While the medical community continues to be divided on the issue of plasma therapy while treating COVID-19 patients, here's what these four doctors have to say.
The Better India has launched a ‘Plasma Donor Registration‘ drive to encourage those eligible to sign up for donations and provide a single-point resource for those looking for Plasma donations.
Blood Plasma Therapy can help prevent COVID-19 patients from going onto ventilators and is helpful in specific timeframes for those infected by the Coronavirus.
We will verify the details of those signing up for the donations and highlight their availability and region, so those in urgent need can get the help they need as soon as possible. If you, or someone you know, has recovered from a COVID-19 attack in the parameters mentioned below, kindly do consider signing up.
Amid the second wave of the coronavirus pandemic, numerous posts and stories have flooded social media, seeking assistance in acquiring plasma from recovered COVID-19 patients for convalescent plasma (CP) therapy. In light of insufficient oxygen tanks, Remdesivir injections, as well bed facilities and ventilators, people are pinning their hopes on plasma therapy to cure themselves or their loved ones.
As India grapples with this grim crisis, the confusion about the efficacy of plasma continues to loom. Over the last year, several studies and the medical fraternity have produced contradictory results. For example, the Indian Council of Medical Research (ICMR) warned against its indiscriminate use. But the same study has said it may work if the patient is given plasma within the first 3-7 days of the onset of symptoms. Meanwhile, a report by medRxiv said that CP, aka plasma, therapy was effective in reducing hospital stay and addressing the low blood oxygen levels.
The immune system of COVID-19 survivors has new antibodies which attack the virus. With time, these antibodies develop further and find their way into plasma, which is the liquid portion of the blood. In several countries, including India, frontline workers are using plasma to tackle the deadly virus in absence of a concrete treatment as cases continue to claim lives.
The Better India speaks to four doctors to understand whether plasma therapy should be the preferred method of treatment for COVID-19.
- Dr Vishal Rao, Chief of Head & Neck Surgical Oncology & Robotic Surgery at HCG Cancer Centre, Bengaluru
- Dr Om Srivastava, Director Infectious Disease, Jaslok Hospital & Research Centre, and a member of Mumbai’s COVID-19 task force
- Dr Bharat Gopal, Senior Consultant, Pulmonology of Fortis Hospital Vasant Kunj
- Dr Preetam Ahirrao, Pulmonologist & Consulting Physician, Critical Care Medicine, Nasik
‘Don’t give up on plasma’
Since 2020, Dr Vishal Rao has prescribed plasma therapy to over 1,000 patients, 60% of whom benefited from it.
In the below video, he addresses the most important question — ‘Why is the medical fraternity divided over the efficacy of plasma donation?’ He also talks about the crucial role of antibodies and when is the right time to resort to plasma therapy.
Asked how can India successfully adopt CP-based therapy, he says, “Every state must set up a Standard of Protocol (SOP) and establish a plasma bank, to begin with. Every person recovering from the infection must come forward and give blood to test the level of antibodies. A simple awareness programme about who is eligible can be launched to talk about why donors can become true plasma warriors. Each person can save up to three lives and it is a great service to humanity.”
The HCG hospital had set up a toll-free number last year where it helped people get plasma. The team, comprising Dr Ashish, Dr Sachin Jadhav and Dr Shalini Thakur headed by Dr Vishal, looked after everything, from attending calls, running the plasma machines to keeping the patients motivated.
‘Timing is important’
According to Dr Om, there is an 80% chance for patients to recover from COVID-19 if plasma therapy is administered at an appropriate time. He says, “Last year we had done a pan-India Platina trial to test if plasma was working effectively. However, only samples of severe patients were taken into consideration. Their saturation levels were either through the roofs or they were on ventilators. We realised we need to start early and refined the process to get better results.”
Dr Om shares his experience of treating patients with plasma and if there is a need for India to rush to donate plasma.
Dr Bharat Gopal, Senior Consultant, Pulmonology of Fortis Hospital Vasant Kunj, also emphasises on timing of the treatment. He says, “Convalescent plasma has been a therapy devised to passively transfer antibodies from a recovered person to a new patient. While the therapy has been received with different opinions by the medical community, the important aspect is timing.”
He explains, “It’s better if plasma therapy is used early before clinical worsening and therein lies the problem of correct patient selection. Also, plasma with high titre neutralising antibodies would have better results. Hence to achieve good results, correct patient selection, timing and a good quality plasma donor are three ingredients for success in this form of treatment.”
‘Plasma therapy should be the last resort’
Over the last couple of months, Dr Preetam Rao has received a plethora of requests from people to use plasma therapy to ‘cure’ their loved ones. Although, according to him, plasma therapy should be the ‘last resort’. However, he has not denied this therapy to his patients who fall under the mild to moderate category.
“There is no conclusive evidence that states if plasma therapy is working or not yet. According to the Maharashtra government, the protocol to treat patients includes Remdesivir, oxygen therapy but not plasma. So, I have used plasma only in the absence of Remdesivir, oxygen therapy and blood thinner medicines. However, in my experience, the patients who received plasma didn’t get better,” says Dr Preetam.
He further adds, “There are two phases of infection. The best time to give plasma is in the first stage, i.e. the viral phase, when the virus is active in the body. Plasma will not work at all once the cytokine storm or inflammation takes over.”
It may take a while before there is a consensus on the efficacy of plasma therapy in treating COVID-19, so it is advisable to follow your doctor’s orders. Experts are still of the opinion that not all patients are eligible to receive plasma, such as those on ventilators or experiencing multi-organ failure.
Edited by Yoshita Rao