What is convalescent plasma?
Researchers, scientists, laboratories and medical experts continue to test and develop COVID-19 vaccines with potential and are in the early stages of making them available. However, the midst of the pandemic and the second wave of the coronavirus disease COVID-19 is in full swing. Other effective treatments are still needed in the interim to help our most critical patients.
One option that is being used is convalescent plasma, which simply means the fluid component of blood from someone who has recovered from an illness. In the case of COVID-19, recovered patients have antibodies within their plasma that can attack the coronavirus and can potentially help the sickest patients get better.
Historically, plasma has been transfused between recovered and ailing patients when new diseases or infections develop quickly, and new or no other options are available. The U.S. Food and Drug Administration has authorized limited use of plasma to treat critically ill COVID-positive patients in conjunction with regional blood and plasma donation centers and health systems. This treatment is well-known as it was used in similar, more recent situations, like SARS.
As a physician who works with vulnerable patients, I place an order for plasma with our Wisconsin blood supplier, who actively collects plasma from recovered COVID-19 patients. As physicians, we have specific criteria for which of our patients would be the best candidates for this plasma based on their clinical diagnosis, symptoms and presence of two chronic diseases or conditions. The team’s first patient was an elderly man who fit the criteria and would be the best option for him to avoid needing a ventilator due to his other medical conditions. We made sure the family and patient understood what this option entailed, answered their questions and got their consent before proceeding.
Once we receive the plasma for our patient, we administer it like how other plasma or blood transfusions are normally done in our hospital and system. The plasma transfusion procedure entails an IV inserted into the patient’s vein. Through the IV, the patient begins to receive the new plasma, approximately 250cc of plasma (one unit) over a period of 2-3 hours. Usually it takes a few days to see if the plasma has offered any benefit to a patient.
The COVID-19 convalescent plasma protocol calls for 2 doses on 2 consecutive days, however we hold the second dose if dramatic improvement occurs after 1 dose. Our patient referenced above only needed one dose as he stabilized and began improving. (He is doing well now and back at his nursing home.) There isn’t enough data yet on outcomes, but there is anecdotal evidence that there is benefit when given early. There are currently clinical trials being done to demonstrate true benefit.
Since that first treatment our Advocate Aurora Health system has treated over 2,300 patients in our Illinois and Wisconsin communities using over 3,200 units of plasma. With this current COVID-19 surge there is even further of a demand for plasma to help our most vulnerable and critical patients affected by this disease.
The biggest need is to have more patients who have recovered from COVID-19 donate plasma so the sicker patients in our hospitals can have a chance at recovery and eventually go home to their families.
Have you recently recovered from COVID-19 and interested in donating your plasma? Check out our Illinois and Wisconsin partner Versiti Blood Center’s website and the American Red Cross in Illinois for eligibility criteria and how to apply to be a donor.
About the Author
Dr. Ajay Sahajpal is a board-certified transplant surgeon at Aurora St. Luke’s Medical Center in Milwaukee, WI.