Proportions of US Blood Donors With Serological Evidence of Severe Acute Respiratory Syndrome Coronavirus 2 Infections Who Reported Survey-Based Diagnosed Infections During July 2020-December 2022

Akintunde Akinseye; David J Wright; Eduard Grebe; Mars Stone; Cassandra A Hathaway; Rebecca V Fink; Bryan R Spencer; Paula Saa; Marion C Lanteri; Michael Busch; Jefferson M Jones

doi:10.1093/ofid/ofaf210

Proportions of US Blood Donors With Serological Evidence of Severe Acute Respiratory Syndrome Coronavirus 2 Infections Who Reported Survey-Based Diagnosed Infections During July 2020-December 2022

Open Forum Infect Dis. 2025 Apr 10;12(5):ofaf210. doi: 10.1093/ofid/ofaf210. eCollection 2025 May.

Authors

Akintunde Akinseye¹, David J Wright¹, Eduard Grebe², Mars Stone^{2

3}, Cassandra A Hathaway¹, Rebecca V Fink¹, Bryan R Spencer⁴, Paula Saa⁴, Marion C Lanteri^{2

5}, Michael Busch^{2

3}, Jefferson M Jones⁶

Affiliations

¹ Westat, Rockville, Maryland, USA.
² Vitalant Research Institute, San Francisco, California, USA.
³ Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA.
⁴ American Red Cross, Scientific Affairs, Dedham, Massachusetts, USA.
⁵ Creative Testing Solutions, Tempe, Arizona, USA.
⁶ Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Abstract

The proportion of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections diagnosed by coronavirus disease 2019 (COVID-19) tests, including home antigen tests, is unknown. We detected infections among blood donors in the United States (US) by testing for nucleocapsid antibody (anti-N) seroconversion and administered a questionnaire to determine the proportion of those infections that were associated with a self-reported positive COVID-19 test. Among US blood donors with serologic evidence of SARS-CoV-2 infection who completed a survey, 47.7% reported an associated self-reported positive COVID-19 test. This proportion changed from July-December 2020 (44.9%) to July-December 2022 (54.8%). This study suggests many SARS-CoV-2 infections in adults are not diagnosed with a test.

Keywords: COVID-19; SARS-CoV-2; antibody assay; blood donors; viral tests.

Published by Oxford University Press on behalf of Infectious Diseases Society of America 2025.