Transfusion requirements in recipients of plasma units from blood donors with recent SARS-CoV-2 infection

SARS-CoV-2 infection is associated with hypercoagulability in patients with Coronavirus disease (COVID-19). We used a vein-to-vein database to examine the impact of transfusion of plasma units from blood donors with recent SARS-CoV-2 infection.

We linked donor SARS-CoV-2 serology data with plasma transfusions occurring between 6/1/2020 and 3/31/2022. Using multivariable regression, we examined changes in the international normalized ratio (INR) and subsequent transfusion requirements following plasma transfusion relative to the timing of donor SARS-CoV-2 nucleocapsid antibody (anti-N Ab) positivity.

We identified 2350 adults who received 5397 plasma units with donor SARS-CoV-2 serology data as part of 3721 plasma transfusion events. 8.1% (436/5397) of plasma units were from anti-N Ab positive donors, and median time from index seropositivity to donation was 89 days (interquartile range [IQR] 0-210). In recipients of plasma units from recently SARS-CoV-2 infected donors (<120 days), the adjusted odds of a 0.25 per unit lowering of the INR were increased (aOR 1.6 [1.1-2.5]; p = .03) and the odds of additional plasma transfusions within 24 h were decreased (aOR 0.6 [0.4-0.9]; p = .04).

Recipients of plasma units from blood donors with recent SARS-CoV-2 infection were more likely to have post-transfusion reductions in the INR and less likely to require additional plasma transfusions.