Coronavirus Survivors' Antibodies Needed, Mount Sinai Doctor Appeals For Volunteers

Grant Boone
March 30, 2020

A preliminary study released Friday found that blood serum from people who recovered from coronavirus was effective at treating critically ill patients, raising hope that the technique will curtail a pandemic that has already killed more than 30,000 people around the globe.

Use of convalescent plasma was recommended as an "empirical treatment" during outbreaks of Ebola, as well as MERS, and other research in SARS and H1N1 influenza suggested "transfusion of convalescent plasma is effective", they said.

As the U.S. Food and Drug Administration (FDA) works to facilitate expedited access to several investigative drug interventions to treat COVID-19 patients, one particularly promising treatment is now set to enter clinical trials in NY. "The intervention, administration of convalescent plasma, was not evaluated in a randomized clinical trial, and the outcomes in the treatment group were not compared with outcomes in a control group of patients who did not receive the intervention".

In an accompanying editorial, John Roback, MD, PhD, and Jeannette Guarner, MD, both of Emory University School of Medicine in Atlanta, said that while "the donor plasma had demonstrable IgG and IgM anti-SARS-CoV-19 antibodies and neutralized the virus in in vitro cultures", because the plasma was administered up to 3 weeks after hospital admission, "it is unclear whether this timing is optimal or if earlier administration might have been associated with different clinical outcomes".

According to the agency, within four to eight hours, the FDA will reply to many other demands. Complications prior to plasma transfusion included severe ARDS, and bacterial pneumonia in two of five patients and one patient was receiving extracorporeal membrane oxygenation (ECMO). The other two are in stable condition 37 days following plasma transfusion.

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Scaling may also be an issue with this approach, with the editorialists noting, "the deployment of convalescent plasma will have limited reach because transfusions are typically performed in hospital settings and may require large infusion volumes".

Dr Gail Muflin, NHS Blood and Transplant's medical director and a consultant haemotologist, said the United Kingdom planned to start "providing plasma from recovered people to hospitals as treatment" for Covid-19 "in the very near future".

Mr Cuomo said: "We think it shows promise, and we're going to be starting that this week".

The FDA advises physicians to address various donor eligibility considerations, including a previous diagnosis of COVID-19 documented by a laboratory test; complete resolution of symptoms at least 14 days before donation; negative female donors to HLA antibodies or male donors, and negative COVID-19 results from one or more nasopharyngeal swab specimens or by a molecular blood diagnostic test.

At this point, though, there is no proven cure for COVID-19, the disease caused by the new coronavirus, which has since sickened more than 500,000 people worldwide. It is also planning to purify coronavirus antibodies from plasma for further clinical testing against the disease. "What some people have thought is, could there be an inflammatory response with the virus that we would initially see these patients worsen?" she said. When I was at the FDA, I helped tackle the SARS epidemic.

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