Can the convalescent-plasma therapy save us from Coronavirus?

Convalescent plasma therapy has proven to be instrumental in defeating H1N1 and Ebola virus infections in the past, will it save us from coronavirus this time?

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Well, it seems there is. Have you heard about convalescent-plasma therapy? If a pathogen like a novel coronavirus infects a human, the first and foremost responsibility of our immune system is to produce antibodies. Like the security officers in our locality, the antibodies reach out to identify and track the infectious virus. White blood cells encapsulate the detected intruders, and the body can get rid of the infections over time by regulating its temperature and completing the life cycle of the virus in question. The lifecycle of this particular virus is around 5-30 days depending upon viral load, the person in question, immunity of the person and health of the host. The convalescent-plasma therapy, like a blood transfusion, yields the serum from a patient that had the viral infection and generated antibodies for it. The serum is administered into a sick patient and the immune system, assisted by the antibody, wages vigorous battle against the virus. The chances of survival increase manifolds and can eventually help in combating urgent cases.

How is the treatment administered to a sick patient?

Blood is drawn from a person that has recovered from the illness caused by COVID-19. The plasma is isolated and tested for antibodies to neutralize the virus. The convalescent serum, which is the blood serum acquired from a patient that has recovered from an infectious disease and is especially rich in antibodies against that pathogen, is then given to a COVID-19 patient who might be in serious condition. The patient gets a passive immunization. “Potential donor would be examined before the blood serum is extracted and given to a sick person. First, the swab test must be negative and the potential donor has to be declared as cured. Then the recovered person has to wait for two weeks. Or else the potential donor should be asymptomatic for at least 28 days. Either of the two is mandatory” said Dr. Kishore while speaking with India Science Wire.

Who will be receiving the treatment?

“Initially we will try in a small number of patients. At present, it is permitted as an experimental therapy for restricted use for severely affected patients only. We will be getting informed consent before they are recruited. This will be conducted as a clinical trial” said Dr. Kishore. COVID clinics of five medical college hospitals will be partnering”.

Is this a new treatment?

Earlier in 1890, Emil von Behring, a German physiologist, found that the serum derived from a rabbit afflicted with diphtheria was effective in the prevention of diphtheria among other rabbits who are susceptible to the disease. Behring was awarded the first Nobel Prize in medicine in 1901. Around that time, antibodies were not identified. Convalescent serum treatment was less successful and had serious side effects. It took several years before the fraction of the antibody could be isolated. Also, unwanted antibodies and impurities produced side effects that were difficult to control.

Challenges with the therapy?

Although the treatment seems promising are some issues which have to be dealt with before administering it to anyone:

  • Only individuals whose blood group matches will donate or can accept blood
  • The donor has to undergo tests for infections like HIV, tuberculosis, and so on to ensure that they do not spread any other pathogen to the recipient.
  • The positive result of plasma transfusion is realized within the first three to four days, if the patient does not recover, then it becomes really difficult to save the person
  • Receiving large quantities of plasma from patients is a difficult task
  • For illnesses caused by COVID-19, where most people are elderly, suffer from other medical problems such as asthma, diabetes, and so on, not all patients that have been treated can volunteer to donate blood.

The silver lining

In the year 2009–2010 outbreak of the H1N1 influenza virus pandemic, patients with an illness needing intensive care were treated with this treatment. During passive antibody therapy, serum-treated patients demonstrated clinical progress beyond expectations. The viral strain was reduced and the mortality rate decreased drastically. The technique was also effective during the 2018 Ebola outbreak.

This treatment has shown that even deadly diseases like Ebola can be contained which is far more deadly than COVID-19. But as we all know the present pandemic has already overwhelmed our health care system and the economy, how successfully we would be able to harness antibodies from recovered patients is still a question that needs to be answered. But, it is assuring that we have a probable cure that has worked in the past and has been effective in solving real-world problems. The trials of untested vaccines and drugs can take ages but this therapy can become the tool for success against the Novel Coronavirus.

Further readings:

Recommendations for Investigational COVID-19 Convalescent Plasma

Effectiveness of convalescent plasma therapy in severe COVID-19 patients