Background/Case Studies: SARS-CoV-2 has been known to cause viremia in those infected with COVID-19, which raises concerns for transfusion transmitted COVID-19. However, generally respiratory viruses aren’t transmitted through blood transfusion, and according to the FDA, there have been no known cases of SARS-CoV-2 transmission through blood transfusion. Nevertheless SARS-CoV-2 RNA has been detected in plasma of blood donors who reported COVID-19 diagnosis after donation.
Study
Design/Methods: Examine medical record of recipient of granulocyte transfusion from donor who reported COVID-19 positivity the day after granulocyte donation.
Results/Findings: A 23-year-old female diagnosed with acute lymphoblastic leukemia in May 2022 who achieved minimal residual disease negative complete remission, was seen emergently for severe foot and arm pain. Due to chemotherapy, she had acquired pancytopenia and on admission was found to have WBC of 0.1 K/uL. She was started on G-CSF and later sargramostim as well. A few days after hospitalization, she was found to have disseminated mucormycosis with lung, brain, and soft tissue involvement. Consequently, she began antifungal medications, amphotericin B and isavuconazole. After one week on those medications, chest CT showed worsening of the lung infiltrate and her absolute neutrophil count remained 0, and she was started on daily granulocyte transfusion. The fourth granulocyte unit she received was donated by a donor who reported COVID-19 positivity the day after donation. Four days after the implicated granulocyte transfusion, the recipient tested negative for COVID-19. Conclusions: Transfusion of granulocytes from a COVID-19 infected donor did not result in COVID-19 transmission in a severely immunocompromised recipient.
Importance of research: SARS-CoV-2 has been known to cause viremia in those infected with COVID-19, which raises concerns for transfusion transmitted COVID-19. However, generally respiratory viruses aren’t transmitted through blood transfusion, and according to the FDA, there have been no known cases of SARS-CoV-2 transmission through blood transfusion. This case study examines if COVID-19 can be transmitted to a severely immunocompromised patient through a granulocyte transfusion.
