BACKGROUND

A novel coronavirus (currently named 2019-nCoV) emerged in Wuhan, China in December 2019.  WHO declared a global health emergency on 30 January 2020, and a number of blood and tissue donor guidelines have been issued - largely based on previous guidelines for SARS-CoV and MERS-CoV. Like SARS and MERS, 2019-nCoV displayed high mortality but low infectivity in the early weeks, with limited person-to-person transmission.  However, the epidemic quickly changed to display lower mortality but higher infectivity with increasing evidence of sustained person-to-person transmission. Various public health measures taken at a local or national level are likely to aid and/or complicate donor assessment, while the rapid evolution of the epidemic demands a precautionary yet flexible approach to suitability guidelines.


AT VERIFICATION TYPING OR WORKUP

Geographical risk – donors returning from a risk area

Collection should be deferred for 4 weeks after a donor’s return from a 2019-nCoV risk area. If the patient’s need for transplant is urgent, the donor is completely well and there are no suitable alternative donors, earlier collection may be considered subject to careful risk assessment.  Risk assessment should be based on:


Contact with 2019-nCoV – donors who report contact with a confirmed case

Collection should be deferred for 4 weeks after a donor’s last contact with a person with confirmed 2019-nCoV infection. If the patient’s need for transplant is urgent, the donor is completely well and there are no suitable alternative donors, earlier collection may be considered subject to careful risk assessment.  Risk assessment should be based on:


History of 2019-nCoV infection

Collection should be deferred for 3 months after recovery. If the patient’s need for transplant is urgent, the donor is completely well and there are no suitable alternative donors, earlier collection may be considered subject to careful risk assessment.  Risk assessment should be based on:


Additional 2019-nCoV questions

Geographical risk:

Contact with 2019-nCoV:

History of 2019-nCoV infection:


RATIONALES

While 2019-nCoV is new and not yet well understood, early guidelines have been based on previous guidelines for SARS-CoV and MERS-CoV with conservative adjustments based on early evidence:

With limited numbers and a rapidly evolving epidemic, individual cases should ideally be assessed in consultation with infectious disease and/or public health experts.


REFERENCES

WHO: https://www.who.int/emergencies/diseases/novel-coronavirus-2019

ECDC: https://www.ecdc.europa.eu/en/publications-data/risk-assessment-outbreak-acute-respiratory-syndrome-associated-novel-1