EDITORIAL ANALYSIS ! 01 MAY 2020 !! { Convalescent Plasma Therapy }


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Convalescent Plasma Therapy

The COVID-19 pandemic has posed unprecedented challenges to governments, health professionals and the general public at large, around the world.

The health community across the world is looking at plasma or antibody therapy to battle COVID-19. Convalescent plasma has been listed as a therapeutic method by China’s National Health Commission.

In India, many states have sought and received the approval of ICMR for convalescent plasma therapy. But so far, ICMR does not recommend it as a treatment option outside clinical trials.

Convalescent Plasma Therapy

Convalescent plasma (CP) therapy is an age-old concept of passive immunity.

The convalescent plasma therapy seeks to make use of the antibodies developed in the recovered patient against the coronavirus.

The whole blood or plasma from such people is taken, and the plasma is then injected in critically ill patients so that the antibodies are transferred and boost their fight against the virus.

Other important functions of plasma

Removal of waste from cellular functions that help to produce energy.

Plasma accepts and transports this waste to other areas of the body, such as the kidneys or liver, for excretion.

Plasma also helps maintain body temperature

Approval for the clinical protocol

Recently, Kerala has got the Indian Council of Medical Research (ICMR) approval for the clinical protocol exploring the feasibility of convalescent plasma transfusion which may be administered to severe Covid-19 patients.

Four patients have been enrolled in Ahmedabad and the study will be rolled out in 20 hospitals by the end of this week and at more centres over the next month.

Risks Involved in Plasma Therapy

Transfer of blood substances: As the blood transfusion takes place, there are risks that an inadvertent infection might get transferred to the patient.

Effect on immune system: The antibody administration may end up suppressing the body’s natural immune response.

This will leave a Covid-19 patient vulnerable to subsequent re-infection.

Need for more research

The most important principle in medical ethics is “do no harm”.

The transfusion of convalescent plasma is also not without risks, which range from mild reactions like fever, itching, to life-threatening allergic reactions and lung injury.

To recommend a therapy without studying it thoroughly with robust scientific methods may cause more harm than good.

After China and the US, India has given a go ahead for framing a protocol to conduct a clinical trial for convalescent plasma therapy.

Has Plasma therapy been used earlier

According to the WHO, the experience in the past suggests that the empirical use of convalescent plasma can be a potentially useful treatment for COVID-19.

The method ‘Convalescent Serum Therapy’ dates to 1918; when it was used during the outbreak of the Spanish Flu.

After which it has been used in 2005 during the SARS epidemic.

According to the medical journal The Lancet, it was used to improve the survival rates of patients.

In 2009 it was used for H1N1 patients, 2014 for those infected by Ebola in 2014 and in 2015 for MERS patients in different parts of the world.

Other serious outbreaks that have seen the use of this therapy are the SARS outbreak, Measles, HIV, polio and mumps.

Way forward

To overcome the pandemic comprehensively, we should focus on strengthening health systems at all levels, including referral systems, supply chain, logistics and inventory management.

Government needs to work on protecting our healthcare workers, improving prevention methods,effective quarantining and accurate testing.

Pushing one or the other therapy without evidence or caution can only set back our larger fight against COVID-19.

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