Max Hospital doctor who oversaw blood plasma treatment in COVID-19 patient in Delhi


Explains how the therapy works



A 49-year-old patient was admitted to Max Super Speciality Hospital, Saket on the 4th of April exhibiting moderate symptoms of COVID-19. By the 8th of April, he was in respiratory failure and required ventilator support. The hospital was following procedures laid down by the Ministry of Health and Family Welfare; he was being treated for symptoms and was on the hydroxychloroquine and azithromycin combination as well.


Still, he wasn’t getting better. This is when the family stepped in and requested the hospital to try convalescent plasma therapy on compassionate grounds since it is still an experimental technique in the context of COVID-19. They managed to find a donor, and on the 14th of April, the transfusion took place.


Both of the patient's parents had also contracted the novel coronavirus. While, unfortunately, his father passed earlier this month, his mother has recovered.

MyUpchar spoke with Dr Sandeep Budhiraja, Group Medical Director, Max Healthcare and Senior Director, Institute of Internal Medicine, who oversaw the blood plasma treatment, to find out more about the procedure.


The promise and limits of plasma therapy


“Plasma therapy can be attempted in cases that are moderate to severe. The patient, in this case, was experiencing respiratory distress, had developed acute pneumonia, and was not responding to other medication. It is not a therapy that will work if the patient is on the brink, though,” Dr Budhiraja explained.


When asked if plasma therapy can be used preventively or prophylactically, the doctor said that this was not the purpose of its application. “Plasma therapy can be thought of as an added support to the body when it is overpowered by an acute infection. Antibodies from an external source may strengthen the body’s attack on the pathogen and help the patient overcome a difficult situation”, he said.


Who can donate blood plasma?


Convalescent plasma therapy, or passive antibody therapy, involves taking the blood plasma of a recovered patient and transferring it to an infected person. The antibodies produced by the survivor persist in the body for a period of time (depending on the infection) and provide varying degrees of immunity by mounting a swift attack should the body encounter the pathogen again.


“In this case, the donor had previously been infected with COVID-19 and subsequently tested negative twice. A healthy and suitable donor is one with no underlying conditions and who has been declared negative for at least two weeks. We also checked for Hepatitis B, C and HIV, all of which were clear,” he said.


He added that serological (or antibody) tests could not be performed, but it was reasonable to assume that the donor had sufficient antibodies since they had cleared the disease.


The recovery


The patient seemed to respond well to the treatment and was gradually weaned off the ventilator on the 18th of April. As of Sunday, April 19, he was able to eat and has since tested negative. “However, it is important that we also understand that plasma therapy is no magic bullet. During the patient’s treatment, other standard treatment protocols were followed. Plasma therapy could have worked as a catalyst in speeding up his recovery. We cannot attribute the recovery to plasma therapy completely, as there are multiple factors which carved that path,” the doctor added.


This is where clinical trials come in - controlled studies assign causality and will help us to understand to what extent plasma therapy can work. Trials are ongoing in India and abroad. Plasma therapy could be promising until a vaccine is produced. Cases such as these may spur scalability initiatives; blood banks could identify and take plasma from COVID-19 survivors to provide for compassionate cases and clinical trials.


Source - FIRST POST

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