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One threat, different answers: The impact of COVID-19 pandemic on cornea donation and donor selection across Europe

Lookup NU author(s): Professor Francisco Figueiredo


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© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.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.

Publication metadata

Author(s): Thuret G, Courrier E, Poinard S, Gain P, Baud'huin M, Martinache I, Cursiefen C, Maier P, Hjortdal J, Sanchez Ibanez J, Ponzin D, Ferrari S, Jones G, Griffoni C, Rooney P, Bennett K, Armitage WJ, Figueiredo F, Nuijts R, Dickman M

Publication type: Article

Publication status: Published

Journal: British Journal of Ophthalmology

Year: 2020

Volume: 106

Pages: 312-318

Online publication date: 26/11/2020

Acceptance date: 28/10/2020

ISSN (print): 0007-1161

ISSN (electronic): 1468-2079

Publisher: BMJ Publishing Group


DOI: 10.1136/bjophthalmol-2020-317938

PubMed id: 33243832


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