ABSTRACT
Background/Case Studies: Routine testing of donations for COVID-19 antibody was implemented as a tool to evaluate donor suitability for convalescent plasma (CCP) donation, monitor geographic and demographic trends, and associate COVID-related symptoms (Sx) to serological test results. We report initial results of antibodyreactive donors and associated responses regarding their Sx >14d prior to donation. Study Design/Methods: Starting June 15, 2020, allogeneic donors were tested using the Ortho Anti-SARSCoV2 Total Ig Test. Reactive donors were invited to an online survey ≈2 weeks post-donation;eligibility criteria were ≥ age 18, English proficiency and an email on file. The survey inquired about COVID-related Sx and COVID testing performed outside the blood center. Sx duration and severity were not ascertained. Donor responses were linked via DIN to operational data. Results/Findings: During the first 6 weeks, cumulative seroprevalence was 1.5% (8588 reactive/573,586 donations tested). Reactive rates were higher in first-time vs repeat donors (2.4 vs 1.3%, X2 p<0.0001), and in Hispanic and African American donors vs Caucasians (3.5% vs 1.4%, p<0.0001). Antibody (Ab) prevalence did not differ by sex, and the age group with the highest rate was 18-24yo (3.1%). Modest differences were observed by geography, ranging from 1.3% Ab prevalence in the West to 1.9% in the Northeast. The range of reported Sx from 1546 survey respondents was 0 to 12, with 44% of donors indicating they were asymptomatic pre-donation. The average number of Sx was 2.9 for all donors, and 5.2 from those with any reported symptom. Ortho-reactive donors who previously tested reactive reported more Sx on average than previously nonreactive donors (4.0 vs 2.5 Sx), as did those diagnosed with COVID-19 by a healthcare provider (5.0 vs 2.3). Fatigue (41%), myalgia (35%), headache (33%), cough (29%), loss of smell (29%) and taste (28%), and fever (22%) were most commonly reported. The number of Sx reported did not differ by presence or count of 5 chronic health conditions associated with increased COVID morbidity. An algorithm to select candidate CCP donors based on the 3 most common symptoms identified 357 donors (23%), while also requiring a diagnostic test or physician diagnosis yielded 177 donors (11.4%). S/CO ratios correlated with symptom number, with asymptomatic infections or those with 1-4 symptoms having lower S/COs (median S/CO < 85) than those with 5-8 Sx(median S/CO 108) or 9-12 Sx (median S/CO 170);Kruskal-Wallis p<0.0001. Conclusions: The demographics and geographic associations with COVID-19 Ab prevalence were generally consistent with widely reported findings. Prior symptoms of donors may be useful in identifying suitability for convalescent plasma collection.