(P-BC-16) Blood Donor Characteristics and Blood Safety Before and During the COVID-19 Pandemic: A BEST Collaborative Study

Background/Case Studies: The COVID-19 pandemic is an unprecedented catastrophic event that hindered blood collection and likely altered the profile of blood donors. However, no studies have comprehensively evaluated the impact of the COVID-19 pandemic on blood donations, blood donor demographics, and blood safety across several countries.

Study

Design/Methods: This was an international survey of senior blood service employees who were contacted through the Biomedical Excellence for Safer Transfusion (BEST) on 02-10-2023. No other eligibility criteria applied. The respondents were asked to report data on red blood cell (RBC) donors and donations recorded from 03-11-2019 to 09-11-2019 (“pre-pandemic period”) and from 03-11-2020 to 09-11-2020 (“pandemic period”). The survey questions pertained to the number of donations, donor demographics, and positivity rates for selected infectious disease markers (IDMs), which included hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), human T-lymphotropic virus (HTLV), and Treponema pallidum (syphilis).

Results/Findings: Eleven blood services (Australia – center A, Spain – center B, Canada (1) – center C, US – center D, France – center E, Canada (2) – center F, Ireland – center G, Japan – center H, The Netherlands – center I, Brazil – center J, US – center K) completed the survey, reporting data associated with >4 million donations in each period. On average, the number of donations dropped by 4.0% between the pre-pandemic and pandemic periods, and this drop was remarkably consistent among the blood services (Figure 1). The reduction was driven by fewer donations from active repeat donors (-5.6%) and first-time (FT) donors (-14.0%), but was partially offset by more donations from lapsed donors (+15.7%). The decline was also driven by fewer donations from male donors (-7.6%), but was partially offset by a modest increase in the number of donations from female donors (+1.4%). Younger donors (i.e., 16-25 years) also accounted for a significant part of the shortfall (-19.0%).

Overall, the rate of any IDM positivity dropped from 100.0 to 88.6 per 100,000 donors (-11.4%) between the pre-pandemic and pandemic periods, with all but two participating blood services reporting a decline in the overall rate of IDM positivity (Figure 1). This reduction was mostly driven by fewer positive donations from active repeat donors (-39.3%). The magnitude of the reduction in any IDM positivity rate appeared similar among male (-10.9%) and female (-9.9%) donors. The lower rate of IDM positivity was primarily driven by HBV (HBsAg: -19.6%) and HCV (-11.6%).

Conclusions: These results suggest that the pandemic reduced the number of FT, active repeat, male, and younger donors, which translated into lower rates of IDM positivity, with minimal improvements in blood safety due to changing donor demography at the expense of contraction of the blood supply.