Blood plasma from recovered COVID-19 patients is still an experimental treatment. here’s why

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The World Health Organization warns that the use of plasma collected from the blood of patients who have recovered from COVID-19 remains an experimental treatment, stressing the need for better data, especially from a large trial ongoing in Canada.Plasma is the yellowish liquid component of blood rich in proteins and antibodies. It has been used to treat people in previous epidemics, including the SARS and MERS coronaviruses and as far back as the 1918 influenza pandemic.

Earlier this week, the US Food and Drug Administration gave emergency approval to extend use of plasma to help hospital patients with COVID-19 after President Donald Trump appeared to exert political pressure on the agency via Twitter.

Supporters of the treatment claim that plasma from recovered patients may help current COVID-19 patients early in their illness, because the plasma contains the protective antibodies of the immune system that work specifically against this virus.

For the treatment to use, a blood donor who has recovered from COVID-19 is given a needle in both arms while their blood is drawn and placed in a sterile machine that separates the plasma portion. This plasma is then administered to a current COVID-19 patient.

WHO chief scientist Soumya Swaminathan said on Monday the data was not convincing enough to endorse its widespread use.

“The trials have been relatively small and the results in some cases indicate some benefit, but were inconclusive,” Swaminathan told reporters.

WATCH | The Potential of Plasma to Fight COVID-19:

Coronavirus survivors are joining the fight against COVID-19 by donating their antibody-rich plasma, which can be useful in helping others fight the virus. 2:07

Trump pointed to data from a large U.S. program led by the Mayo Clinic in which more than 70,000 COVID-19 patients received plasma infusions to support the expansion of treatment.

Dr. Donald Arnold, Professor of Medicine at McMaster University in Hamilton, co-chairs the Canadian clinical trial test whether convalescent plasma is an effective treatment for COVID-19.

Arnold said that since the US data did not include a comparison with other care options, there is no way yet to tell if plasma improved outcomes better than standard care. This is what his trial is about.

Politicize plasma

Plus, the standard of care for COVID-19 is changing, Arnold said, as other treatments appear to be working in a randomized trial.

Data from the United States and other countries suggests that convalescent plasma is relatively safe, but Arnold said he is watching for possible adverse events such as worsening lung damage and circulatory overload from excess fluids.

There are several examples of treatments that looked attractive in the first data, but were not found to be effective, says Dr. Donald Arnold, who is leading Canadian trials using blood plasma from recovered patients to treat COVID-19 . (Submitted by Dr. Donald Arnold)

Arnold is also concerned about the politicization of plasma, as was previously treatment with hydroxychloroquine. Both have been used to treat other illnesses, but neither have been proven effective against COVID-19.

“Hydroxychloroquine is a good example,” he said. “There are other examples of things that look really appealing and the first data might suggest that it works, but later, once the data is entered and all the testing has been done, it actually did. not worked or was potentially dangerous. ”

Arnold hopes that plasma will be an effective treatment for COVID-19. He just wants to be sure it is.

Intuitive appeal

Richard Carl shares this hope. He and most of his family fell ill with COVID-19 while traveling in the United States

When Carl recovered at Sunnybrook Health Sciences Center in Toronto at the end of March, he signed up as a patient representative for the Canadian clinical trial and donated his plasma for the effort.

Carl said the idea behind convalescent plasma made intuitive sense, but it wasn’t good enough in medicine.

“It is intended to put the rich antibodies of a cured patient into a sick patient and to effectively boost his immune system. So it is a treatment. It’s not a cure, ”Carl said.

He urged other patients who recovered to show up to participate in the clinical trial.

Arnold said the team is taking a slow and steady approach to all the details of the trial, which is expanding to include other countries with more cases than Canada. The results are months away.

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