LAUSR

A 23-year-old male from Uttarakhand, India who manages a farm business, donated whole blood for the first time at a blood center. During component separation using centrifuge and component separator, it was observed that plasma within the bag was dark-brown in color (Figure 1). The donor was informed about plasma discoloration. On evaluation, it was found that he had tested positive for COVID-19 5 months prior and had been taking Ayurvedic “decoction” (it is a herbal tea made of Tulsi [Basil], Dalchini [Cinnamon], Kalimirch [Black pepper], Shunthi [Dry Ginger], and Munakka [Raisin]).1–3 He had been drinking this decoction (Figure 2, dark brown liquid) 3–4 cups daily for last 5 months. He underwent further investigation using complete blood count (CBC), liver function test (LFT), blood culture, PT-APTT, kidney function test (KFT), iron studies, serum LDH and serum haptoglobin. Sterility testing of the plasma unit was performed. All tests rendered normal values except PTAPTT, [PT18secs (control-11secs), APTT51secs (control-38 secs)]. The PT-APTT elevations can be explained by the consumption of large amounts of ginger present in the decoction. The donor was advised to consult Ayurvedic physician who advised him to reduce the intake of decoction. On follow-up 4 months later, he informed us that he had reduced his consumption of this herbal drink to 3–4 cups/week. On blood sampling, his reports were normal including PT-APTT values (PT – 13secs, APTT40secs). Plasma was separated from the EDTA vial, inspected and found, to be of near normal coloration (Figure 3). The ayurvedic decoction (as shown in Figure 2) is a dark brown colored opaque liquid which was taken orally at a high dose by this donor. Dark brown plasma resulting from high dose of ayurvedic kadha has not been described earlier in the literature.