Kerala Gets Nod for Trial of Plasma Therapy | 10 Apr 2020

Why in News

• Recently, Kerala has got the Indian Council of Medical Research (ICMR) approval for the clinical protocol exploring the feasibility of convalescent plasma transfusion which may be administered to severe Covid-19 patients.

Key Points

• A proposal was submitted to ICMR saying that the Transfusion Medicine Department of the Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala would help the Health Department in exploring the possibility of Convalescent Plasma (CP) therapy for Covid-19 treatment.
• The move was taken as a precautionary step to be prepared for the more severe second and third waves of the novel coronavirus pandemic.
• Kerala had also sought ICMR’s early clearance for using HIV antivirals (lopinavir/ritonavir) for treating Covid-19 after reports on their potential use surfaced.
• Kerala might need to submit an expanded access protocol to ICMR and Drugs Controller General’s approval and Institutional Ethics Committee approval would be necessary before the administration of the treatment.
• One major challenge is the non-availability of the kit for checking the antibody level in the plasma of a recovered person.
  
  • It is not available in India and has to be brought from Germany.
  • The cancellation of international flights would lead to delay in importing the desired number of kits.

Convalescent Plasma Therapy

• Convalescent plasma (CP) therapy is not a new therapy and banks on the age-old concept of passive immunity.
• Basis of the Therapy:
  
  • The convalescent plasma therapy seeks to make use of the antibodies developed in the recovered patient against the coronavirus.
  • The whole blood or plasma from such people is taken, and the plasma is then injected in critically ill patients so that the antibodies are transferred and boost their fight against the virus.
• Time Period for Infusion:
  
  • A study in The Lancet Infectious Diseases stated that a Covid patient usually develops primary immunity against the virus in 10-14 days.
  • Therefore, if the plasma is injected at an early stage, it can possibly help fight the virus and prevent severe illness.
• Infusion into Covid-19 Patients:
  
  • The plasma can be infused into two kinds of Covid-19 patients, those with a severe illness or individuals at a higher risk of getting the virus.
  • However, while plasma transfers immunity from one person to another, it is not known if it can save lives in Covid-19 infection.
  • The treatment could be effective for patients in the age group 40-60, but may be less effective for people aged beyond 60 years.
• Previous Application:
  
  • The United States used plasma of recovered patients to treat patients of Spanish flu (1918-1920).
  • Hong Kong used it to treat SARS (Severe Acute Respiratory Syndrome) patients in 2005.
  • In 2009, the Swine flu (H1N1) patients were treated with plasma.
  • It has also been used to treat critically ill patients during Ebola as well.
• The report of a study, Proceedings of National Academies of Sciences (U.S.), highlighted that CP therapy shows a potential therapeutic effect and low risk in the treatment of severe Covid-19 patients.
• According to the study, one dose (200 ml) of convalescent plasma with a high concentration of neutralising antibodies is well-tolerated by patients and it can rapidly reduce the viral load in patients and improve clinical symptoms significantly.

Source: TH