@article{Andersson:2020:10.12688/wellcomeopenres.16002.2,
author = {Andersson, MI and Arancibia-Carcamo, CV and Auckland, K and Baillie, JK and Barnes, E and Beneke, T and Bibi, S and Brooks, T and Carroll, M and Crook, D and Dingle, K and Dold, C and Downs, LO and Dunn, L and Eyre, DW and Gilbert, Jaramillo J and Harvala, H and Hoosdally, S and Ijaz, S and James, T and James, W and Jeffery, K and Justice, A and Klenerman, P and Knight, JC and Knight, M and Liu, X and Lumley, SF and Matthews, PC and McNaughton, AL and Mentzer, AJ and Mongkolsapaya, J and Oakley, S and Oliveira, MS and Peto, T and Ploeg, RJ and Ratcliff, J and Robbins, MJ and Roberts, DJ and Rudkin, J and Russell, RA and Screaton, G and Semple, MG and Skelly, D and Simmonds, P and Stoesser, N and Turtle, L and Wareing, S and Zambon, M},
doi = {10.12688/wellcomeopenres.16002.2},
journal = {Wellcome Open Res},
title = {SARS-CoV-2 RNA detected in blood products from patients with COVID-19 is not associated with infectious virus.},
url = {http://dx.doi.org/10.12688/wellcomeopenres.16002.2},
volume = {5},
year = {2020}
}

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TY  - JOUR
AB  - Background: Laboratory diagnosis of SARS-CoV-2 infection (the cause of COVID-19) uses PCR to detect viral RNA (vRNA) in respiratory samples. SARS-CoV-2 RNA has also been detected in other sample types, but there is limited understanding of the clinical or laboratory significance of its detection in blood. Methods: We undertook a systematic literature review to assimilate the evidence for the frequency of vRNA in blood, and to identify associated clinical characteristics. We performed RT-PCR in serum samples from a UK clinical cohort of acute and convalescent COVID-19 cases (n=212), together with convalescent plasma samples collected by NHS Blood and Transplant (NHSBT) (n=462 additional samples). To determine whether PCR-positive blood samples could pose an infection risk, we attempted virus isolation from a subset of RNA-positive samples. Results: We identified 28 relevant studies, reporting SARS-CoV-2 RNA in 0-76% of blood samples; pooled estimate 10% (95%CI 5-18%). Among serum samples from our clinical cohort, 27/212 (12.7%) had SARS-CoV-2 RNA detected by RT-PCR. RNA detection occurred in samples up to day 20 post symptom onset, and was associated with more severe disease (multivariable odds ratio 7.5). Across all samples collected ≥28 days post symptom onset, 0/494 (0%, 95%CI 0-0.7%) had vRNA detected. Among our PCR-positive samples, cycle threshold (ct) values were high (range 33.5-44.8), suggesting low vRNA copy numbers. PCR-positive sera inoculated into cell culture did not produce any cytopathic effect or yield an increase in detectable SARS-CoV-2 RNA. There was a relationship between RT-PCR negativity and the presence of total SARS-CoV-2 antibody (p=0.02). Conclusions: vRNA was detectable at low viral loads in a minority of serum samples collected in acute infection, but was not associated with infectious SARS-CoV-2 (within the limitations of the assays used). This work helps to inform biosafety precautions for handling blood products from patients with c
AU  - Andersson,MI
AU  - Arancibia-Carcamo,CV
AU  - Auckland,K
AU  - Baillie,JK
AU  - Barnes,E
AU  - Beneke,T
AU  - Bibi,S
AU  - Brooks,T
AU  - Carroll,M
AU  - Crook,D
AU  - Dingle,K
AU  - Dold,C
AU  - Downs,LO
AU  - Dunn,L
AU  - Eyre,DW
AU  - Gilbert,Jaramillo J
AU  - Harvala,H
AU  - Hoosdally,S
AU  - Ijaz,S
AU  - James,T
AU  - James,W
AU  - Jeffery,K
AU  - Justice,A
AU  - Klenerman,P
AU  - Knight,JC
AU  - Knight,M
AU  - Liu,X
AU  - Lumley,SF
AU  - Matthews,PC
AU  - McNaughton,AL
AU  - Mentzer,AJ
AU  - Mongkolsapaya,J
AU  - Oakley,S
AU  - Oliveira,MS
AU  - Peto,T
AU  - Ploeg,RJ
AU  - Ratcliff,J
AU  - Robbins,MJ
AU  - Roberts,DJ
AU  - Rudkin,J
AU  - Russell,RA
AU  - Screaton,G
AU  - Semple,MG
AU  - Skelly,D
AU  - Simmonds,P
AU  - Stoesser,N
AU  - Turtle,L
AU  - Wareing,S
AU  - Zambon,M
DO  - 10.12688/wellcomeopenres.16002.2
PY  - 2020///
SN  - 2398-502X
TI  - SARS-CoV-2 RNA detected in blood products from patients with COVID-19 is not associated with infectious virus.
T2  - Wellcome Open Res
UR  - http://dx.doi.org/10.12688/wellcomeopenres.16002.2
UR  - https://www.ncbi.nlm.nih.gov/pubmed/33283055
VL  - 5
ER  - 

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