Clinical outcomes in hospitalized plasma and platelet transfusion recipients prior to and following widespread blood donor SARS‐CoV‐2 infection and vaccination

Abstract

BackgroundThe safety of transfusion of SARS‐CoV‐2 antibodies in high plasma volume blood components to recipients without COVID‐19 is not established. We assessed whether transfusion of plasma or platelet products during periods of increasing prevalence of blood donor SARS‐CoV‐2 infection and vaccination was associated with changes in outcomes in hospitalized patients without COVID‐19.MethodsWe conducted a retrospective cohort study of hospitalized adults who received plasma or platelet transfusions at 21 hospitals during pre‐COVID‐19 (3/1/2018–2/29/2020), COVID‐19 pre‐vaccine (3/1/2020–2/28/2021), and COVID‐19 post‐vaccine (3/1/2021–8/31/2022) study periods. We used multivariable logistic regression with generalized estimating equations to adjust for demographics and comorbidities to calculate odds ratios (ORs) and 95% confidence intervals (CIs).ResultsAmong 21,750 hospitalizations of 18,584 transfusion recipients without COVID‐19, there were 697 post‐transfusion thrombotic events, and oxygen requirements were increased in 1751 hospitalizations. Intensive care unit length of stay (n = 11,683) was 3 days (interquartile range 1–5), hospital mortality occurred in 3223 (14.8%), and 30‐day rehospitalization in 4144 (23.7%). Comparing the pre‐COVID, pre‐vaccine and post‐vaccine study periods, there were no trends in thromboses (OR 0.9 [95% CI 0.8, 1.1]; p = .22) or oxygen requirements (OR 1.0 [95% CI 0.9, 1.1]; p = .41). In parallel, there were no trends across study periods for ICU length of stay (p = .83), adjusted hospital mortality (OR 1.0 [95% CI 0.9–1.0]; p = .36), or 30‐day rehospitalization (p = .29).DiscussionTransfusion of plasma and platelet blood components collected during the pre‐vaccine and post‐vaccine periods of the COVID‐19 pandemic was not associated with increased adverse outcomes in transfusion recipients without COVID‐19.