Blood Transmission of Corona Virus Disease 2019. Are there any Threat?

Review Article

Ann Hematol Oncol. 2022; 9(4): 1402.

Blood Transmission of Corona Virus Disease 2019. Are there any Threat?

Nagwa A. Sabri¹* and Eslam MS²

¹Department of Clinical Pharmacy, Faculty of Pharmacy-Ain Shams University, Cairo, Egypt

²Clinical and Bio-analysis Department, Drug Research Centre, Cairo, Egypt

*Corresponding author: Nagwa Ali Sabri, Department of Clinical Pharmacy, Faculty of Pharmacy- Ain Shams University, Cairo, Egypt

Received: August 15, 2022; Accepted: September 08, 2022; Published: September 15, 2022


Background: Corona Virus infection is rapidly expanding and has a significant worldwide influence on the status of health and the economic process.

Aim: Performing a literature search to investigate possible impacts of transmission of COVID-19 disease through blood transfusion process in health care system, and disease prevalence.

Methods: Internet search in scientific publications and collecting data regarding different viral transmission routes, viral detection and disease diagnosis methods, what are the potential problems and risks in COVID-19 management, and COVID-19 protective measures to undertake during blood transfusion.

Discussion and Conclusion: Coronavirus spreads mostly by droplets produced by infected persons while coughing, sneezing, or speaking. Different Covid-19 diagnosis methods include Computed Tomography (CT) scan, reverse transcription-polymerase chain reaction, antibody testing (IgG, and IgM), and biochemical tests. Different disease management risks may occur including antibiotic resistance, occupational stress, immune function suppression or dysregulation, pharmacodynamic interactions like prolongation of the QT interval. Although the findings indicated that blood transfusion did not transmitted coronavirus, but protective measures should be undertaken during blood transfusion process in healthcare facilities and blood transfusion centers. This will aid in mitigating viral transmission and associated management risks that may occur.

Keywords: COVID-19; Blood transfusion; Polymerase chain reaction; C-reactive protein; Social distancing


Infection with Corona Virus Disease 2019 is exponentially spreading and has a remarkable global impact on the state of health and the economic process [1]. Estimated patients suffering from COVID-19 as of 31 January 2021 were 102,139,771 cases, with mortality rate of 2.17 percent [2].

This disease was caused by infection with the SARS-CoV-2 virus, where, Numerous cases of pneumonia with unknown Etiology by the end of 2019 has been observed in China and is thought to be a source of infection in the seafood market in Wuhan City, China [3].

The incidence of COVID-19 severity and mortality is much greater than that of usual influenza, and as population’s age and lifestyle and dietary habits change, the prevalence of chronic diseases such as diabetes and hypertension increases. It was found that diabetes and hypertension are closely related to severity and mortality [1].

The national cumulative prevalence of COVID-19 (past and current infections relative to population size) is estimated at 31% in Peru, 27% in Mexico, 22% in Brazil, 12% in USA, 11% in the United Kingdom, 8.2% in France, 7.4% in Sweden, 4.2% in Canada, 1.8% in Germany and 0.12% in Japan [4].

The first COVID-19 symptoms are commonly known as fever, dry cough, tachypnea, and shortness of breath. Even though diarrhea was present in approximately 20–25 percent of patients with MERSCoV or SARS-CoV infection, intestinal symptoms are rarely seen in COVID-19 patients. Confusion, chest pain, vomiting, and nausea were also reported as COVID-19 symptoms [5,6].

Other symptoms include pain in the throat, sneezing, nasal congestion, production of sputum, anosmia and dyspepsia, skin rash, finger or toe discoloration, and viral conjunctivitis. Some laboratory studies have shown that cytokine storm, and sepsis has occurred in COVID-19 infected patients [7].

COVID-19 can be spread by asymptomatic people, and the average incubation time for SARS-CoV-2 infection has been observed to range between 0 and 14 days. These characteristics may be important in the probability of disease transmission in blood transfusion centers [8].

Concerns about transfusing positive donors’ blood products to unknowing recipients arose as the number of asymptomatic cases increased. As a result, China and Pakistan conducted real-time SARSCoV- 2 screening in blood products held at various blood centers [9].

According to an observational research in Zhejiang, China, the data showed that the province experienced a 67 percent decline in blood donation activities. Furthermore, 81 percent of the donor respondents’ top worry during the donation procedure was acquiring COVID-19 [10].

According to world Health Organization (WHO), the coronavirus family is not known to be transmitted by blood and blood products. Hundreds of case reports have revealed that receivers who received blood products from positive donors did not get Covid-19 infection [9,11].

Corona Virus Disease 2019 Viral Transmission

Coronavirus spreads mainly through droplets that are generated by infected people during coughing, sneezing, or speech. While it was previously assumed that since these droplets are too heavy to remain in the air, coronavirus is not airborne. Viruses may be airborne in the form of aerosols, which are tiny pieces that can remain in the air for a sustained period of time. A recent research on aerosol and surface stability found that SARS-COV-2 was stable in its aerosol form for three hours [12].

This indicates that air transmission of the virus is probable due to its ability to stay viable as an aerosol. While aerosolized viral particles cannot travel far from the normal respiration of an infected patient, coughing and sneezing can lead to an estimated traveling distances of up to 20 feet [13].

Corona Virus Disease 2019 Testing

Reverse Transcription-Polymerase Chain Reaction (RTPCR)

The test results for COVID-19 may lead to the primary step to determine the scale of the disease outbreak. Previously, the diagnostic method of choice was reverse transcription-polymerase chain reaction (RT-PCR) tests. However, due to their long wait times of two to three hours, as well as the need for expensive laboratory equipment and trained professionals, these methods are not ideal for rapid diagnosis. For the rapid diagnosis of current infection, COVID-19 testing stations use molecular tests to determine the presence of SARS-CoV-2 relying on the genetic sequence of SARSCoV- 2 and use PCR [15].

Isothermal Nucleic Acid Amplification Technology

Currently, Abbott’s ID Now, a rapid in vitro diagnostic molecular test using isothermal nucleic acid amplification technology, has a COVID-19 test feature that takes less than 13 minutes. It may be possible to use a nasopharyngeal, throat, and nasal swab. Although the sensitivity of 90% of these molecular tests is considered, the risks and consequences of false-negative tests with these current devices remain [16].

Computed Tomography Scan

As COVID-19 is considered to be a respiratory infection, several studies focus on the use of pulmonary screening scans to track disease progression. A study in China, looked at the progression of COVID-19 in the lungs of 81 patients and used CT scans to track disease progression [17].

Abnormal chest CTs were observed in all patients with and without ‘viral pneumonia’ symptoms, specifically as bilateral, subpleural, ground-glass opacities with air bronchograms, poorly defined margins and a slight predominance in the lower right lobe. As the patient heals, the lungs of the patient show improvements in the lung lesions. It was considered that this medical screening is faster and more sensitive than the RT-PCR test. Ultrasound is a safer way to test for lung changes, as the evolution of the disease can be tracked to inform clinical decision-making. Ultrasounds still cannot detect lesions deep inside the lung, in which case a CT scan would be needed. However, lung ultrasonography may be the first step of detection because it does not use radiation and the detection would be repeatable at a lower cost [15].

CT has limited COVID-19 sensitivity and a lower specificity than testing with RT-PCR. it carries a risk that providers may be exposed to Severe Acute Respiratory Syndrome, Coronavirus 2 (SARS-CoV-2). Chest CT, particularly for patients who show symptoms, should be considered a supplementary diagnostic tool [18].

Antibody Testing (SARS-CoV-2 IgG/IgM Assay)

Abbott and LabCorp looked at mass-producing antibody tests for rapid diagnosis of COVID-19. These tests focus on the testing of immunoglobulin G (IgG) antibodies because their reactions relate to adaptive immunity and to the immunological memory of previous virus encounters. The presence of these IgG antibodies can identify the specific antigen that has a high affinity to the previous virus. The antibody test (SARS-CoV-2 IgG assay) has shown 100 percent sensitivity and 99.9 percent specificity to date [19,20,21].

Immunoglobulin’s against SARS-CoV indicated that IgM and IgG antibodies were detectable 7 days later. COVID-19 patients also demonstrated that both IgM and IgG can be detected by an anti- SARS-CoV-2 (ELISA) after 5 days of onset [22].

The ELISA-based IgM and IgG antibody tests showed more than 95% specificity as a diagnostic test for COVID-19, as antibodies are produced against viral nucleocapsid and the receptor-binding domain of the spike protein are produced. The nucleocapsid is a protein containing viral nucleic acid and the RBD-S is a protein used by the virus for attachment to the host cell; these antigens can be used individually or together to detect IgM and IgG antibodies, as well as increase overall sensitivity [23].

Researchers using a single-lane rapid IgG/IgM lateral flow assay for SARS-CoV-2 nucleocapsid protein found that IgG sensitivity and specificity were 92.2 percent and 97.0 percent. Even so, IgM sensitivity and specificity were only 57.9 percent and 91.3 percent respectively [24].

Citation: Sabri NA and Eslam MS. Blood Transmission of Corona Virus Disease 2019. Are there any Threat?. Ann Hematol Oncol. 2022; 9(4): 1402.