Plasma Therapy and its use for COVID19 Treatment
Do you really think Plasma Therapy suppress the virus and helps COVID19 patients to survive? Let's learn more about this.
An energetic plasma donor, Alok Siddhi Tuladhar shared his experience of donating plasma 3 times since September last year and urged people to donate plasma to help ailing Covid-19 patients in the first plasma discussion held virtually on May 4, 2021 organized by Plasma Connect, Hamro Life Bank and Plasma Bank Nepal.
Since the second wave struck, there has been a sharp increase in demand for plasma, a component that makes up 55% of blood (the remaining 45% is composed of red blood cells, white blood cells and platelets). A transparent yellow liquid made of water, clotting factors, CO2, hormones, mineral ions, glucose, and dissolved proteins that include antibodies, plasma has been much talked about lately owing to its capability of supposedly healing Covid-19.
Plasma Therapy, also known as Convalescent Plasma Therapy (CPT) is a medical procedure that uses plasma from people who’ve recovered from COVID19 to help others recover. Plasma from donors who have recovered may contain antibodies to Serve Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) that may help suppress the virus and modify the inflammatory response. These antibodies, when transfused into patients infected with COVID19 are thought to exert an antiviral effect, suppressing virus replication before patients have mounted their own humoral immune responses.
Recently, a 6-months back research done by Nepal Health Research Council (NHRC) has shown the effectiveness of Plasma Therapy as 50% success rate. Prior to this, world widely this therapy was taken as a clinical trial to see if it reacts well to COVID19 patients to deal with it. On August 23, 2020, FDA issued an emergency use authorization (EUA) for COVID-19 convalescent plasma for the treatment of hospitalized patients with COVID-19. It mentioned CPT as an investigational product and is not currently approved or licensed for any indication. Following the on-going clinical trials, the FDA on March 9, 2021, further authorizes the emergency use of high titer COVID-19 convalescent plasma for treatment of hospitalized patients with COVID-19 based on the totality of scientific evidence available to FDA that it may be effective in treating COVID-19. Lately, with the updated data presented by National Institutes of Health (NIH) on April 21, 2021, the clinical trials did not demonstrate a benefit of CPT in hospitalized patients with COVID-19.
“Last year in September 2020, I was tested positive with COVID19. I donated blood (through which plasma was extracted) to one of the COVID19 patients. Few days later I received a call from patient and thanked me for donating plasma. After three months, in January, again I donated plasma through plasmapheresis at Himal Hospital. Today on May 2, again I came to Himal Hospital to check my antibody and it showed 91 counts. For the third time, I donated plasma.” — Alok Siddhi Tuladhar
Still, many countries are opting this therapy as a last stage support treatment despite many experts and scientists being against this treatment. Plasma Therapy is still an experimental procedure that has little evidence of its benefits as large-scale research hasn’t been done to show the accurate evidence of this treatment.
Despite the unproven and little evidence of plasma as a treatment for COVID19, there has been sheer increase in its demands in Nepal, and people are curious about whether or not they can donate it.
In order to donate plasma, there’s a series of eligibility criteria that one should fulfill. First of all, a person should have recovered from COVID-19. Then comes the following:
a) An individual should have fully recovered from the COVID-19 (followed by a negative PCR report) and must have been free from symptoms for more than 14 days. In the unavailability of a PCR report, 28 days past being symptoms free, one can donate plasma.
b) An antibody test in which plasma count should be over 18. Reports illustrate this as >18.
c) Age should be between 18–60 years.
d) Weight should be at least 50 kg.
e) Should not have donated blood or blood components in the past 28 days.
If you have recently taken any COVID-19 related vaccinations (either one or both doses), you have to wait for 15 days, then you are eligible to donate plasma. Also, if you are one who have recovered from COVID-19 within 6 months’ time-period, you must have taken an antibody count.
Who can’t donate Plasma?
a) Pregnant women or lactating mothers and women with children aren’t recommended to donate plasma. According to experts, during their pregnancy, women develop antibodies called Human Leukocyte Antigen (HLA). Once developed, they’re in blood forever. It is said if it is transfused to another person, it can cause a rare but serious complication called Transfusion-Related Acute Lung Injury (TRALI).
b) Severe type of cancers and heart disease patients.
c) People who are HIV positive and/or have other sexually transmitted infections (STIs) such as syphilis.
d) Hepatitis B or C carrier.
I was infected with COVID-19 on 2077/07. After 7 months of time, my total antibody level is 162. For plasma donation we just need to have antibody level of 18. We can donate plasma twice in a week and maximum upto 24 times a year. In single plasma donation, our plasma helps 2 covid patients. — Kiran Yogi, Incharge, Himal Hospital Blood Transfusion Center
How is plasma extracted from blood?
Plasmapheresis is a clinical procedure through which only plasma is extracted from blood and the rest is sent back to the body. The procedure takes up to 1 hour and extracts 600 ml of plasma from your body that can be transfused into two patients. A donor can donate multiple times (twice a week) until your body has the ideal antibody count (>18). Currently, only Himal Hospital in Kamalpokhari, Kathmandu practices this medium of plasma extraction. Grande International Hospital and Mediciti Hospital procure plasma extraction through normal blood donation, i.e., they extract plasma from the blood that is available. Once extracted or procured, plasma can be stored for upto a year in temperatures under -30 degrees.
So, you really shouldn’t have to wait for urgency to donate your plasma. You can get tested and do it right away as you could possibly save lives in these dire times!
At last, there isn’t a proper guidelines and criteria issued by the Ministry of Health and Population (MoHP), but still doctors at hospitals requests the relatives of patients to get the plasma in time. That’s how they get panicked to get the plasma and explore every possibility either sharing on social medias or asking favor with friends and relatives around. That’s how PlasmaConnect as a support platform was created to provide a right matching of plasma for the patients and manage donors.
Initiatives carrying out Plasma Collection:
- Red Cross Plasma Bank
- Plasma Connect Nepal
- Plasma Bank Nepal
- Hamro Life Bank
- Hamro Plasma
- Covid Plasma Help Nepal Network
On May 13, 2021, finally, Nepal Medical Council releases treatment guidelines where they have specified Convalescent Plasma. They have now not recommended Plasma Therapy in hospitalized patients with COVID19. Similarly, they included that there is insufficient evidence to recommend for or against convalescent plasma in ambulatory patients with mild or moderate COVID19.
Thus, PlasmaConnect along with many initiatives have halted their services.
This piece is written by Zenith Shah and Saurav Thapa Shrestha.
