How Effective is Convalescent Plasma to Cure SARS-CoV-2?Dindayal
The world is battling with the COVID-19 caused by the infection of SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2). In the absence of any specific vaccination or medication against the virus TO DATE, management of COVID-19 has mainly focused on infection prevention, case detection, symptomatic treatment, and supportive care.
Convalescent Plasma Therapy or Therapeutic Plasma Exchange (TPE)- healthcare community sees a high hope in it based on the past records. Though in most of the affected countries, it is still in its trial phase to evaluate the safety and efficacy of convalescent plasma treatment, we can see a silver lining in the cloud.
There were instances where patients in critical conditions particularly with underlying health issues came out of danger. It improved the survival rate of patients and reduced their hospitalization period. Here is a quick summary of this investigative treatment.
What is Convalescent Plasma?
Convalescent Plasma or immunoglobulins is obtained from the blood donated by people who’ve recovered from COVID-19 infection. The plasma along with the antibodies is segregated from the rest of the blood cells and is transmitted into a patient to fight the virus. Before donated blood can be used, it must be tested for safety. The immunoglobulins are nothing but antibodies produced by the immunity system of our body in response to the infection. Hence, Convalescent Plasma Treatment is the transfer of desired immunity from healthy to sick persons.
Convalescent Plasma has also been experimented in the treatment of previous virus-led epidemic including SARS, pandemic 2009 influenza A H1N1 (H1N1pdm09), and Ebola.
Convalescent Plasma Treatment: Real-World Test
China deserves to be named first in the list. The trial and treatment using the antibody-rich plasma has come up with promising results in China. In this regard, Shenzhen Third People’s Hospital, Second Hospital Affiliated to Southern University of Science and Technology is worth getting a mention. The healthcare institution adopted the therapy to improve the conditions of its patients, claims JAMA (The Journal of the American Medical Association) Network.
Based on the opinion of the healthcare staff where they discussed the application of plasma therapy on 5 critically ill COVID-19 patients (Ventilator Support) and the outcomes.
“Viral load declined within days of treatment with convalescent plasma, and the clinical conditions of these patients improved, as indicated by body temperature reduction, improved Pao2/Fio2, and chest imaging. Four patients who had been receiving mechanical ventilation and ECMO no longer required respiratory support by 9 days after plasma transfusion.”
One of the worst-hit countries is also planning to fight the deadly infection using the Convalescent Plasma Treatment. CNN reports “doctors in Italy are hoping to turn Italy’s terrible suffering to its advantage”. Baldanti, a virologist at the University of Pavia San Matteo Hospital in Italy’s northern Lombardy region, hopes “this plasma treatment can be crucial for controlling the infection in patients admitted to intensive care units.”
The quality of the Convalescent Plasma holds significance. With the quality of plasma, we strictly mean the amount and quality of the antibodies contained in it. A series of serology or blood tests is conducted. Italy has yet to finalize a standard serology exam. Afterwards, the Italian National Blood Center, will go on the drive of collecting plasma from healthy donors.
The USA is a step ahead. The U.S. Food and Drug Administration (FDA) has approved the practice but in the context of clinical trials only with expanded access. Red Cross is collaborating with The U.S. Food and Drug Administration (FDA) to collect healthy plasma with the right quality of antibodies. Anyone has fully recovered from COVID-19 and is free from symptoms is entitled to donate. Interested eligible donors (at least 17 years old and weigh 110 lbs) can fill up the Donor Eligibility Form. A Red Cross representative will follow him or her. FDA has issued a detailed guidance to healthcare providers on the following:
- Pathways for use of investigational COVID-19 convalescent plasma
- Patient eligibility
- Collection of COVID-19 convalescent plasma, including donor eligibility and donor qualifications
- Labeling, and
- Record keeping
The Indian Council of Medical Research (ICMR) —the apex body for medical research in India— is conducting a trial in this regard. It has invited healthcare institutions with equipment and infrastructure fulfilling its terms to participate in a clinical trial of convalescent plasma therapy. Participating institutions have to be registered with Clinical Trial Registry of India, and Drugs Controller General of India, Central Drugs Standard Control Organization.
The trial is aimed at observing and studying the safety and efficacy of therapeutic plasma exchange before making it available as a treatment option outside trial.
The aim is to study the safety and efficacy of said therapy in treating COVID-19 patients. The treatment method has reportedly shown promising results in China—the epicentre of novel coronavirus outbreak that has now infected nearly 20 lakh people globally.
Conclusion: By the time I last updated this post on May 05 2020, none of the healthcare apex bodies across any countries have approved Convalescent Plasma Therapy as a specific treatment for the disease.