Page History

COVID-19 infection and risk exposure

• History of COVID-19 infection
• Contact with COVID-19 – donors who report contact with a confirmed case
• Donor preparation
• Donation collection
• Planned cryopreservation
• Post-donation cryo-quarantine
• Summary table

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*There is ample evidence that SARS-CoV-2 RNA can remain detectable by PCR in nasopharyngeal samples for an extended period after full recovery, but without being infectious.  Nonetheless some institutions may still consider a donor with detectable nasopharyngeal SARS-CoV-2 RNA to be a public health risk.

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• The last date of contact.
• The nature of the contact.
• The results of any post-contact testing.

For at least 14 days prior to donation, donors in a region with ongoing local transmission should be advised to practice good hygiene and to socially isolate as much as possible. Unnecessary travel should be avoided.

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However, it is acknowledged that many jurisdictions have recommended or even mandated routine pre-donation screening of HPC donors.  Depending on the stipulated purpose, any such testing should be performed early enough to forestall patient conditioning, donor mobilisation or collection.

In the absence of symptoms, testing the donor for COVID-19 at the point of collection – or testing the donation itself – is not recommended because:

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• The donor is a volunteer who in most cases has already started or completed G-CSF conditioning.
• There is a possibility of false positive results with rapid or instant screening assays.
• The blood phase of COVID-19 is known to be difficult to detect in symptomatic patients, rarely detectable in pre-symptomatic patients, and there is no evidence for its infective potential.
• Any delay in transplant that results from the cancellation or rejection of the donation will therefore disadvantage the patient with no known or likely risk of COVID-19 transmission.

If there is concern that the donor is at high risk of community-acquired infection between work-up and collection, pre-planned cryopreservation will allow patient conditioning to be delayed until successful donation and delivery are confirmed.

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Reassuringly, however, data published by the US National Marrow Donor Program (NMDP) showed no significant adverse effect on early transplant outcomes from cryopreserved product during the COVID-19 pandemic compared to the same months in 2019 [Stefanski et al, Blood (2021) 138 (Supplement 1): 478].

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Nonetheless, it is acknowledged that certain jurisdictions may require cryo-quarantine by regulation.