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COVID-19 antibody testing in blood donors: Prevalence, symptoms, and suitability for convalescent plasma donation

Background/Case Studies: Routine testing of donations for COVID-19 antibody was implemented as a tool to evaluate donor suitability for convalescent plasma (CCP) donation, monitor geographic and demographic trends, and associate COVID-related symptoms (Sx) to serological test results We report initial results of antibodyreactive donors and associated responses regarding their Sx >14d prior to donation Study Design/Methods: Starting June 15, 2020, allogeneic donors were tested using the Ortho Anti-SARSCoV2 Total Ig Test Reactive donors were invited to an online survey ≈2 weeks post-donation;eligibility criteria were ≥ age 18, English proficiency and an email on file The survey inquired about COVID-related Sx and COVID testing performed outside the blood center Sx duration and severity were not ascertained Donor responses were linked via DIN to operational data Results/Findings: During the first 6 weeks, cumulative seroprevalence was 1 5% (8588 reactive/573,586 donations tested) Reactive rates were higher in first-time vs repeat donors (2 4 vs 1 3%, X2 p<0 0001), and in Hispanic and African American donors vs Caucasians (3 5% vs 1 4%, p<0 0001) Antibody (Ab) prevalence did not differ by sex, and the age group with the highest rate was 18-24yo (3 1%) Modest differences were observed by geography, ranging from 1 3% Ab prevalence in the West to 1 9% in the Northeast The range of reported Sx from 1546 survey respondents was 0 to 12, with 44% of donors indicating they were asymptomatic pre-donation The average number of Sx was 2 9 for all donors, and 5 2 from those with any reported symptom Ortho-reactive donors who previously tested reactive reported more Sx on average than previously nonreactive donors (4 0 vs 2 5 Sx), as did those diagnosed with COVID-19 by a healthcare provider (5 0 vs 2 3) Fatigue (41%), myalgia (35%), headache (33%), cough (29%), loss of smell (29%) and taste (28%), and fever (22%) were most commonly reported The number of Sx reported did not differ by presence or count of 5 chronic health conditions associated with increased COVID morbidity An algorithm to select candidate CCP donors based on the 3 most common symptoms identified 357 donors (23%), while also requiring a diagnostic test or physician diagnosis yielded 177 donors (11 4%) S/CO ratios correlated with symptom number, with asymptomatic infections or those with 1-4 symptoms having lower S/COs (median S/CO < 85) than those with 5-8 Sx(median S/CO 108) or 9-12 Sx (median S/CO 170);Kruskal-Wallis p<0 0001 Conclusions: The demographics and geographic associations with COVID-19 Ab prevalence were generally consistent with widely reported findings Prior symptoms of donors may be useful in identifying suitability for convalescent plasma collection