COVID-19 and transfusion medicine

Background

On December 31, 2019, the World Health Organization (WHO) was alerted to several cases of pneumonia, of an unknown etiology, in Wuhan, China (Hubei province). A novel coronavirus was identified as the cause and it has since been named “SARS-CoV-2” by the International Committee on Taxonomy of Viruses (ICTV)1. The WHO has named the disease caused by the virus “COVID-19” (a shortened version of coronavirus disease 2019)2. The early cases were linked to a seafood and meat market in Wuhan; however, person-to-person spread is now confirmed, including local and community transmission in countries around the world3-7. On March 11, 2020, the WHO declared the COVID-19 outbreak a global pandemic8.  

This repository aims to support Canadian transfusion medicine health care professionals during the COVID-19 pandemic. It will be updated regularly as new information is available. In addition, the public and donors can learn more about how Canadian Blood Services is responding to COVID-19 by visiting blood.ca/covid-19.

Blood products inventory management

The National Emergency Blood Management Committee meets regularly to review the supply of blood components and products during the pandemic and make inventory advisories.

  • May 6, 2020:  Recovery Phase Advisory declared for all fresh blood components and plasma protein products.  This indicates a period of controlled transition to normal demand within hospitals.
  • April 08, 2020: Notice of continuation of the Green Phase Advisory, declared March 17, 2020, for platelets and plasma protein products. The advisory no longer applies to red blood cells, frozen plasma and cryoprecipitate.
  • March 31, 2020: Notice of continuation of Green Phase Advisory for all blood components and products declared on March 17, 2020.
  • March 24, 2020: Notice of continuation of Green Phase Advisory for all blood components and products declared on March 17, 2020.
  • March 17, 2020: Green Phase Advisory declared for all blood components and products. 

Resources for blood product conservation practices during COVID-19

National Blood Shortage Contingency Planning During a Pandemic:  Hospital Transfusion Medicine Laboratory (TML) Checklist and Considerations” published by National Advisory Committee on Blood and Blood Products

National Plan for Management of Shortages - Summary for Blood Banks published by Canadian Blood Services on March 20, 2020)

ONTraC Program - Patient Blood Management Resources published by Ontario Transfusion Coordinators.

Blood Conservation in the Time of COVID-19 Poster published by Choosing Wisely Canada.

Pandemic Preparedness - Blood Utilization Poster.

Choosing Wisely COVID-19 recommendations (recommendations #7 and 9 for clinicians) published by Choosing Wisely Canada.

COVID-19 Transfusion education events

To find upcoming transfusion education events related to COVID-19, visit our Events page or view the list here.

Treatment of COVID-19 patients

Intravenous Immune Globulin (IVIG)

Currently, IVIG is not available for patients with COVID-19 and there is no evidence to suggest it would be an effective treatment. Given limited supplies of IVIG, its use to treat COVID-19 patients would rapidly deplete current stocks and limit access to other patients with diagnoses where IVIG is proven effective.

For information see “Fact Sheet on Convalescent Plasma and Intravenous Immune Globulin (IVIG) for Treatment of COVID-19 in Canada” published by National Advisory Committee on Blood and Blood Products on March 31, 2020.

Convalescent plasma

Currently, Canadian patients are only able to receive therapy with COVID-19 convalescent plasma in the context of a national clinical trial called the CONCOR-1 trial. Well-designed clinical trials are necessary to determine if COVID-19 convalescent plasma could be a safe and efficacious treatment option for COVID-19 patients.

To learn more about Canadian Blood Services’ contributions to CONCOR-1 see below. 

  • April 16, 2020: Canadian Blood Services Chief Scientist, Dana Devine spoke with The Agenda to discuss the clinical trial.  
  • April 2, 2020: Canadian Blood Services announces that it is actively working with Health Canada and the international research community as part of a global effort to determine if convalescent plasma could effectively treat COVID-19. Canadian Blood Services will contribute by collecting and preparing plasma from fully recovered COVID-19 patients. Canadian physicians caring for patients with COVID-19 will have access to the convalescent plasma in the context of the clinical trial.
  • March 31, 2020: Watch this video interview with Dr. Dana Devine, Chief Scientist at Canadian Blood Services, where she discusses how convalescent plasma could help patients with COVID-19 disease.

 

 

Additional information

References

1.    Gorbalenya AE. Severe acute respiratory syndrome-related coronavirus – the species and its viruses, a statement of the Coronavirus Study Group. bioRxiv 2020.02.07.937862. Feb 2020 [internet publication]. 
2.    World Health Organization. COVID-19 Situation Report 22. February 11, 2020. Available at: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200211-sitrep-22-ncov.pdf 
3.    Phan LT, Nguyen TV, Luong QC, et al. Importation and human-to-human transmission of a novel coronavirus in Vietnam. N Engl J Med. 2020 Jan 28 [Epub ahead of print]. Available at: https://www.nejm.org/doi/full/10.1056/NEJMc2001272 
4.    Jasper Fuk-Woo Chan, Shuofeng Yuan, Kin-Hang Kok, Kelvin Kai-Wang To, Hin Chu, Jin Yang et al.  A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. The Lancet. Available at: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30154-9/fulltext#seccestitle10 
5.    World Health Organization. Statement on the second meeting of the international health regulations emergency committee regarding the outbreak of novel coronavirus. Available at: https://www.who.int/news-room/detail/30-01-2020-statement-on-the-second-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of-novel-coronavirus-(2019-ncov) 
6.    Nishiura, H.; Linton, N.M.; Akhmetzhanov, A.R. Initial Cluster of Novel Coronavirus (2019-nCoV) Infections in Wuhan, China Is Consistent with Substantial Human-to-Human Transmission. J. Clin. Med. 2020, 9, 488. Available at: https://www.mdpi.com/2077-0383/9/2/488.  
7.    World Health Organization. COVID-19 Situation Report #51. March 11, 2020. Available at: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200311-sitrep-51-covid-19.pdf?sfvrsn=1ba62e57_4 
8.    World Health Organization. WHO Director-General's opening remarks at the media briefing on COVID-19 - 11 March 2020. Available at: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020