Plasma Therapy For COVID-19: A Possible Treatment For Coronavirus?

Plasma therapy: ICMR, DGCI are working to give approvals for it in critically ill COVID-19 patients

In a first, a COVID-19 patient undergoing treatment at a private hospital in New Delhi has shown positive results to Plasma Therapy. The 49-year old was critically ill and was administered fresh plasma as a treatment modality along with standard treatment protocol on the night of 14 April. Post therapy, his condition improved and he was taken off ventilator support by the fourth day.

In a press release shared by the hospital, Dr Sandeep Budhiraja, Senior Director of Internal Medicine at Max Healthcare, said, "During the patient's treatment, other standard treatment protocols were followed and we can say that plasma therapy could have worked as a catalyst in speeding up his recovery. We cannot attribute 100% recovery to plasma therapy only, as there are multiple factors which carved his path to recovery."

What is convalescent plasma therapy?

The convalescent plasma therapy aims at using antibodies from the blood of a recovered COVID-19 patient, to treat those who are critically ill after being infected with the virus. The concept of the therapy is based on the premise that the blood of a patient who has recovered from COVID-19 contains antibodies with the specific ability of fighting this novel coronavirus. The recovered patient's antibodies can be injected to someone under treatment. They will then begin targeting and fighting the novel coronavirus in the second patient.

What are the prerequisites for using plasma therapy?

According to Dr Deven Juneja, Associate Director at the Institute of Critical Care Medicine, Max Healthcare, "To use plasma therapy, there are specific criterion laid down by the US FDA, which include that the patient should be a confirmed case of COVID-19, the family members and the patient should give consent for this therapy and clinically, the patient should have a severe disease or any life-threatening problems. These problems may include breathlessness, dropping of oxygen levels, need for mechanical ventilation, low blood pressure or presence of multiple organ failure."

"This therapy has a good potential to help COVID-19 patients who have disease severity which fits into moderate to severe category. One donor can donate 400ml of plasma which can save two lives, as 200ml is sufficient to treat one patient," informs Dr Budhiraja. 

What is the right time to use plasma therapy for COVID-19 treatment?

Dr Juneja says, "Research suggests that the best results from the plasma therapy can be obtained when it is used within the first 14 days of symptoms. After that, chances of recovery are low as there can be permanent damage to some organs of the body, etc."

Are there are any risks associated with plasma therapy?

"No serious side effects have been reported with the plasma therapy. There could be minor risks which are associated with transfusion of blood", Dr Juneja informed.

Is plasma therapy a new therapy?

"Studies have shown that plasma therapy has been effective in Ebola and in other coronavirs infections like MERS and SARS," says Dr P Raghu Ram, President of the Association of Surgeons of India.

"Only small number of studies have been done in COVID-19 patients world over and in these limited studies, plasma therapy has been found to be effective. However, thus far, no definitive large-scale trials have demonstrated its proven benefit. There are now several trials being undertaken in several countries including USA and China to assess the efficacy of this therapy," Dr Ram added. " The Drugs Controller General of India (DCGI) has recently given the go ahead for Indian Council of Medical Research (ICMR) to assess the efficacy of convalescent plasma therapy and its role in limiting the complications in COVID-19 patients."

How plasma therapy works as part of COVID-19 treatment?

"It is not wise to expect miraculous recovery after the therapy," says Dr Juneja while adding that at least 72 hours are required for the patient to show a response to this therapy. Some patients may take up to 10 days, he says.

Here are some symptoms to show that the therapy is effective in a patient:

• The patient's oxygen requirement is reduced.
• Chest x-ray becomes better.
• Patient experiences improvement in breathing.
• The patient no longer require support from mechanical ventilation.
• Viral load decreases after the therapy. "Our patient tested positive twice before he was given this therapy. After the therapy, he was tested negative," Dr Juneja explained.

Are there chances of the virus coming back after testing negative?

According to Dr Juneja, there have been a few reports of patients becoming positive again but it's exact cause remains unknown. This could be due because of the following reasons: 

1. Re-infection - Catching the infection from someone who was positive

2. Re-activation - Maybe the virus was inactive for a few days and became active again

3. False-positive

"For plasma therapy, we are taking plasma after at least 28 days of clinical recovery of the donor, or at least 14 days after his RT-PCR samples have been tested negative for COVID-19. That's how we are choosing a donor," says Dr Juneja.

In a video message shared by Dr Budhiraja, he stressed that patients who have recovered from the novel coronavirus and are now healthy should willingly come forward to donate plasma as it can be life saving for many other patients who have not been as lucky.

Government approval awaited

Both ICMR and DGCI are working at a fast pace to give regulatory approvals and clearances for using plasma therapy in critically ill COVID-19 patients. "In fact, both the organisations have uploaded protocols on their website," Dr Budhiraja says while adding, "We are hoping for the approvals to happen in the next few days. After that, a lot of centres in the country can use plasma therapy as an important part of treatment for critically ill patients. It does show positive response in a subset of patients."

(Dr Sandeep Budhiraja, Group Medical Director - Max Healthcare and Senior Director - Institute of Internal Medicine)

(Dr Deven Juneja, Associate Director, Institute of Critical Care Medicine, Max Speciality Hospital, Saket)

(Dr P Raghu Ram, President of the Association of Surgeons of India)

Disclaimer: Plasma therapy is not proven to be coronavirus cure, it is only being tested as one. This content including advice provides generic information only. It is in no way a substitute for qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.