Investigating Blood Donors With Postdonation Respiratory Tract Symptoms During the Wild-Type, Delta, and Omicron Waves of the Coronavirus Disease 2019 Pandemic in England

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been shown to be detectable in blood from infected individuals. Though RNAemia frequencies are typically low, the presence of potentially infectious virus potentially poses a transmission risk during blood transfusion. Methods: Archived plasma samples were collected from blood donors who later reported possible SARS-CoV-2 infection with the wild-type strain, Delta variant, or Omicron variant. This was based on either symptom onset or a positive test within 2 weeks from their donation. Donations were tested for SARS-CoV-2 RNA, and information on symptoms and testing results were gathered during postdonation interview. Results: Of 518 archived plasma samples tested, 19 (3.7%) were found to have detectable levels of SARS-CoV-2 RNA. SARS-CoV-2 RNA was detected in donors who donated during the Delta (10/141 [7.1%]) and Omicron (9/162 [5.6%]) waves. SARS-CoV-2 RNA was not detected in donors who donated during the wild-type wave (0/215). Seventeen of 19 RNAemic donors reported symptom onset or a positive test within 2 days of donating. SARS-CoV-2 RNA was detected in asymptomatic or presymptomatic blood donors. Conclusions: Despite RNAemia being correlated with SARS-CoV-2 disease severity, RNAemia was detected in asymptomatic or presymptomatic blood donors.