Woman (65), first in Noida to get plasma therapy, now home

NOIDA: A 65-year-old woman, the first Covid-19 patient in a Noida hospital to be administered convalescent plasma therapy, has made a full recovery and returned home, after spending most of May in hospital. She was among the more critical patients to be admitted and was on oxygen support.
The woman, who is from Agra, was treated at state-run Covid-19 hospital GIMS, under the second phase of the nationwide plasma trials.“We have successfully treated a 65-year-old patient from Agra with blood drawn from a Covid-19 patient who had recovered earlier,” said Brigadier RK Gupta (retired), director of GIMS.

The woman, who had hypertension and was overweight (comorbid factors in Covid-19 cases) had been admitted to GIMS from Metro Hospital after severe breathing problems. “The patient’s X-ray showed pneumonia and acute breathing problems and chronic lung disease. She was already on oxygen support when she was admitted,” said Dr Saurabh Srivastava, in charge of the Covid-19 ward at GIMS, who was handling the case.
On May 5, she tested positive. She was still dependent on oxygen support. “Twelve days after she was admitted here, we started plasma therapy. After two days of being administered convalescent plasma transfusion, she recovered,” said Dr Gupta. She was discharged a fortnight after testing positive.
The premise of plasma therapy is this — a person infected with Covid-19 develops antibodies to fight against the disease. “By the time the patient recovers, the blood develops rich antibodies. Those can boost another patient’s recovery,” said Dr Gupta. A recovered patient can donate plasma 28 days after full recovery and again 15 days after donation.
The protocol has been used for patients with SARS, Ebola and H1N1 and has been seen to improve survival rates of patients whose condition continued to deteriorate — much like the patient at GIMS. The Indian Council of Medical Research (ICMR), however, has not approved of the procedure as a treatment protocol on a wide scale and allowed limited number of controlled trials “for research”. The second phase of the countrywide trials began in the first week of May. The data that comes up, ICMR has said, can help research until the efficacy of the protocol as a treatment method can be established.
The guidelines call for plasma therapy only when a case turns moderately serious or critical, defined as cases in which patients need ventilators or oxygen support. The patient’s consent is imperative to beginning the procedure. Then, the hospital has to submit a list of cases for which it thinks the trial can begin to ICMR, which takes a call on whether medication should continue or plasma therapy be introduced. Once that approval is in, the hospital can begin treatment. “All information about the treatment has to be updated on the ICMR site, with a complete history of the patient’s case and recovery status,” said Dr Srivastava.
In Noida, GIMS was the first Covid-19 hospital to apply for plasma therapy trials in April last month. The approval came through and on May 11, it got its first two plasma donors — a 30-year-old man from Bisnoli village in Dadri and a 30-year-old man from Accheja in Greater Noida. Both had been treated at GIMS. They donated 400ml units of plasma each. So far, the hospital has had five donors. One donor’s plasma can be used to treat two patients, Dr Gupta said. The hospital had asked another patient, a man from JJ Colony Sector 8, if he would also join the trial but he had declined. He recovered after 28 days of being on medication.
Of the 128 actives cases in Noida — 54 each at GIMS and Sharda Hospital and 20 at Child PGI — 14 are serious. Seven are at GIMS, five at Sharda and two at Child PGI. Of the three, only GIMS has approval for plasma therapy.
When a patient turns serious, sustained oxygen support of 12-13 litre per minute is immediately started along with a combination of medicines. Age is a factor while considering line of treatment, as are comorbid conditions (having more than one disease like diabetes, anxiety, hypertension, depression, among others) and respiratory problems (asthma, bronchitis, chronic pulmonary fibrosis, rheumatoid lung disease) — it would take longer for such patients to respond to treatment. These are cases considered for plasma therapy.