In a critical development, the Indian Council of Medical Research (ICMR) has given its approval to Kerala for a clinical protocol that explores using convalescent plasma transfusion as a potential treatment for severe Covid-19 patients. This move positions Kerala in the forefront of India’s battle against the relentless pandemic.
The Proposal and Impending Challenges
The Transfusion Medicine Department of the Sree Chitra Tirunal Institute for Medical Sciences and Technology proposed this protocol to ICMR. The proposal stated that the institute would aid the Health Department in investigating the potential application of Convalescent Plasma therapy for treating Corona virus. It was designed as a preparatory action in anticipation of more severe second and third waves of the pandemic.
However, there are pertinent challenges in implementing this protocol. A primary obstacle is the unavailability of kits used to measure antibody levels in the plasma of recovered patients. These kits, not available in India, need to be imported from Germany. The current international travel restrictions could potentially hinder the timely import of these kits.
Kerala’s Proactive Approach to Covid Treatment
Moreover, due to recent reports regarding its potential effectiveness against covid-19, Kerala requested ICMR’s approval to employ HIV antivirals (lopinavir/ritonavir) as a part of the treatment protocol. An expanded access protocol would need to be submitted to ICMR for this purpose. Approvals from the Drugs Controller General and the Institutional Ethics Committee would also be required before these treatments can be administered.
Understanding Convalescent Plasma Therapy
Convalescent Plasma therapy isn’t novel. It uses the concept of passive immunity which involves transferring antibodies from recovered patients into critically ill ones, thereby bolstering their response against the virus.
According to a study in The Lancet Infectious Diseases, a Covid-19 patient develops immunity against the virus within 10 to 14 days. Thus, early administration of plasma may help in combating the virus and preventing severe illness. However, its effectiveness in saving lives and its efficacy in patients above 60 years of age remains uncertain.
Historically, this therapy has been used in treating multiple outbreaks like the Spanish flu (1918-1920), Severe Acute Respiratory Syndrome (SARS) in 2005, Swine flu (H1N1) in 2009, as well as critical Ebola patients.
Efficacy of Convalescent Plasma Therapy
A report from the Proceedings of National Academies of Sciences (U.S.) suggests that Convalescent Plasma therapy could hold promising results. It indicated that a single dose (200 ml) of convalescent plasma containing high concentrations of neutralising antibodies was well-tolerated by patients. Its administration was associated with a rapid reduction in viral load and significant improvement in clinical symptoms. This adds to growing evidence suggesting the potential therapeutic effect and low risk associated with this treatment strategy for Covid-19 patients.
As we continue to navigate through these challenging times, such innovative and potentially life-saving approaches are indispensable in the global fight against Covid-19.