Introduction
As the whole world is suffering from corona virus pandemic so for that the most successful treatment till date is plasma therapy. So, we should know what plasma therapy actually is? In scientific language, it is called convalescent plasma therapy (Kon-Vuh-Les-Unt PLAZ-Muh) in which antibodies present in serum or blood are used to fight against the infection.
Recently, this therapy is widely used for COVID-19 pandemic as there is no FDA approved drug or vaccine is available. Dr.Cassadevall was the first one who used convalescent plasma therapy for the treatment of corona virus. In this therapy people who recovered from COVID-19 develop some antibodies against the virus to fight with infection. Blood from the recovered patient is taken and transferred to seriously ill COVID patients to provide antibodies against the virus.
History
Convalescent plasma therapy was first introduced in the 19th century by physiologist Emil von Behring and bacteriologist kitasato Shibasaburo. In 1930s passive antibody therapy used to treat both viral and bacterial infections like pneumonia, meningitis, measles. Behring got the Nobel prize in 1901 to treat diphtheria by using serum/ plasma.
What Is Convalescent Plasma Therapy?
This therapy aims to treat critically affected patients by the virus by using antibodies from the blood of recovered COVID-19 patients. The concept is simple and similar to passive immunization. According to researchers, it can be a preventive measure but not a successful treatment for the COVID-19. Many drugs are being used for treating COVID-19. Among them, the oldest treatment which is proved to be somewhat successful is the convalescent plasma therapy.
Now the somehow the question arises in our mind what is plasma? So, plasma is the liquid portion of blood that remains after the removal of all WBC, RBC, and platelets through the process of centrifugation or plasmapheresis.
Plasma is the largest part of your blood. It makes up more than half (about 55%) of its overall content. When separated from the rest of the blood, plasma is a light yellow liquid. Plasma carries water, salts, and enzymes.
The key component used for the treatment of infection in plasma is antibodies. Antibodies are Y shaped molecule which is synthesized exclusively by the β-cells and mostly bivalent in nature.
Recent Work on Plasma Therapy
Approximately sixty clinical trials have been enrolled worldwide to study the effect of convalescent plasma therapy on COVID-19 patients. for the trial, approximately 500ml plasma is taken from the recovered patient and injected intravenously to the infected patient.
The research was published in the American Journal of pathology. In which researchers applied convalescent plasma therapy on 25 patients and gives a conclusion. And According to researchers, this therapy may be a safe treatment option until the vaccine or proper drug is not discovered.
Plasma Therapy in India
Pune was the first city of India where plasma therapy has successfully done. A senior doctor from Sasson general hospital in Pune used plasma therapy firstly on 47-year-old women who were in critical condition including hypertension, hyperthyroid, and obesity. Women were convalescent plasma therapy twice and the condition of the women is improved and show negative against coronavirus within 14 days.
Approximately 38 institutions all over India get permission by the Indian Council of Medical Research (ICMR) to conduct phase 2 clinical trials to check the safety and efficacy of convalescent plasma therapy for the treatment of moderate to serve cases of COVID-19 pandemic. And the name of this project is PLACID i.e. A phase II, open-label, randomized clinical trial of convalescent plasma therapy.
List of the institution:
- NHL Municipal Medical College, Ahmedabad
- J. Medical College and Civil hospital, Ahmedabad
- Government Medical College, Bhavnagar
- Government Medical College, Surat
- GMERS Medical College, Vadodara
- Sawai Man Singh Medical College, Jaipur
- Mahatma Gandhi Medical College and Hospital, Jaipur
- Santokba Durlabhji Memorial Hospital, Jaipur
- S.N. Medical College, Jodhpur
- Satguru Pratap Singh Hospital, Ludhiana
- Christian Medical College, Ludhiana
- Dayanand Medical College, Ludhiana
- Guru Gobind Singh Medical College and Hospital, Faridkot
- Sri Guru Ram Das Institute of Medical Sciences and Research Amritsar
- J. Government Medical College, Pune
- Poona Hospital and research center, Pune
- Sir H. N. Reliance Foundation Hospital and Research Centre, Mumbai
- Rajarshee Chhatrapati Shahu Maharaj Government Medical College and CPR Hospital Kolhapur
- TMC & BYL Nair Hospital. Mumbai Kasturba Hospital, Sane Guruji Marg, Arya Nagar, Chinchpokli, Mumbai
- Government Medical College, Nagpur
- Madurai Medical college, Madurai
- Madras Medical College, Chennai
- Tirunelveli Medical College Hospital, Tirunelveli
- Christian Medical College, Vellore
- Gandhi Medical College, Bhopal
- Mahatma Gandhi Memorial Medical College, Indore
- Chirayu Medical College and Hospital, Bhopal
- Government Institute of Medical Sciences, Noida
- Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow
- Super Speciality Paediatric Hospital and Post Graduate Teaching Institute, Noida
- Institute of Medical Sciences, Hubli
- Mysore Medical College, Mysuru
- Hassan Institute of Medical Sciences, Hassan
- Mandya Institute of Medical Sciences, Mandya,
- Gandhi Medical College, Telangana
- ESIC Medical College, Hyderabad
- Postgraduate Institute of Medical Education and Research
- Lady Hardinge Medical College
In Delhi, for 2nd phase clinical trial approximately 20 patients have been undergone plasma therapy and get recovered. Then Delhi got the center’s approval for the 3rd phase trial of plasma therapy with approximately 200 patients.
recently Delhi government announced to the opening of India’s first plasma bank in ILBS Hospital for COVID-19 patients
Delhi govt will start a plasma bank https://t.co/8DIqHadS6J
— AAP (@AamAadmiParty) June 29, 2020
Procedure
Firstly, select a donor who has recovered from the COVID-19 and had been tested negative for COVID-19 two times. After that, those persons considered as a donor for giving plasma. also, they should be asymptomatic from the last 14 days.
Further, explain those rules to the donor which is necessary and a standard protocol for any blood donation. further, the person is checked for hepatitis B, hepatitis C, and HIV. Once these tests come negative, the donor is again tested for COVID-19 and the test result has to be negative. And then checked the patient history. Patients should not have any chronic medical illnesses. The donor must be age between 18-65 years.
After taking blood from the donor the sample is separated through plasmapheresis (it is a process in which liquid part of the blood, or plasma, is separated from the blood cells). This plasma can be stored at a low temperature of around -30 °C for almost up to a year.
Further, according to the need, approximately 500ml of plasma is delivered to the COVID positive patient through intravenously under the medical supervision
side effects
- Allergies and anaphylactic reaction
- Transfusion-related acute lung injury (TRALI)
- Difficulty in breathing
- Transfusion-associated circulatory overload
Other less common side effects are:
- Transmission of infection
- Febrile non-hemolytic transfusion reactions
- RBC alloimmunization
- Hemolytic transfusion reactions
- Fluid overload and citrate toxicity
- Renal toxicity and aseptic meningitis
Conclusion
As there is no drug or vaccine approved by the FDA for the treatment of COVID-19. Plasma therapy proves to be quite beneficial especially for the patients who are several affected by the virus. Meanwhile, plasma therapy somehow improves the ability of patients to recover from the disease. Collectively we can say that the therapy shows effective against COVID-19. Researchers evaluate the results from people who received the therapy. they said it is beneficial somewhat unless the proper vaccine is not discovered.
As the whole world suffers from COVID-19 pandemic we hope that we get an approved drug or vaccine for this deadly virus treatment soon.