR) and considered as cases, while 122 (41%) tested negative and considered as control. COVID-19 positive cases were more likely to be males, and non-health care providers. Hypertension (15%), diabetes (10%) and two or more concurrent comorbidities (54.4%) were more prevalent among COVID-19 patients. Patients presented with fever, cough, and loss of taste/smell were more likely to test positive for COVID-19 (P = 0.001, 0.008, 0.008; respectively). Radiological evidence of pneumonia was associated with confirmed COVID-19 disease (P = 0.001). Shortness of breath and gastrointestinal symptoms were not associated with the risk of COVID-19 at presentation. On admission, white blood cells, neutrophils, lymphocytes, eosinophils, basophils, and platelets were significantly lower among COVID-19 patients compared with controls. Surprisingly, D-Dimer levels were lower among COVID-19 positive patients when compared with controls. CONCLUSION: Male gender, hypertension, and diabetes are the most commonly observed risk factors associated with COVID-19 disease in Jeddah, Saudi Arabia. COVID-19 patient had significantly lower lymphocyte and neutrophil counts.

Lack of Antibodies to SARS-CoV-2 among Blood Donors during COVID-19 Lockdown: A Study from Saudi Arabia.

In response to the coronavirus disease 2019 (COVID-19), Saudi Arabia have imposed timely restrictions to minimize the infection spread, lower the risk for vulnerable groups, and reduce the pressure on healthcare services. The effectiveness of these measures has not been assessed comprehensively and, thereby, remains uncertain. Besides monitoring the number of COVID-19 cases diagnosed by molecular assays, the seroprevalence can serve as an indicator for the incidence rate among the general population. This study aimed to evaluate seroprevalence status of all healthy blood donors who attended one of the main largest hospital located in the western region of Saudi Arabia from 1 January to 31 May 2020. The study period covered two months prior to reporting the first COVID-19 case in the country on 2 March 2020. Importantly, it covered the period when "lock-down type" measures have been enforced. Samples were subjected to in-house enzyme-linked immunosorbent assay (ELISA), chemiluminescence immunoassay (CLIA), and microneutralization (MN). The sero statuses of all samples were confirmed negative, demonstrating the lack of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among blood donors during COVID-19 lockdown period. This study supports the hypothesis that COVID-19 restrictions have potential for limiting the extent of the infection.