Shift focus from plasma therapy, say health experts

A blood sample being collected from a Dharavi resident who had COVID-19, to check for antibodies, and to collect plasma later for the treatment of patients in July 2020. Pic/Pradeep Dhivar

The latest study from Canada published in the international journal, Nature Medicine, has concluded that plasma therapy is not effective in the treatment of COVID-19; on the contrary, it leads to serious side effects and can cause death, say health experts.

The study from Montreal, published on September 9, studied 614 COVID-19 patients who were administered plasma therapy as compared to 307 patients who were provided standard care. The results of the study are an eye opener. At least 199 patients (32.4%) died in the plasma therapy group whereas 86 patients (28%) died in the standard care group.

Experts had first raised concerns about the therapy in mid-day's article on May 4, 2020, Plasma Therapy: To use or not to use.

Dr Wiqar Shaikh, professor of medicine, Grant Medical College and Sir JJ Group of Hospitals explained that the therapy involves removing plasma, which contains antibodies, from donors who have had COVID-19 and administering it to patients suffering from it.

Dr Shaikh had said in the mid-day article in 2020, that giving antibodies through plasma is of little value to the recipient, because in a viral infection, the main role of attacking and killing virus containing human cells is performed by specialized memory T-cells - the Natural Killer T cells (NK cells) and the Cytotoxic T cells.

He added, "The most common adverse events in the plasma therapy group as mentioned in the Nature Medicine study were worsening of oxygen levels, acute lung injury, respiratory failure and transfusion related breathlessness." Dr Shaikh recalled two large studies earlier this year which had conclusions similar to the Canadian study - the Concor trial published in the journal Trials and the Recovery trial published in the Lancet. Both studies concluded that plasma therapy did not reduce the risk of death and patients on it experienced more serious adverse events. Both studies concluded that plasma therapy was not associated with improvement in efficacy outcomes.

‘Used for new epidemics'

Dr Subhash Hira, professor of Global Health at University of Washington-Seattle and an invited member of WHO-Geneva Review Groups for COVID-19, said, "Interestingly, plasma therapy for a new viral epidemic has been used since the Spanish flu of 1918 that killed 5 crore people globally. It was again used against Ebola in 2004, H1N1 in 2008, and Nipah virus in 2018 with mixed results. The recent study in Nature Medicine once again endorses the lack of the effect of convalescent plasma therapy in the treatment of COVID. The study should re-focus governments that research should now be concentrated on finding new drug molecules to treat and cure SARS-COV-2 and that will be the best strategy to extinguish this pandemic."

‘Not just plasma'

Dr Santosh Bansode, head of the department, Emergency Medicine, Wockhardt hospitals, Mumbai Central, said, "I feel the government should not give up on the idea of setting up a plasma center. The government should develop a hi tech centre for production of blood byproducts which are important in treatment of various medical conditions. Human Albumin is one such blood product which has huge demand. It is used in treating patients with liver cirrhosis and patients with burns. Also platelet concentrate, packed red blood cells and plasma are useful in treating many conditions."

Dr Ketan Vaholkar, professor of surgery at DY Patil medical college said, "Convalescent plasma therapy had shown marginal yet debatable therapeutic benefit in isolated cases. However, there is now evidence to suggest that it has no therapeutic benefit in treatment of COVID-19."