TY - JOUR
T1 - One threat, different answers
T2 - the impact of COVID-19 pandemic on cornea donation and donor selection across Europe
AU - Thuret, Gilles
AU - Courrier, Emilie
AU - Poinard, Sylvain
AU - Gain, Philippe
AU - Baud'Huin, Marc
AU - Martinache, Isabelle
AU - Cursiefen, Claus
AU - Maier, Philip
AU - Hjortdal, Jesper
AU - Sanchez Ibanez, Jacinto
AU - Ponzin, Diego
AU - Ferrari, Stefano
AU - Jones, Gary
AU - Griffoni, Carlo
AU - Rooney, Paul
AU - Bennett, Kyle
AU - Armitage, W John
AU - Figueiredo, Francisco
AU - Nuijts, Rudy
AU - Dickman, Mor
N1 - © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2022/3
Y1 - 2022/3
N2 - OBJECTIVES: To assess to which extent the COVID-19 pandemic affected corneal transplantation by virtue of donor selection algorithms in different European countries.DESIGN: Survey.SETTING: 110 eye banks in 26 European countries.PARTICIPANTS: 64 eye banks covering 95% of European corneal transplantation activity.INTERVENTIONS: A questionnaire listing the number of corneas procured and distributed from February to May 2018-2020 was circulated to eye banks.MAIN OUTCOME MEASURES: The primary outcome was the number of corneal procurements. Additional outcomes were national algorithms for donor selection, classified according to their stringency (donors with COVID-19 history, suspected for COVID-19, asymptomatic, PCR testing) and the pandemic severity in each country. We calculated Spearman's correlation coefficient to determine, two by two, the relationship between the 3-month decline in eye banking activity (procurement), the stringency of donor selection algorithm and the grading of pandemic severity (cases and deaths). A partial correlation was run to determine the relationship between decline and stringency while controlling for pandemic severity.RESULTS: Procurements decreased by 38%, 68% and 41%, respectively, in March, April and May 2020 compared with the mean of the previous 2 years, while grafts decreased, respectively, by 28%, 68% and 56% corresponding to 3866 untreated patients in 3 months. Significant disparities between countries and the decrease in activity correlated with stringency in donor selection independent of pandemic severity.CONCLUSIONS: Our data demonstrate significant differences between countries regarding donor screening algorithms based on precautionary principles and, consequently, a decrease in the donor pool, already constrained by a long list of contraindications. Fundamental studies are needed to determine the risk of SARS-CoV-2 transmission by corneal transplantation and guide evidence-based recommendations for donor selection to justify their substantial medical and economic impact.
AB - OBJECTIVES: To assess to which extent the COVID-19 pandemic affected corneal transplantation by virtue of donor selection algorithms in different European countries.DESIGN: Survey.SETTING: 110 eye banks in 26 European countries.PARTICIPANTS: 64 eye banks covering 95% of European corneal transplantation activity.INTERVENTIONS: A questionnaire listing the number of corneas procured and distributed from February to May 2018-2020 was circulated to eye banks.MAIN OUTCOME MEASURES: The primary outcome was the number of corneal procurements. Additional outcomes were national algorithms for donor selection, classified according to their stringency (donors with COVID-19 history, suspected for COVID-19, asymptomatic, PCR testing) and the pandemic severity in each country. We calculated Spearman's correlation coefficient to determine, two by two, the relationship between the 3-month decline in eye banking activity (procurement), the stringency of donor selection algorithm and the grading of pandemic severity (cases and deaths). A partial correlation was run to determine the relationship between decline and stringency while controlling for pandemic severity.RESULTS: Procurements decreased by 38%, 68% and 41%, respectively, in March, April and May 2020 compared with the mean of the previous 2 years, while grafts decreased, respectively, by 28%, 68% and 56% corresponding to 3866 untreated patients in 3 months. Significant disparities between countries and the decrease in activity correlated with stringency in donor selection independent of pandemic severity.CONCLUSIONS: Our data demonstrate significant differences between countries regarding donor screening algorithms based on precautionary principles and, consequently, a decrease in the donor pool, already constrained by a long list of contraindications. Fundamental studies are needed to determine the risk of SARS-CoV-2 transmission by corneal transplantation and guide evidence-based recommendations for donor selection to justify their substantial medical and economic impact.
KW - epidemiology
KW - eye (tissue) banking
KW - infection
KW - public health
KW - VIRUS TRANSMISSION
U2 - 10.1136/bjophthalmol-2020-317938
DO - 10.1136/bjophthalmol-2020-317938
M3 - Article
C2 - 33243832
SN - 0007-1161
VL - 106
SP - 312
EP - 318
JO - British Journal of Ophthalmology
JF - British Journal of Ophthalmology
IS - 3
ER -