Hyderabad: How effective is convalescent
plasma therapy in Covid-19 management? While researchers say there is no significant difference, city doctors treating Covid-19 patients expressed mixed opinions. Some doctors said it is useful only in the first week of illness.
A recent research published in ‘European Journal of Internal Medicine’ after six randomised clinical trials involving 1,226 Covid-19 patients revealed that there was no significant difference between convalescent plasma and standards of treatment in mortality among patients.
It also said there was no significant difference in halting the progression of illness among patients, who were given plasma therapy.
Dr Pavan Gorukanti, director of Yashoda Hospitals, said: “As the clinical trial research on plasma therapy’s effectiveness in Covid-19 treatment is still in nascent stage, it is probably useful for moderate patients, particularly early in those who are infected. Plasma therapy should be best left to the discretion of physician after considering various stages of the disease and a patient’s underlying condition and potential comorbidities.”
He said it needs to be balanced by small risk of potential complications like transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload (TACO) and other transfusion-related reactions, particularly among the elderly who are weak. “It is definitely not a magical cure that some sections of the public seem to think. Probably at best, it would be an adjunct to the standard treatment,” he observed.
Plasma therapy is being pushed aggressively in the city. The Telangana Plasma Donors’ Association itself has done 6,000 plasma donations. Association president Gudur Narayana Reddy said: “We saw success with good antibodies present in recovered patients who donated their plasma for patients for the use of convalescent plasma therapy. One of my family members (a heart patient with comorbidities) recovered with treatment along with plasma therapy,” he said.
According to Dr Jagadeesh, senior physician, Medicover Hospital, the plasma of a recovered patient contains antibodies which help the patient fight against the pathogens. “This has helped many people to recover faster during the pandemic,” he added.
Dr K Subba Reddy, chief intensivist of Apollo Hospitals, said convalescent plasma is useful in the first week of illness if it is moderate, requiring hospitalisation and oxygen. “ICMR-PLACID trial and other trials did not show benefit if it is given in the late stage (second week). For patients on HFNC, BIPAP, ventilators and very sick patients with multiple organ failures, plasma won’t help,” he explained. He further said, “In the first wave, a lot of people used it thinking plasma was a magic bullet. But in the second wave, it is used only in a very selective group of patients.”