Around the world, researchers and clinicians have shifted their focus to one subject: COVID-19. New treatments and trials are launching every day, all with the potential to stop coronavirus in its tracks. While we look forward to developments in fighting this pandemic, many are searching the past for possibilities.
Case reports from the 1918 Spanish Flu describe the use of blood product transfusions in reducing risk for death and improving symptoms. Such treatments have been documented throughout the 20th century and more recently, sophisticated transfusion techniques including the use of convalescent plasma, have been used in response to the outbreak of both Middle East Respiratory Syndrome coronavirus (MERS-CoV) and Ebola.
Although the efficacy of convalescent plasma has not yet been proven in clinical trials, many hope that it can be effective in treating patients with COVID-19.
According to Joseph Uberti, M.D., Ph.D., division chief, Hematology and co-director, Bone Marrow & Stem Cell Transplant Program at Karmanos Cancer Institute, “(Convalescent plasma) is not proven for this disease, but we are trying to see if this is one way we can help overcome the bad outcomes in some of our patients. There is some information showing that people who have had a COVID-19 infection and recovered from it now have antibodies in their plasma which can help to treat the virus in somebody else.”
There is preliminary data from a small group of patients from China showing that convalescent plasma may be effective in helping critically ill patients recover. Currently, a much larger study is underway at hundreds of hospitals across the country. Data from infused patients will be collected and analyzed to determine efficacy.
In late April, Asif Alavi, M.D., member of the Malignant Hematology and Bone Marrow & Stem Cell Transplant Multidisciplinary teams at Karmanos Cancer Institute performed a convalescent plasma transfusion — the Institute’s first in response to COVID-19. This one-time infusion took place in the hospital over the course of about an hour.
“Our hope is that COVID-19 convalescent plasma will be an effective antibody-based treatment for the virus,” said Dr. Alavi.
The patient who received the transfusion will be monitored by physicians at Karmanos and included in the larger US study examining convalescent plasma transfusions.
While there is promise in the use of convalescent plasma, the treatment must overcome a major hurdle: availability of plasma. Donors must meet set criteria, including the requirement that they be 28 days post-recovery. This timeline, as well as hesitation among recovered patients, has created a long delay in the process.
“I clearly understand how patients might not want to do this because they have been through a lot with the COVID infection but … other patients may be treated successfully with this,” said Dr. Uberti.
Individuals interested in donating plasma can find more information at www.karmanos.org/DonateRedCross.