Asymptomatic Donors Research Articles

Sero-prevalence of SARS-CoV-2 antibodies in blood donors during the third wave of infection in Norway, winter/spring 2021

Cross-sectional studies of the prevalence of anti-SARS-CoV-2 in representative groups are routinely used for surveillance of public health in Norway. The group of blood donors is easily accessible to provide an estimate over the infection prevalence. Repeated testing of returning donors also generates data about the duration of the antibody response following infection and vaccination.The aim of the current study was to provide updated information about the development of the pandemic in the blood donor population, and to estimate the number of asymptomatic donors visiting the blood center, in an effort to evaluate the measures to prevent virus spreading between donors and staff.In the two main blood banks in the Oslo area, all blood donors were offered antibody testing for a period of three months. Almost 12,000 donors were tested, and the mean weekly prevalence of antibody positive donors due to infection was 2.7 % (varied from 2.1 to 4.0 %). The number of donors presenting following vaccination was 810 (6.9 %). An average of 38 % of the infections had been asymptomatic, and 31 % of the antibody-positive donors were unaware of having been infected.In conclusion, the proportion of blood donors seropositive for anti-SARS-CoV-2 in our blood centers was stable whereas the number of vaccinated blood donors rapidly increased. This indicates that the virus spreading in the third wave of infection in the Oslo area mainly happened in groups underrepresented as blood donors. Health care workers prioritized for early vaccination may be overrepresented in the study period.

Efficient inactivation of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in human apheresis platelet concentrates with amotosalen and ultraviolet A light.

ObjectivesThe detection of SARS-CoV-2 RNA in blood and platelet concentrates from asymptomatic donors, and the detection of viral particles on the surface and inside platelets during in vitro experiments, raised concerns over the potential risk for transfusion-transmitted-infection (TTI). The objective of this study was to assess the efficacy of the amotosalen/UVA pathogen reduction technology for SARS-CoV-2 in human platelet concentrates to mitigate such potential risk.Material and methodsFive apheresis platelet units in 100% plasma were spiked with a clinical SARS-CoV-2 isolate followed by treatment with amotosalen/UVA (INTERCEPT Blood System), pre- and posttreatment samples were collected as well as untreated positive and negative controls. The infectious viral titer was assessed by plaque assay and the genomic titer by quantitative RT-PCR. To exclude the presence of infectious particles post-pathogen reduction treatment below the limit of detection, three consecutive rounds of passaging on permissive cell lines were conducted.ResultsSARS-CoV-2 in platelet concentrates was inactivated with amotosalen/UVA below the limit of detection with a mean log reduction of > 3.31 ± 0.23. During three consecutive rounds of passaging, no viral replication was detected. Pathogen reduction treatment also inhibited nucleic acid detection with a log reduction of > 4.46 ± 0.51 PFU equivalents.ConclusionSARS-CoV-2 was efficiently inactivated in platelet concentrates by amotosalen/UVA treatment. These results are in line with previous inactivation data for SARS-CoV-2 in plasma as well as MERS-CoV and SARS-CoV-1 in platelets and plasma, demonstrating efficient inactivation of human coronaviruses.

Blockade of LIRs as a new approach for diagnostics and treatment of ATLL malignancy

In the new world of medicine, one of the main concerns in the field of infectious diseases has been focused on Human T-cell Leukemia Virus type 1 (HTLV-1). During the infection, lymphocyte inhibitory receptors (LIRs) play a prominent role in the occurrence of adult T-cell leukemia/lymphoma (ATLL). These receptors include LAG3, PD-1, TIGIT, CD160, TIM3, and 2B4. First, we have collected all microarray information on the profile of HTLV-1 infected patients from the Gene Expression Omnibus (http://www.ncbi.nlm.gov/geo) database until March 2020, in order to identify the microarray related to evolutionary development of LTRs during various phases of HTLV-1 infection in human peripheral blood CD4+ T cells by searching for keywords such as “Human T-lymphotropic virus type I (HTLV-1)”, “Homo sapiens”, “ATLL”, and “Whole genome sequencing”. Considering the main goal of the study, we have only assessed data related to Homo sapiens particularly CD4+ T cell lineage from human subjects infected with HTLV-1. We evaluated these receptors in ATLL patients compared to healthy control (HC) individuals and HTLV-1 infected-asymptomatic carriers (ASCs). Out of all 18 identified records, we only selected and analyzed three studies: GSE19080, GSE33615, and GSE57259, which satisfied inclusion criteria with proper quality analysis of ATLL vs. normal, ATLL vs. asymptomatic carrier as well as asymptomatic carrier vs. normal. Unfortunately, we could not analyze various stages of ATLL malignancy (acute, lymphomatous, chronic and smoldering) in all included studies due to the lack of sufficient information. Finally, based on Benjamini–Hochberg False discovery rate (FDR), the differentially expressed genes (DEGs) were selected for several categories. Hence, for the first time we demonstrated that the expression rate of LIRs in ATLL group was higher than either in asymptomatic carrier or healthy donor groups. As a conclusion, it seems that the blockade of LIRs has a pivotal role in diagnostics and treatment of ATLL malignancy.

Impact of the COVID-19 Pandemic on Keratoplasty and Corneal Eye Banking.

The purpose of this study was to assess the impact of COVID-19 guidelines for corneal donor tissue screening and the utility of routine postmortem COVID-19 testing of donors intended for surgical use at a single eye bank. A retrospective analysis of referrals to and eligible donors from an eye bank between March 1, 2020, and June 30, 2020, was performed, with the same time period in 2019 as a control. Referrals who were not procured because of Eye Bank Association of America COVID-19 guidelines and eye bank-specific restrictions were noted. The results of 1 month of routine postmortem testing performed by the eye bank were examined. Analysis of variance tests were performed to assess the change between donors from 2019 to 2020. There was a significant reduction in both the number of total referrals to the eye bank (P = 0.044) and donors eligible for surgical transplantation (P = 0.031). Eye Bank Association of America COVID-19 guidelines reduced the number of referrals over this period by 4% to 14%. Of the 266 surgically eligible donors who received postmortem COVID-19 testing in June by the eye bank, 13 resulted positive (4.9%). Despite a reduction in referrals and eligible corneal transplant donors at a single eye bank, there was a surplus of surgically suitable corneal tissue during the first wave of the COVID-19 pandemic. Eye banks should consider routine postmortem COVID-19 testing to identify asymptomatic infected donors although the risk of transmission of COVID-19 from infected donors is unknown.

The predictors of high titer of anti-SARS-CoV-2 antibody of convalescent plasma donors

BackgroundRecent evidence suggested that the higher titers of anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody from convalescent plasma donors contributed to the clinical improvement in coronavirus disease 2019 (COVID-19) patients. However, the titers of anti-SARS-CoV-2 antibodies varied in each individual, and the precise factors that might govern such variation have not been elucidated. ObjectivesTo assess the factors associated with high titers of anti-SARS-CoV-2 antibody among COVID-19 convalescent plasma (CCP) donors. MethodsA cross-sectional study was conducted in Saiful Anwar General Hospital, Malang, Indonesia. Information of interest including demographic characteristics, clinical symptoms, comorbidities, laboratory findings, and the titers of anti-SARS-CoV-2 antibody among COVID-19 CCP donors were collected. The correlation was assessed using multiple logistic regression. ResultsA total of 50 COVID-19 CCP donors with the titers of anti-SARS-CoV-2 antibody of more than 1:320 and 33 donors with the titers of less than 1:320 were analyzed. Our analysis revealed that CCP donors with history of cough, fever, dyspnea, and pneumonia significantly had higher titers of anti-SARS-CoV-2 antibody compared to asymptomatic donors. Moreover, CCP donors with elevated levels of eosinophils and immature granulocytes and low levels of albumins had higher levels of anti-SARS-CoV-2 antibody. The titer of antibody was not affected by comorbidities of donors. ConclusionsCPP donors who had experience of symptomatic COVID-19 with high eosinophils level, high immature granulocytes and low albumin level have higher titers of anti-SARS-COV-2 antibody than those who experienced asymptomatic COVID-19. Our current findings may be used as the additional baseline criteria for selecting the donors of CCP for the management of COVID-19.

West Nile and Usutu viruses co-circulation in central Italy: outcomes of the 2018 integrated surveillance

BackgroundWest Nile (WNV) and Usutu (USUV) are emerging vector-borne zoonotic flaviviruses. They are antigenically very similar, sharing the same life cycle with birds as amplification host, Culicidae as vector, and man/horse as dead-end host. They can co-circulate in an overlapping geographic range. In Europe, surveillance plans annually detect several outbreaks.MethodsIn Italy, a WNV/USUV surveillance plan is in place through passive and active surveillance. After a 2018 WNV outbreak, a reinforced integrated risk-based surveillance was performed in four municipalities through clinical and serological surveillance in horses, Culicidae catches, and testing on human blood-based products for transfusion.ResultsEight WNV cases in eight equine holdings were detected. Twenty-three mosquitoe catches were performed and 2367 specimens of Culex pipiens caught; 17 pools were USUV positive. A total of 8889 human blood donations were tested, and two asymptomatic donors were USUV positive.ConclusionsDifferent surveillance components simultaneously detected WNV only in horses and USUV only in humans and mosquitoes. While in endemic areas (i.e. northern Italy) entomological surveillance is successfully used as an early detection warning, this method in central Italy seems ineffective. To achieve a high level of sensitivity, the entomological trapping effort should probably exceed a reasonable balance between cost and performance. Besides, WNV/USUV early detection can be addressed by horses and birds. Further research is needed to adapt the surveillance components in different epidemiological contexts.Graphical

Blastocystis Colonization Alters the Gut Microbiome and, in Some Cases, Promotes Faster Recovery From Induced Colitis.

Protists are a normal component of mammalian intestinal ecosystems that live alongside, and interact with, bacterial microbiota. Blastocystis, one of the most common intestinal eukaryotes, is reported as a pathogen that causes inflammation and disease, though health consequences likely vary depending on host health, the gut ecosystem, and genetic diversity. Accumulating evidence suggests that Blastocystis is by and large commensal. Blastocystis is more common in healthy individuals than those with immune mediated diseases such as Inflammatory Bowel Diseases (IBD). Blastocystis presence is also associated with altered composition and higher richness of the bacterial gut microbiota. It is not clear whether Blastocystis directly promotes a healthy gut and microbiome or is more likely to colonize and persist in a healthy gut environment. We test this hypothesis by measuring the effect of Blastocystis ST3 colonization on the health and microbiota in a rat experimental model of intestinal inflammation using the haptenizing agent dinitrobenzene sulfonic acid (DNBS). We experimentally colonized rats with Blastocystis ST3 obtained from a healthy, asymptomatic human donor and then induced colitis after 3 weeks (short term exposure experiment) or after 13 weeks (long term exposure experiment) and compared these colonized rats to a colitis-only control group. Across experiments Blastocystis ST3 colonization alters microbiome composition, but not richness, and induces only mild gut inflammation but no clinical symptoms. Our results showed no effect of short-term exposure to Blastocystis ST3 on gut inflammation following colitis induction. In contrast, long-term Blastocystis exposure appears to promote a faster recovery from colitis. There was a significant reduction in inflammatory markers, pathology 2 days after colitis induction in the colonized group, and clinical scores also improved in this group. Blastocystis colonization resulted in a significant reduction in tumor necrosis factor alpha (TNFα) and IL-1β relative gene expression, while expression of IFNγ and IL17re/17C were elevated. We obtained similar results in a previous pilot study. We further found that bacterial richness rebounded in rats colonized by Blastocystis ST3. These results suggest that Blastocystis sp. may alter the gut ecosystem in a protective manner and promote faster recovery from disturbance.

Living Donor Hepatectomy After Proven SARS-CoV-2 Infection: First Report of 9 Cases From 3 Centers

We read the report by Kute et al1 published in Transplantation regarding the safety of live kidney donation in 31 individuals with previous severe acute respiratory syndrome coronovirus-2 (SARS-CoV-2) infection. Liver transplantation (LT) has been severely restricted during the coronavirus disease 2019 (COVID-19) pandemic due to concerns of perioperative SARS-CoV-2 infection in donors and recipients.2,3 Unlike kidney transplantation that can be postponed for an extended duration, there is an element of urgency for patients awaiting LT. While there is general consensus that individuals with symptomatic SARS-CoV-2 infections should not proceed with living donor hepatectomy (LDH), there are no clear recommendations regarding the safety of LDH in individuals with recent asymptomatic infection. We had several instances of asymptomatic donors testing positive on preoperative screening. We set up a protocol of reassessing these donors for LDH if they satisfied the following 4 criteria: asymptomatic infection without abnormal inflammatory markers or liver function tests, have completed 2-wk isolation period, 2 negative real-time polymerase chain reaction (RT-PCR) tests 48 h apart—the second within 48 h of LDLT, and normal preoperative chest computed tomography scan. SARS-nCoV2 antibody levels were not routinely measured. Donors and recipients were managed in a COVID-19 free unit. All donors received perioperative deep venous thrombosis prophylaxis. Postdischarge follow-up visits were minimized and donors were followed by e-consultation with home blood sample collection.4 This is a retrospective report of living donors who tested positive for SARS-nCoV2 infection on routine RT-PCR screening. All clinical procedures were performed in accordance with the principles of the Istanbul Declaration. The study was exempt from ethics board approval as it was a retrospective review of deidentified data. Between July and December 2020, 9 potential living donors tested positive for SARS-nCoV2 infection on routine RT-PCR screening at 3 LT centers in India. There were 3 male and 6 female donors donating to 5 adult and 4 pediatric recipients (Table 1). Six tested positive during donor evaluation, while 3 tested positive during preoperative testing. None had computed tomography chest findings suggestive of SAR-nCoV2 infection. Two potential recipients also had positive testing with no symptoms. LT was postponed in all cases and donors and recipients were managed with strict home isolation for 2 wk. Repeat testing was performed after 2 wk, and donors proceeded with LDH once previously mentioned criteria were satisfied. TABLE 1. - Details of 9 donors who underwent LDH after asymptomatic SARS-CoV-2 infection Center number Donor age/sex Recipient age/sex Cause/MELD (PELD) Donor-patient relationship Graft type Time interval between first positive test and LDH (d) Total RT-PCR tests performed Peak postop serum bilirubin (mg%) Perioperative morbidity Hospital stay (d) Current status of donor Follow-up duration (mo) 1.1 24/M 41/M ALD/12 Uncle LL 92 4 2.1 Nil 7 Good 2.5 1.2 34/F 9/F Wilson’s/11 Mother LL 72 3 1.9 Ileus, NG 5 Good 1 1.3 35/F 47/M ALD/31 Spouse RL 64 3 3.4 Nil 6 Good 2 1.4 29/F 2/F EHBA/18 Mother LLS 53 3 1.6 Nil 6 Good 1 2.1 43/F 48/M ALD/24 Spouse RL 27 5 1.8 Pleural effusion 7 Good 4 2.2 33/F 8/F Wilson’s ACLF/28 Mother LL 15 3 1.3 Nil 7 Good 1 3.1 32/M 12/F BCS with HCC/20 Cousin RL 49 3 3.3 Nil 7 Good 1.5 3.2 30/F 35/M Cryptogenic CLD/22 Spouse RL 22 6 1.7 Nil 8 Good 1 3.3 46/M 3/M Abernathy syndrome Father LLS 87 4 1.0 Nil 7 Good 1 ACLF, acute on chronic liver failure; ALD, alcoholic liver disease; BCS, Budd-Chiari syndrome; CLD, chronic liver disease; EHBA, extrahepatic biliary atresia; F, female, HCC, hepatocellular carcinoma; LDH, living donor hepatectomy; LL, left lobe; LLS, left lateral segment graft; M, male; MELD, Model for End-stage Liver Disease; NG, nasogastric tube; PELD, pediatric end-stage liver disease; RL, right lobe; RT-PCR, real-time polymerase chain reaction; SARS-CoV-2, severe acute respiratory syndrome coronovirus-2. Median interval between the first positive RT-PCR and LDH was 53 d. Three donors had positive RT-PCR tests even 3 wk after the initial positive test necessitating further delays in surgery until 2 consecutive negative tests were obtained. There were no major complications in any of the donors. One recipient needed reoperation for sepsis and developed early allograft dysfunction leading to prolonged hospital stay. All donors and recipients were discharged in stable condition. There were no COVID-19-related complications among the donors or recipients during the perioperative and follow-up period. Our report provides initial evidence for the safety of LDH after previous asymptomatic SARS-nCOV2 infection. Clarity is needed regarding the significance of repeat positive tests beyond 3 wk, role of antibody testing, and the benefit of preoperative vaccination for potential donors with previous asymptomatic SARS-nCOV2 infection.

Arterial abnormalities identified in kidneys transplanted into children during the COVID-19 pandemic.

Graft artery stenosis can have a significant short- and long-term negative impact on renal graft function. From the beginning of the COVID-19 pandemic, we noticed an unusual number of graft arterial anomalies following kidney transplant (KTx) in children. Nine children received a KTx at our center between February and July 2020, eight boys and one girl, of median age of 10years. Seven presented Doppler features suggesting arterial stenosis, with an unusual extensive pattern. For comparison, over the previous 5-year period, persistent spectral Doppler arterial anomalies (focal anastomotic stenoses) following KTx were seen in 5% of children at our center. We retrospectively evidenced severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in five of seven children with arterial stenosis. The remaining two patients had received a graft from a deceased adolescent donor with a positive serology at D0. These data led us to suspect immune postviral graft vasculitis, triggered by SARS-CoV-2. Because the diagnosis of COVID-19 is challenging in children, we recommend pretransplant monitoring of graft recipients and their parents by monthly RT-PCR and serology. We suggest balancing the risk of postviral graft vasculitis against the risk of prolonged dialysis when considering transplantation in a child during the pandemic.

Enhancement of Zika virus infection by antibodies from West Nile virus seropositive individuals with no history of clinical infection

BackgroundRecent outbreaks of Zika Virus (ZIKV) infection and associated microcephaly has raised multiple scientific questions. The close antigenic relatedness between flaviviruses makes diagnosis of specific infection difficult. This relatedness also raises the potential of Antibody Dependent Enhancement (ADE) via cross reactive antibodies to flaviviruses like West Nile Virus (WNV) and Dengue Virus (DENV). Asymptomatic WNV infections are endemic throughout the US creating a large proportion of the population that is seropositive for WNV antibodies. Whether these sero-positive individuals potentially carry ZIKV enhancing antibodies remains unknown.ResultsSerum samples obtained from human subjects with symptomatic or asymptomatic WNV infection from a WNV endemic region in Texas were tested for their ability to enhance or neutralize ZIKV infection. Sero-surveillance data demonstrated a ~ 7% prevalence for WNV antibodies in the population. Sera from both symptomatic and asymptomatic WNV seropositive donors effectively neutralized WNV and to some extent DENV infection. Interestingly, WNV+ sera failed to inhibit ZIKV while significantly enhancing infection. Conversely, ZIKV specific sera effectively neutralized ZIKV, with ADE only evident at lower concentrations. The enhancement of ZIKV via WNV antibody positive sera was likely due to non-neutralizing Envelope (E) antibodies as seen with monoclonal ZIKV E antibodies.ConclusionsOverall, our findings suggest that WNV antibodies in the sera significantly enhance ZIKV infection in Fc receptor positive cells with limited neutralization activity. Further studies in more relevant models of ADE will be needed to confirm the relevance of these findings in vivo.

ARBOVIRUS IN TRANSPLANTS OF SOLID ORGANS AND EYEBALL: HIGH RISK IN ENDEMIC AREA RECEPTORS? / ARBOVÍRUS EM TRANSPLANTES DE ÓRGÃOS SÓLIDOS E GLOBO OCULAR: ALTO RISCO EM RECEPTORES DE ÁREAS ENDÊMICAS?

This work is a retrospective cross-sectional analytical study that evaluated individuals transplanted from solid organs and eye balls that had infection by the Chikungunya or Zika virus and, received the organ from an asymptomatic donor. An epidemiological assessment of infection by the Chikungunya and Zika virus in Brazil, was also carried out, and an assessment of the organ and eyeball transplant situation in Brazil. Other data were obtained from the literature, carrying out a survey of articles published in the PUBMED database, from January 2015 to December 2019, which released data from case reports and retrospective and prospective studies. The symptoms most frequently associated with CHIKV are myalgia (60% - 93%), fever above 38.9 ºC (90%) and asymptomatic cases (16% -27%), which are not as frequent, but are relevant when it comes to transplants. Symptoms and signs generally associated with Zika virus infection are skin rashes (91%), fever above 38.9º C (65% -80%), in addition to asymptomatic (80%). We found that recipients of organs contaminated with CHIKV or ZIKV may have different outcomes depending on the transplanted organ. Through this evidence, people who had a recent infection or death from these arboviruses could be candidates for kidney and liver donation.

Prevalence of dengue NS1 antigenemia among healthy blood donors in a tertiary care hospital in Southern India.

INTRODUCTION:Transmission of dengue by transfusion of blood products has been documented, although the frequency of these occurrences and the level of viremia required to cause clinical dengue are unknown. The primary objective was to assess the prevalence of dengue NS1 antigen among healthy blood donors at our blood center.METHODOLOGY:This was a cross-sectional study conducted in the Department of Transfusion Medicine, a tertiary care hospital in South-eastern India, from February 2019 to January 2020. A total of 968 donor samples were included in the study. Dengue NS1 antigen detection was done using enzyme-linked immunosorbent assay. Data regarding clinical, epidemiological, and demographic characteristics were collected from the donor questionnaire and records.RESULTS:In the study, the overall prevalence of Dengue NS1 antigen was 0.9%, with nine positive samples among the 968 samples tested. Eight of them were male, and 1 was a female donor. All of them were in the age group <32 years. Half of the positive donors were detected during December-January, the immediate post rainy season in this part of the country. Two-third of the positive donors were from rural areas.CONCLUSION:This study with a 0.9% throws light on the seroepidemiological prevalence of dengue among asymptomatic donors and gives an insight into whether dengue screening is required to be implemented in routine transfusion transmissible infection screening in blood transfusion services and shall assist in devising strategies to be adapted as to improve the blood safety.

Co-expression of HBZ, TAX and FOXp3 and HTLV-1-associated myelopathy/ tropical spastic paraparesis development in HTLV-1-infected individuals: A systematic review

Human T-cell lymphotropic virus type 1 (HTLV-1) is associated with the development of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). It has been reported that the HTLV-1 proteins (specifically TAX and HBZ) can modulate FOXp3, resulting in an immune imbalance that can favor the progression of HAM/TSP. This review aims to summarize the literature in order to clarify the relationship between the expression of HTLV-1 mRNAs and/or viral proteins (TAX and HBZ) with the expression of mRNA and/or protein FOXp3 and their correlation with HAM/ TSP development. This systematic review was conducted according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. The search strategy was performed on the Medical Literature Analysis and Retrieval System Online and Latin American and Caribbean Literature in Health Sciences Platform using subject descriptors. After screening, six articles were included in this review. The studies suggested that TAX and HBZ have a directly proportional correlation with FOXp3 in individuals with HAM/TSP, which also presented an increased expression of FOXp3 compared to asymptomatic controls and/or healthy donors. This systematic review indicates that TAX and HBZ can interact with FOXp3 and that interaction may influence HAM/ TSP development.

Performance assessment of SARS-CoV-2 IgM & IgG ELISAs in comparison with plaque reduction neutralization test.

Background & objectives:Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) continues to be a devastating pandemic. This study was aimed at performance assessment of SARS-CoV-2 IgM and IgG ELISAs, and investigation of their utility for patient diagnosis and sero-epidemiologic investigations.Methods:Serum/plasma samples from COVID-19 patients or asymptomatic contacts (n=180) and healthy donors (n=90) were tested in parallel using two commercial IgM ELISAs (Erbalisa and Inbios), and four IgG ELISAs (Kavach, Euroimmun, Erbalisa and Inbios) along with an indigenous β-propiolactone inactivated virus-based ELISA (IRSHA-IgG-ELISA). Plaque reduction neutralization test (PRNT) was used as reference test.Results:Among 180 COVID-19 patients, 125 tested positive by PRNT. Inbios-IgM-ELISA showed sensitivity (Se)/specificity (Sp)/positive predictive value (PPV)/negative predictive value (NPV) of 93.6/97.8/98.4/94.4 per cent in relation to PRNT, and performed better than Erbalisa-IgM-ELISA (Se: 48%, Sp: 95.6%, PPV: 95.2%, NPV: 65.2%). During the first week of disease, only 47.4 per cent of the COVID-19 patients tested IgM positive by Inbios-IgM-ELISA, detection improving at two weeks and beyond (~86-100%). Among IgG tests, Inbios-IgG-ELISA ranked first in terms of sensitivity (83.2%), followed by IRSHA (64.8%), Euroimmun (64%), Erbalisa (57.6%) and Kavach (56%) tests. For all IgG tests, sensitivity improved during the third (73.9-95.7%) and fourth week (100%) of illness. The specificity (96.7-100%) and PPV (96.2-100%) of all IgG tests were high; NPV ranged between 71.9 and 87.1 per cent with Inbios-IgG-ELISA scoring highest.Interpretation & conclusions:Our results show that IgM detection by the current, most sensitive ELISAs cannot replace molecular diagnosis, but may aid as a supplement test. The available IgG tests are suitable for serosurveys for the assessment of previous virus exposure.

Transplantation of allogeneic cryopreserved hematopoietic cell grafts during the Covid-19 pandemic: A National Marrow Donor Program perspective.

Transplantation of allogeneic cryopreserved hematopoietic cell grafts during the Covid-19 pandemic: A National Marrow Donor Program perspective.

ASYMPTOMATIC DONOR STONES: MANAGEMENT ALGORITHM

Introduction: Kidney transplantation in India is largely a live donor program. With incorporation of Computed Tomogram Angiography (CTA) during donor workup, significant number of renal stones are diagnosed. Herein, we present our experience and management algorithm of asymptomatic donor kidney stones. Materials and Methods: We retrospectively reviewed all donor and recipient files of transplants done between April 2013 and September 2018 done in our institute. All records of donors diagnosed with asymptomatic renal stones were analyzed for demography, stone size, metabolic workup, intraoperative management and follow up. Recipient follow up records were evaluated for any stone related event including surgical intervention. Our algorithm of asymptomatic donor stone management is as depicted in Figure 1.Results: Between April 2013 and September 2018, 1083 transplants were done. Follow up of 827 patients could be retrieved from hospital electronic health record (EHR). The results described in Figure 2. We do not use Ho LASER to fragment stones due to risk of injury to avascular graft kidney. No recurrence was seen in donors.Conclusion: Donors with asymptomatic stones could be safely accepted, provided metabolic workup is negative. We believe our algorithm is a practical and safe approach to deal with asymptomatic donor stones.

Use of a NAT-based assay to improve the surveillance system and prevent transfusion-transmitted malaria in blood banks

BackgroundMalaria can be transmitted by blood transfusion through donations collected from asymptomatic donors. Transfusion-transmitted malaria (TTM) poses a great risk to blood services worldwide. A good screening tool for Plasmodium spp. detection in blood banks must have a high sensitivity for prevention of TTM. However, in Brazilian blood banks, screening for malaria still relies on microscopy.MethodsIn Brazil, screening for human immunodeficiency virus type 1 (HIV), RNA/DNA for hepatitis C (HCV) and hepatitis B (HBV) viruses is mandatory for every blood donation and uses nucleic acid amplification testing (NAT). The aim of this study was to evaluate the inclusion of an assay for malaria to identify Plasmodium sp. from total nucleic acid (TNA; DNA/RNA) by targeting the 18S rRNA gene of the parasite.ResultsConsidering the limitations of microscopy and the wide availability of the Brazilian NAT platform in the screening of blood units for HIV, HCV, and HBV, a molecular diagnostic tool was validated for detection of Plasmodium sp. in blood banks; a pilot study showed that using this novel NAT assay could reduce the risk of TTM.ConclusionThe prototype HIV/HCV/HBV/malaria NAT assay was effective in detecting infected candidate donors and has good prospects to be applied in routine screening for preventing TTM.

Presence of anti-Leishmania antibodies in candidates for kidney transplantation

ObjectivesVisceral leishmaniasis (VL) is a progressive disease that, left untreated, is typically fatal. The purpose of this investigation was to detect Leishmania sp. infection in hemodialysis patients who had received multiple blood transfusions at a private clinic in Campo Grande, Mato Grosso do Sul state, Midwest Brazil. MethodsFifty randomly selected volunteers were interviewed for collection of demographic, socioeconomic, and epidemiological data. Indirect immunofluorescence (titers positive when ≥1:40) and rK39 immunochromatographic tests were employed for serological investigation. ResultsMales predominated (60%). Age ranged from 20 to 77 years. Most subjects reported being on hemodialysis for at least one year (94%) and 84% were candidates for kidney transplantation, 67% of whom were on the waiting list. Leishmania sp. infection was detected in 32%. Contact with infected dogs was the only variable associated with infection. ConclusionsUnder immunocompromised conditions, VL is opportunistic and potentially fatal. Despite existing risks, screening for VL is not performed in asymptomatic donors and recipients. The detection of anti-Leishmania antibodies in these patients reinforces the need for infection screening before immunosuppressive treatment is initiated to reduce not only the risks of VL development and severity, but also mortality rates in cases of reactivation of latent infection.

Ethical Issues in the COVID Era: Doing the Right Thing Depends on Location, Resources, and Disease Burden.

Ethical Issues in the COVID Era: Doing the Right Thing Depends on Location, Resources, and Disease Burden.

Severe Acute Respiratory Syndrome Coronavirus 2 RNA Detected in Blood Donations.

Because of high rates of 2019 novel coronavirus disease in Wuhan, China, Wuhan Blood Center began screening for severe acute respiratory syndrome coronavirus 2 RNA on January 25, 2020. We screened donations in real-time and retrospectively and found plasma samples positive for viral RNA from 4 asymptomatic donors.