Covidaemia and its implications

Anushri Soni, Tanya Manish Arickatt, Akshita Bhalerao, Santosh Kondekar


Coronavirus disease 2019 (COVID-19) pandemic has taught many lessons to the medical fraternity. Academicians and the general population have been through phases of anxiety, panic, and trail and errors. The growing assumption at the onset of the pandemic that COVID infection may spread by blood has not found its roots deep enough for any clinical consequences. As all the symptoms of COVID relate to its local invasion at the alveolar level and its immunological sequelae, this article discusses the possibilities with the research available over the last 10 months. So far, the plasma viral load detected by reverse transcriptase polymerase chain reaction (RT-PCR) seems immaterial in comparison to the viral concentration from nasopharyngeal swabs. So the recommendations to prefer caesarean section for positive mothers, deferring blood donations by COVID patients, frequent antigen testing from blood serum and body fluids like breast milk or amniotic fluid, may really need to be given a second thought. Also, this article concludes about giving up the panic around the viremia-related possibility of vertical transmission from mother to fetus and other clinical implications of testing of blood for the same. This will help in saving the resources heavily to be used only selectively. Newborns in neonatal intensive care unit (NICU) may be permitted to be handled without gloves and using simple practices of handwashing, saving further resources and reducing neonatal infections.



Viraemia, Vertical transmission, COVID-19, Neonatal COVID, RT-PCR

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Likos AM, Kelvin DJ, Cameron CM, Rowe T, Kuehnert MJ, Norris PJ. National Heart, Lung, Blood Institute Retrovirus Epidemiology Donor Study‐II (REDS‐II). Influenza viremia and the potential for blood‐borne transmission. Transfusion. 2007;47(6):1080-8.

Grant PR, JA, Tedder RS, Chan PK, Tam JS, Sung JJ. Detection of SARS coronavirus in plasma by real-Garson time RT-PCR. New Engl J Med. 2003;349(25):2468-9.

Chan KH, Poon LL, Cheng VC, Guan Y, Hung IF, Kong J, et al. Detection of SARS coronavirus in patients with suspected SARS. Emerging infectious diseases. 2004;10(2):294.

Ng EK, Hui DS, Chan KA, Hung EC, Chiu RW, Lee N, et al. Quantitative analysis and prognostic implication of SARS coronavirus RNA in the plasma and serum of patients with severe acute respiratory syndrome. Clinical chemistry. 2003;49(12):1976-80.

Peiris JS, Lai ST, Poon LL, Guan Y, Yam LY, Lim W et al. Coronavirus as a possible cause of severe acute respiratory syndrome. The Lancet. 2003;361(9366):1319-25.

Tahamtan A, Ardebili A. Real-time RT-PCR in COVID-19 detection: issues affecting the results.

Poon LL, Chan KH, Wong OK, Yam WC, Yuen KY, Guan Y et al. Early diagnosis of SARS coronavirus infection by real time RT-PCR. Journal of Clinical Virology. 2003;28(3):233-8.

Ng EK, Ng PC, Hon KE, Cheng WF, Hung EC, Chan KA, et al. Serial analysis of the plasma concentration of SARS coronavirus RNA in pediatric patients with severe acute respiratory syndrome. Clinical Chemistry. 2003;49(12):2085-8.

Grant PR, Garson JA, Tedder RS, Chan PK, Tam JS, Sung JJ. Detection of SARS coronavirus in plasma by real-time RT-PCR. New Engl J Med. 2003;349(25):2468-9.

Corman VM, Albarrak AM, Omrani AS, Albarrak MM, Farah ME, Almasri M, et al. Viral shedding and antibody response in 37 patients with Middle East respiratory syndrome coronavirus infection. Clinical Infectious Diseases. 2016;62(4):477-83.

Kim SY, Park SJ, Cho SY, Cha RH, Jee HG, Kim G, et al. Viral RNA in blood as indicator of severe outcome in Middle East respiratory syndrome coronavirus infection. Emerging infectious diseases. 2016;22(10):1813.

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y,et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The lancet. 2020;395(10223):497-506.

Lescure FX, Bouadma L, Nguyen D, Parisey M, Wicky PH, Behillil S, et al. Clinical and virological data of the first cases of COVID-19 in Europe: a case series. The Lancet Infectious Diseases. 2020;20(6):697-706.

Duan K, Liu B, Li C, Zhang H, Yu T, Qu J, et al. Effectiveness of convalescent plasma therapy in severe COVID-19 patients. Proceedings of the National Academy of Sciences. 2020;117(17):9490-6.

Chen X, Zhao B, Qu Y, Chen Y, Xiong J, Feng Y. Detectable serum severe acute respiratory syndrome Coronavirus 2 viral load (RNAemia) is closely correlated with drastically elevated interleukin 6 level in critically Ill Patients with Coronavirus disease 2019. Clin Infect Dis. 2020.

Christensen J, Kumar D, Moinuddin I, Bryson A, Kashi Z, Kimball P, et al. Covid-19 Viremia, Serologies and Clinical Course in a Case Series of Transplant Recipients. In: Transplantation Proceedings. Elsevier. 2020;52(9):2637-41.

Bermejo-Martin JF, Gonzalez-Rivera M, Almansa R, Micheloud D, Dominguez-Gil M, Resino S, et al. SARS-CoV-2 RNA viremia is associated with a sepsis-like host response and critical illness in COVID-19. medRxiv. 2020.

Zheng S, Fan J, Yu F, Feng B, Lou B, Zou Q, et al. Viral load dynamics and disease severity in patients infected with SARS-CoV-2 in Zhejiang province, China, January-March 2020: retrospective cohort study. bmj. 2020;369.

Chen W, Lan Y, Yuan X, Deng X, Li Y, Cai X,et al. Detectable 2019-nCoV viral RNA in blood is a strong indicator for the further clinical severity. Emerging microbes and infections. 2020;9(1):469-73.

Jin Y, Yang H, Ji W, Wu W, Chen S, Zhang W, et al. Virology, epidemiology, pathogenesis, and control of COVID-19. Viruses. 2020;12(4):372.

World Health Organization. Blood donor selection: guidelines on assessing donor suitability for blood donation. World Health Organization. 2012. Accessed on 07 September 2020.

Chang L, Yan Y, Wang L. Coronavirus disease 2019: coronaviruses and blood safety. Transfusion medicine reviews. 2020;34(2):75-80.

Cheng PK, Wong DA, Tong LK, Ip SM, Lo AC, Lau CS, et al. Viral shedding patterns of coronavirus in patients with probable severe acute respiratory syndrome. The Lancet. 2004;363(9422):1699-700.

Hung IF, Cheng VC, Wu AK, Tang BS, Chan KH, Chu CM, et al. Viral loads in clinical specimens and SARS manifestations. Emerging infectious diseases. 2004;10(9):1550.

Eickmann M, Gravemann U, Handke W, Tolksdorf F, Reichenberg S, Müller TH, et al. Inactivation of three emerging viruses–severe acute respiratory syndrome coronavirus, Crimean–Congo haemorrhagic fever virus and Nipah virus–in platelet concentrates by ultraviolet C light and in plasma by methylene blue plus visible light. Vox Sanguinis. 2020;115(3):146-51.

Hashem AM, Hassan AM, Tolah AM, Alsaadi MA, Abunada Q, Damanhouri GA, et al. Amotosalen and ultraviolet A light efficiently inactivate MERS‐coronavirus in human platelet concentrates. Transfusion Medicine. 2019;29(6):434-41.

Hindawi SI, Hashem AM, Damanhouri GA, El‐Kafrawy SA, Tolah AM, Hassan AM, et al. Inactivation of Middle East respiratory syndrome‐coronavirus in human plasma using amotosalen and ultraviolet A light. Transfusion. 2018;58(1):52-9.

Eickmann M, Gravemann U, Handke W, Tolksdorf F, Reichenberg S, Müller TH, et al. Inactivation of Ebola virus and Middle East respiratory syndrome coronavirus in platelet concentrates and plasma by ultraviolet C light and methylene blue plus visible light, respectively. Transfusion. 2018;58(9):2202-7.

Darnell ME, Taylor DR. Evaluation of inactivation methods for severe acute respiratory syndrome coronavirus in noncellular blood products. Transfusion. 2006;46(10):1770-7.

World Health Organization. Guidance on maintaining a safe and adequate blood supply during the coronavirus disease 2019 (COVID-19) pandemic and on the collection of COVID-19 convalescent plasma: interim guidance, 2020. World Health Organization. 2020. Accessed on 07 September 2020.

Chen Y, Peng H, Wang L, Zhao Y, Zeng L, Gao H,et al. Infants born to mothers with a new coronavirus (COVID-19). Frontiers in pediatrics. 2020;8:104.

Zeng L, Xia S, Yuan W, Yan K, Xiao F, Shao J, et al. Neonatal early-onset infection with SARS-CoV-2 in neonates born to mothers with COVID-19 in Wuhan, China. JAMA pediatrics. 2020;8:287.

Khan S, Peng L, Siddique R, Nabi G, Xue M, Liu J, et al. Impact of COVID-19 infection on pregnancy outcomes and the risk of maternal-to-neonatal intrapartum transmission of COVID-19 during natural birth. Infection Control and Hospital Epidemiology. 2020;41(6):748-50.

Alzamora MC, Paredes T, Caceres D, Webb CM, Valdez LM, La Rosa M. Severe COVID-19 during pregnancy and possible vertical transmission. American journal of perinatology. 2020;37(8):861.

Zeng H, Xu C, Fan J, Tang Y, Deng Q, Zhang W, et al. Antibodies in infants born to mothers with COVID-19 pneumonia. Jama. 2020;323(18):1848-9.

Mlakar J, Korva M, Tul N, Popović M, Poljšak-Prijatelj M, Mraz J, et al. Zika virus associated with microcephaly. New England Journal of Medicine. 2016;374(10):951-8.

Wong SF, Chow KM, Leung TN, Ng WF, Ng TK, Shek CC, et al. Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome. American journal of obstetrics and gynecology. 2004;191(1):292-7.

Gu J, Han B, Wang J. COVID-19: gastrointestinal manifestations and potential fecal–oral transmission. Gastroenterology. 2020;158(6):1518-9.

Wang Z, Xu X. scRNA-seq profiling of human testes reveals the presence of the ACE2 receptor, a target for SARS-CoV-2 infection in spermatogonia, Leydig and Sertoli cells. Cells. 2020;9(4):920.

Song C, Wang Y, Li W, Hu B, Chen G, Xia P, et al. Absence of 2019 novel coronavirus in semen and testes of COVID-19 patients. Biology of reproduction. 2020.

Qiu L, Liu X, Xiao M, Xie J, Cao W, Liu Z, et al. SARS-CoV-2 is not detectable in the vaginal fluid of women with severe COVID-19 infection. Clinical Infectious Diseases. 2020;71:15.

Costa S, Posteraro B, Marchetti S, Tamburrini E, Carducci B, Lanzone A,et al. Excretion of SARS-CoV-2 in human breast milk. Clin Micro Infect. 2020;26(10):1430-32.

Tian Y, Rong L, Nian W, He Y. gastrointestinal features in COVID‐19 and the possibility of faecal transmission. Alimentary pharmacology and therapeutics. 2020;51(9):843-51.

Xia J, Tong J, Liu M, Shen Y, Guo D. Evaluation of coronavirus in tears and conjunctival secretions of patients with SARS‐CoV‐2 infection. Journal of medical virology. 2020;92(6):589-94.

Sun J, Zhu A, Li H, Zheng K, Zhuang Z, Chen Z, et al. Isolation of infectious SARS-CoV-2 from urine of a COVID-19 patient. Emerging microbes & infections. 2020;9(1):991-3.