President Donald Trump on Sunday approved an emergency authorization of convalescent plasma for coronavirus patients on August 23. The World Health Organization says using plasma from the recovered to treat Covid-19 is still considered an “experimental” therapy and that the preliminary results showing it may work are still “inconclusive.”
Dr. Thomas File, President Infectious Diseases Society of America explains how the therapy works.
“If you can take that part of the blood after a patient has convalesced from a specific infection, in this case, Covid-19, they should have a large amount of antibodies in there. And then if you take that part and infuse it into patients, particularly early in an infection with Covid, the antibodies in that amount of the transfusion of the plasma can interact with the virus of the patient, reduce the virus, neutralize the virus, and hopefully reduce the consequences of infection.”
Dr. File says randomized clinical trials are crucial.
“I really think that this convalescent plasma, when given appropriately to the appropriate patient, looks promising. But we just need the results of these randomized clinical trials to show that, to prove it. So to make sure that when we give this, that we’re giving the benefit without potential harm. Although quite honestly, at least in that large observational study from Mayo Clinic of, I don’t know, 30,000 patients, for the most part, it was well tolerated. The real question is going to be, is it really beneficial and when is it beneficial? And we need the randomized clinical trials to tell us that.”
He adds that therapy would be most beneficial given early in the course of the infection
“My feeling is that this, theoretically or at least pragmatically, would be an intervention that would most benefit the patient when given early in the course of the infection. Now, mainly we’re talking about somebody who developed symptoms. It’s those patients that are starting to develop fever and the pneumonias. And early in the course, if we can get the antibodies to reduce the consequences of the infection, then I think we can most benefit the patients.”
WHO’s chief scientist Dr. Soumya Swaminathan said convalescent plasma therapy has been used in the last century to treat numerous infectious diseases, with varying levels of success.
Swaminathan says WHO still considers convalescent plasma therapy to be experimental and said it should continue to be evaluated. She added that the treatment is difficult to standardize, since people produce different levels of antibodies and the plasma must be collected individually from recovered patients.
Swaminathan says that the studies have been small and provided “low-quality evidence.” She says countries can “do an emergency listing if they feel the benefits outweigh the risks” but that that’s “usually done when you’re waiting for the more definitive evidence.”
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