Low rate of detection of SARS-CoV-2 RNA in deceased tissue donors

Abstract

Given the possibility for disease transmission, this study was performed to determine whether there is detectable SARS-CoV-2 viral RNA in the blood of deceased tissue donors. A retrospective analysis of blood samples from eligible deceased tissue donors from Oct 2019 through June 2020 was performed. Plasma aliquots were initially tested with a SARS-CoV-2 NAT Assay; positive samples were further tested using an alternate NAT and an antibody assay. The proportion of donors with confirmed RNAemia and 95% confidence intervals were computed. Of donor samples collected in 2019, 894 yielded valid results, with 6 initially positive, none of which confirmed positive by alternate NAT. Of donor samples collected in 2020, 2562 yielded valid initial NAT results, with 21 (0.8%) initially positive. Among those, 3 were confirmed by alternate NAT, 17 were not confirmed, and 1 had an invalid alternate NAT result. The rate of SARS-CoV-2 RNAemia in deceased tissue donors is approximately 1 per 1000, and it is unknown whether this RNAemia reflects the presence of infectious virus. Given these results, the risk of transmission through tissue is thought likely to be low.

Testing of tissue specimens obtained from SARS-CoV-2 nasopharyngeal swab-positive donors

“…To date, there has been no known transmission via tissue or ocular transplantation (FDA 2021 ) or blood transfusion (FDA 2022 ), and the only verified organ transmission was via lung transplantation (Kaul et al 2021 ). In a study testing blood specimens from deceased tissue donors without COVID-19 symptoms, the rate of SARS-CoV-2 NAT-positive results (about 1 in 1000) was found, while infectivity data are unavailable (Greenwald 2022 ). Considering that, through Spring 2022, most tissue establishments have excluded donors with positive NP swab results for SARS-CoV-2, the true risk of transmission is difficult to measure.…”

“…AATB sponsored two studies to help evaluate the potential role of SARS-CoV-2 transmission in tissue transplantation. The first (Greenwald 2022 ) was to examine the risk of SARS-CoV-2 viremia in blood of deceased tissue donors, showing an incidence of RNAemia of approximately 1 in 1000. However, in that study, the results of SARS-CoV-2 RNA testing of donor nasopharyngeal (NP) swabs, if performed, was unknown, and tissues from these donors were not tested.…”