A coronavirus patient was able to come off ventilation just two days after receiving the blood plasma of people who have recovered from the virus in a breakthrough described as "remarkable" by scientists. The Daily Telegraph reports that the first trials looking at whether antibodies of people who have successfully fought the virus can help others do the same found that all 10 severely ill patients made a speedy recovery.
The treatment, known as convalescent plasma (CP) therapy, was used during the 1918 Spanish Flu pandemic before vaccines or antivirals were available. It relies on the fact that the blood of people who have recovered contains powerful antibodies trained to fight the virus.
Researchers from the Shanghai Jiao Tong University School of Medicine said the findings suggest blood plasma therapy is a safe and promising treatment for severe COVID-19 patients, and called for larger clinical trials.
However, British experts said larger studies were needed to be sure that the treatment was safe and effective before being widely rolled out. Sir Munir Pirmohamed, the president of the British Pharmacological Society, said: "This was not a randomised trial and all patients also received other treatments, including antivirals such as remdesivir, which are currently in trials for COVID-19."
Sir Munir added that it was also important to remember that there are potential safety concerns around the treatment, including diseases that occur through transfusion. He said: "Even if shown to work, scalability to treat large numbers of patients may become an issue."
The pilot study involved 10 patients, aged between 34 and 78, who showed severe symptoms such as shortness of breath and chest pain. All received a transfusion of a 200ml dose of blood plasma and the researchers said all clinical symptoms, which also included fever and cough, subsided within three days.
Abstract
Currently, there are no approved specific antiviral agents for novel coronavirus disease 2019 (COVID-19). In this study, 10 severe patients confirmed by real-time viral RNA test were enrolled prospectively. One dose of 200 mL of convalescent plasma (CP) derived from recently recovered donors with the neutralizing antibody titers above 1:640 was transfused to the patients as an addition to maximal supportive care and antiviral agents. The primary endpoint was the safety of CP transfusion. The second endpoints were the improvement of clinical symptoms and laboratory parameters within 3 d after CP transfusion. The median time from onset of illness to CP transfusion was 16.5 d. After CP transfusion, the level of neutralizing antibody increased rapidly up to 1:640 in five cases, while that of the other four cases maintained at a high level (1:640). The clinical symptoms were significantly improved along with increase of oxyhemoglobin saturation within 3 d. Several parameters tended to improve as compared to pretransfusion, including increased lymphocyte counts (0.65 × 109/L vs. 0.76 × 109/L) and decreased C-reactive protein (55.98 mg/L vs. 18.13 mg/L). Radiological examinations showed varying degrees of absorption of lung lesions within 7 d. The viral load was undetectable after transfusion in seven patients who had previous viremia. No severe adverse effects were observed. This study showed CP therapy was well tolerated and could potentially improve the clinical outcomes through neutralizing viremia in severe COVID-19 cases. The optimal dose and time point, as well as the clinical benefit of CP therapy, needs further investigation in larger well-controlled trials.
Authors
Kai Duan, Bende Liu, Cesheng Li, Huajun Zhang, Ting Yu, Jieming Qu, Min Zhou, Li Chen, Shengli Meng, Yong Hu, Cheng Peng, Mingchao Yuan, Jinyan Huang, Zejun Wang, Jianhong Yu, Xiaoxiao Gao, Dan Wang, Xiaoqi Yu, Li Li, Jiayou Zhang, Xiao Wu, Bei Li, Yanping Xu, Wei Chen, Yan Peng, Yeqin Hu, Lianzhen Lin, Xuefei Liu, Shihe Huang, Zhijun Zhou, Lianghao Zhang, Yue Wang, Zhi Zhang, Kun Deng, Zhiwu Xia, Qin Gong, Wei Zhang, Xiaobei Zheng, Ying Liu, Huichuan Yang, Dongbo Zhou, Ding Yu, Jifeng Hou, Zhengli Shi, Saijuan Chen, Zhu Chen, Xinxin Zhang, Xiaoming Yang
[link url="https://www.telegraph.co.uk/science/2020/04/07/blood-recovered-coronavirus-victims-helps-patient-come-ventilator/?WT.mc_id=e_DM1231333&WT.tsrc=email&etype=Edi_FAM_New_ES&utmsource=email&utm_medium=Edi_FAM_New_ES20200408&utm_campaign=DM1231333"]Full report in The Daily Telegraph[/link]
[link url="https://www.pnas.org/content/early/2020/04/02/2004168117"]PNAS abstract[/link]