No antibiotics, plasma therapy to treat adult COVID patients: govt

Subject : Science and technology

Section: Health

Concept :

The COVID19 National Task Force of the Union Health and Family Welfare Ministry on Sunday issued revised clinical guidelines for the management of adult COVID19 patient.
As per the new guidelines, convalescent plasma therapy and drugs, including lopinavir-ritonavir, molnupiravir, favipiravir, azithromycin and doxycycline, are not to be used for treatment.

About Convalescent Plasma Therapy (CPT)

Patients who have recovered from a disease have permanent antibodies generated by the immune system floating in their blood plasma, the liquid component of blood.
To turn that into a drug, the plasma is harvested, tested for safety, and purified to isolate those protective antibodies.
When injected into a new patient, the plasma-derived therapy, provides “passive immunity” until the patient’s immune system can generate its own antibodies.

Recent Use of CPT

The United States used plasma of recovered patients to treat patients of Spanish flu (1918-1920).
Hong Kong used it to treat Severe Acute Respiratory Syndrome (SARS) patients in 2005.
In 2009, H1N1(Swine Flu) patients were treated with CPT.
Convalescent serum was also used in the 2013 West African Ebola epidemic.
A protocol for treatment of Middle East respiratory syndrome (MERS) coronavirus with convalescent plasma was established.

Process

The process to infuse plasma in a patient can be completed quickly. It only requires standard blood collection practices, and extraction of plasma.
If whole blood is donated (350-450 ml), a blood fractionation process is used to separate the plasma.
Otherwise, a special machine called aphaeresis machine can be used to extract the plasma directly from the donor.
While blood is indeed extracted from the donor, the aphaeresis machine separates and extracts the plasma using a plasma kit, and the remaining blood components are returned into the donor’s body.

WHO Guidelines Regarding CPT

WHO guidelines in 2014 mandate a donor’s permission before extracting plasma.
Plasma from only recovered patients must be taken, and donation must be done from people not infected with HIV, hepatitis, syphilis, or any infectious disease.
If whole blood is collected, the plasma is separated by sedimentation or centrifugation, then injected in the patient.
If plasma needs to be collected again from the same person, it must be done after 12 weeks of the first donation for males and 16 weeks for females.

Chance of Success in case of COVID-19 Treatment

The treatment has been successful in other disease outbreaks.
As a disease develops, the body has already begun developing antibodies against the virus.
Infusing convalescent plasma is essentially like topping with more antibodies hoping that increased amount of antibodies will dampen the disease progression.
Antibodies in the plasma bind to the virus and prevent them from entering the cells.
But by the time it is given, many cells have already been infected. Hence, convalescent plasma therapy might not prove effective against COVID-19 treatment.