Plasma therapy: To use or not to use...

While trials on plasma therapy for COVID19 continue they have sparked debate among medical professionals While one set of experts feels that plasma therapy can work wonders with a supportive line of treatment the other set opines that it is too premature to make such claims without thorough clinical evidenceInterestingly the first set of experts is now further puzzled as to whom they should administer plasma therapy Thats because of the high risk involved as COVID19 patients may still have existing ailments that may not respond well to plasma therapyThe concern was raised after the recent death of a 52yearold man who was given plasma therapy at a Mumbai hospital The man had comorbidities and was on ventilator supportDr Anoop Kumar consultant and chief of Critical Care Medicine at BM Hospital CalicutPremature to consider itDr Asha Kishore medical director Sree Chitra Tirunal Institute for Medical Sciences and Technology Thiruvananthapuram said While there have been a few reports of convalescent plasma therapy being effective in treating COVID patients unless there is a clinical study it is premature to consider it as an accepted form of treatment It should be considered experimental therapy and should be monitored and regulated by the health ministry Even data from China is too limited to confirm successful experiment of plasma therapyOur transfusion medicine department has applied for participation in a clinical trial of convalescent plasma for the treatment for COVID19 called by the Indian Council of Medical Research ICMR The ICMRs sponsored trial will be conducted to evaluate the safety and efficacy of convalescent plasma in patients with moderate COVID19 infection We are awaiting approval said Dr AshaAgainst immunology principleDr Wiqar Shaikh senior allergy and asthma specialist who had treated the 52yearold Byculla resident who was treated at home and recovered from COVID19 said Plasma therapy means giving antibodies from a COVID cured patient to one still suffering from it This is not within the principle of immunology When a person has a viral infection the first reaction of the bodys immune system is to form IgM Immuno Globulin M antibodies and IgG Immuno Globulin G However these are not the important defences against a virus When the virus enters a body it does so by mistake and cannot survive within the body and hence enters a cell to survive Dr Shaikh added The COVID virus is an RNA virus which cannot replicate on its own it requires the cell apparatus to multiply Whenever the immune system identifies a virus containing cell two types of cells are activated Both are Tlymphocytes the first category is the cytotoxic Tlymphocyte and the second is the Natural Killer NK Tlymphocyte both of which destroy the virus containing cell using bodily chemicals called perforins and granzymes This cytotoxic and NK cells develop a memory for the virus within the body and when the person gets infected with the same virus again the memory cytotoxic and NK cells launch an immediate attack and kill the virus Therefore antibodies plasma therapy has a very poor role in defence against COVID and hence is of no use claims Dr ShaikhDr Asha Kishore medical director Sree Chitra Tirunal Institute for Medical Sciences and Technology Thiruvananthapuram There are no doubleblind placebocontrolled trials anywhere in the world of plasma therapy actually helping in recovery of serious COVID patients Moreover such clinical research is a welcome move but it takes months or years of painstaking research said Dr ShaikhIn favour of plasma therapyDr Anoop Kumar consultant and chief of Critical Care Medicine at BM Hospital Calicut said The Kerala government was concerned about the rapid rise in COVID19 cases and called for a meeting of wellknown health professionals in Kerala on March 20 At the meeting it was agreed to make use of plasma therapy as we have come across case studies of successful results in China South Korea and other countries However it is yet to be published in the international journalPlasma therapy has been effective in various virus outbreaks in the past such as Nipah virus in 2018 H1N1 in 2008 and even the 1918 flu outbreak said Dr Anoop adding We intend to collect plasma from patients who have recovered from COVID19 For instance a 55yearold recovered patient can donate around 800ml of plasma from the blood and this can save four lives with a mere 200 ml of plasmaHowever donor protocol mandates that the donor should not have any fever or foreign travel history or respiratory infection and should have remained in selfisolation for 14 days post discharge and the swab collected after selfquarantine period should be negative200Quantity in ml of plasma required for treatmentCatch up on all the latest Mumbai news crime news current affairs and a complete guide from food to things to do and events across Mumbai Also download the new midday Android and iOS apps to get latest updates MidDay is now on Telegram Click here 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