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Safety of Platelet and Plasma Transfusions in the COVID-19 Era

December 13, 2023

By September 2022, 96% of U.S. blood donors had antibodies to SARS-CoV-2 due to infection and/or vaccination.  Some patient advocacy groups and lawmakers have raised concern about the safety of SARS-CoV-2 antibodies in blood components.  To investigate the safety of plasma and platelet transfusions from blood donors with SARS-CoV-2 antibodies, researchers performed a retrospective cohort study using electronic health data from 21 hospitals associated with Kaiser Permanente Northern California.  All adult, non-obstetric patients without COVID-19 who were transfused plasma or platelets (N=18,584) were included during three time-periods: pre-COVID-19 (3/1/2018 to 2/29/2020), COVID-19 pre-vaccine (3/1/2020 to 2/28/2021), and COVID-19 post-vaccine (3/1/2021 to 8/31/2022).  Based on multivariate logistic regression with generalized estimating equations, no differences or trends were observed over the three study periods for thromboses (p=0.22), oxygen requirements (0=0.41), length of ICU stay (p=0.83), in-hospital mortality (p=0.36), or 30-day rehospitalization (p=0.29).  In addition, no differences in these outcomes were observed between vaccinated and unvaccinated plasma and platelet transfusion recipients.  These findings are consistent with COVID-19 convalescent plasma randomized clinical trials supporting the safety of platelet and plasma transfusions with SARS-CoV-2 antibodies.

Reference:

Roubinian, NH, Greene, J, Liu, VX, Lee, C, Mark, DG, Vinson, DR, et al. Clinical outcomes in hospitalized plasma and platelet transfusion recipients prior to and following widespread blood donor SARS-CoV-2 infection and vaccination.  Transfusion.  2023.

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