۱٫ Diversity of Coronaviruses

۲٫ SARS-CoV

۳٫ MERS-CoV

۴٫ SARS-CoV-2

۵٫ Inactivation of Coronavirus in Blood Products

۶٫ Conclusions

Declarations of interest

References

Abstract

With the outbreak of unknown pneumonia in Wuhan, China, in December 2019, a new coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), aroused the attention of the entire world. The current outbreak of infections with SARS-CoV-2 is termed Coronavirus Disease 2019 (COVID-19). The World Health Organization declared COVID-19 in China as a Public Health Emergency of International Concern. Two other coronavirus infections—SARS in 2002-2003 and Middle East Respiratory Syndrome (MERS) in 2012—both caused severe respiratory syndrome in humans. All 3 of these emerging infectious diseases leading to a global spread are caused by β-coronaviruses. Although coronaviruses usually infect the upper or lower respiratory tract, viral shedding in plasma or serum is common. Therefore, there is still a theoretical risk of transmission of coronaviruses through the transfusion of labile blood products. Because more and more asymptomatic infections are being found among COVID-19 cases, considerations of blood safety and coronaviruses have arisen especially in endemic areas. In this review, we detail current evidence and understanding of the transmission of SARS-CoV, MERS– CoV, and SARS-CoV-2 through blood products as of February 10, 2020, and also discuss pathogen inactivation methods on coronaviruses.

Diversity of Coronaviruses

As the largest known RNA viruses, CoVs are further divided into four genera: α-CoVs, β-CoVs, γ-CoVs, and δ-CoVs [11], among which α- and β-CoVs are able to infect mammals, whereas the other two genera can infect birds and could also infect mammals [12]. So far, seven coronaviruses have been found to infect humans and cause respiratory diseases. Four of seven are common human CoVs (HCoVs) usually leading to common self-limited upper respiratory disease: HCoV-229E, HCoV-OC43, HCoV-NL63, and HCoV-HKU1. These viruses can occasionally cause more serious disease in young, elderly, or immunocompromised individuals.

The first two HCoVs, HCoV-229E and HCoV-OC43, have been known since the 1960s. With the emergence of SARS in 2002, a novel βcoronavirus came to attention; and subsequently, HCoV-NL63 and HCoV-HKU1 were identified in 2004 and 2005, respectively [13]. MERS-CoV, which was isolated in 2012, is similar to SARS-CoV—both can infect the lower respiratory tract and usually cause a severe respiratory syndrome in humans [14] with a case fatality rate of 35.5% and 10%, respectively [15]. SARS-CoV-2 was recently isolated from human airway epithelial cells, characterized by next-generation sequencing in January 2020, and identified to be a new member of β-CoVs [16]. SARS-CoV-2 can also infect the lower respiratory tract, but the clinical symptoms are milder than SARS and MERS according to current limited evidence and reports [1].