ICMR permits Convalescent Plasma(CP) therapy in India

Convalescent plasma (CP) therapy,  a classic adaptive immunotherapy  has been applied to the prevention and treatment of many infectious diseases for more than one century. Convalescent plasma (CP) or Passive antibody therapy provides a person with already developed antibodies to fight corona virus. This plasma treatment holds injecting of blood plasma who have recovered from this infection, so that another patients immune system can boost up. These  antibodies are produced by immune cells “B lymphocytes” found in blood plasma.

Abstract:

Convalescent plasma (CP )theory was first used in 1918 during the Spanish influenza outbreak. Over the past two decades,  CP was successfully used in 2003 for severe acute respiratory syndrome (SARS) Covid Apedemic 1, in 2007 for influenza A (H5N1), 2009 when influenza A (H1N1)  pandemic with satisfactory efficacy and safety. An analysis from 32 studies of SARS coronavirus infection and severe influenza showed a statistically significant reduction in the pooled odds of mortality following CP  therapy,  compared with placebo. Since the virological and clinical characteristics share similariy among SARS, Middle East Respiratory Syndrome(MERS), and COVID-19,  CP therapy might be a promising thrapy to rescue COVID-19 patients. This is an old technique as horse serum is used for creating vaccine for diphtheria, tetanus and scarlet fever.

Testing results in positive response :

In Shenzhen, china used convalescent plasma on some patients and got encouraging results.  It was found that therapy was safe and it cleared 7 out of 10 patients. The British and American Trials have already begin   The Food and Drug Administration (FDA) have also approved the use of therapy.  One dose of200 mL of convalescent plasma(CP) derived from recently recovered donors with the neutralizing antibody titers above 1:640 was transfused to the patients as an addition to maximal supportive care and antiviral agents.  Radiological examinations showed varying degrees of absorption of lung lesions within 7 days.  This study showed CP therapy was well tolerated and could potentially improve the clinical outcomes through neutralizing viremia in  severe COVID-19 cases.

 

India gears up to begin Convalescent Plasma theory:

Kerala becomes the 1st state to start clinical trial of plasma treatment on coronavirus patients.  As per directives, donors will be those that recovered with no signs of the infection  for 2- 3 weeks.

The Post Graduate Institute of Medical Education and Research (PGIMER) in chandigarh will soon launch trials for plasma therapy for curing will test it in the COVID-19 patients. Dr Jagat Ram, Director, PGIMER told that the institute ill collaborate with another Covid-19 centre to launch the plasma therapy trials.

According to Manoj Murhakar director of Indian Institute of Epidemiology, “this  treatment will be for those who on ventilators and under clinical trial mode,  before being recommended for all patients”.   Meanwhile a recent research published by journal of the American Medical Association and Proceedings of National Academy  of Science ,United States of America (PNAS) has shown that a single dose of blood plasma can treat 10 patients.

Doners of Convalescent Plasma transfusion:

Ten donar patients who recovered from COVID-19 were recruited from three participating hospitals.  The criteria were as follows: 1) normalized temperature of body for more that 3 days, 2) resolution of respiratory tract symptoms, and 3) two consecutive negative results of sputum SARS- CoV-2 by  RT-PCR assay (1 –d sampling interval).

Is this “The Cure”

Convalescent Plasma is a stop gap measure until a better  treatment is available.  Its for hospitalized Covid patients who are not in critical position.  Nevertheless, the preliminary results of this trial seem promising and justifying.  The CP therapy  shows a potential therapeutic effect and low risk in the treatment of severe COVID-19 patients. One dose of CP with a high concentration  of neutralizing antibodies can rapidly reduce the viral load and tends to improve clinical outcomes.