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2020-03-29

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A COVID-19 recoveree, right, donates plasma at a hospital in Zouping, China.   | Photo Credit: AFP

As the debate rages about the viability of convalescent plasma (plasma extracted from those who are recovering from coronavirus (COVID-19), a paper published in the Journal of American Medical Association has hit a home run for a possible treatment methodology. At a time when the world is grasping at straws for treatment methods, every positive outcome raises hope.

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Though the study has a very small cohort, five patients, critically ill with COVID-19, the preliminary results are said to be promising, by experts across the world. In a paper authored by Chinese scientists Chenguang Shen, Zhaoqin Wang, Fang Zhao, et al, it has been argued that the ‘preliminary findings raise the possibility that convalescent plasma transfusion may be helpful in the treatment of critically ill patients with COVID-19 and ARDS, but this approach requires evaluation in randomised clinical trials.’ While the cohort is small, there is less scepticism about the study results, experts argue, because the method (convalescent plasma) has worked well for other conditions.

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Five critically ill patients with confirmed COVID-19 and with acute respiratory distress syndrome (ARDS), who also had the following — severe pneumonia with rapid progression and continuously high viral load despite antiviral treatment; and mechanical ventilation — were chosen for treatment with convalescent plasma transfusion. The plasma was drawn from five patients, who had recovered from COVID-19. The study was conducted at the infectious disease department, Shenzhen Third People’s Hospital in Shenzhen, China, from January 20, 2020, to March 25, 2020. Clinical outcomes improved dramatically post the intervention, the authors record.

They added: “Following plasma transfusion, body temperature normalised within 3 days in 4 of 5 patients, the Sequential Organ Failure Assessment score decreased, and the ratio that determines severity of ARDS increased within 12 days (172-276 before and 284-366 after). Viral loads also decreased and became negative within 12 days after the transfusion.

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ARDS resolved in four patients 12 days after transfusion, and 3 patients were weaned from the ventilator within two weeks. Of the 5 patients, 3 have been discharged from the hospital and 2 are in a stable condition 37 days after transfusion, the paper recorded.

Vincent Rajkumar, haematologist and oncologist at Mayo Clinic, in Minnesota, says: “This study provides encouraging data that treatment with plasma collected from patients who have recovered from COVID 19 treatment can work. Since collecting, storing, and giving plasma is routine process for blood banks, it’s something that is easy to do. It will also get increasingly easier as there are more and more people who recover from COVID-19.”

Meanwhile, the British Medical Journal has reported that the U.S. FDA has approved the use of plasma from recovered patients to treat people who are critically ill with COVID-19, ‘provided that doctors get approval over the telephone.’ The article added: The method has been used in the past to treat diseases such as polio, measles, and mumps, in the 1918 flu epidemic.

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