Scientists are testing whether blood plasma from coronavirus survivors could prevent infection in others.
Survivors of COVID-19 donate their blood plasma in hopes that it will help other patients recover from the coronavirus.
It is still not entirely clear whether or how much plasma from recovered patients increases the chances of survival for those still battling viruses, but if it is preventive, it could be a huge untapped resource if the U.S. battles to get a second one Suppress wave.
"We have a glimmer of hope," said Dr. Shmuel Shoham of Johns Hopkins University, who is starting a study with 150 volunteers to find out if the plasma rich in immune cells can prevent infection.
Aubrie Cresswell, 24, of Delaware, is among the 20,000 survivors of the American coronavirus who donated convalescent plasma. Scientists now hope that plasma can prevent coronavirus infection and help treat it
Thousands of coronavirus patients in hospitals around the world have been treated with so-called convalescence plasma, including more than 20,000 in the United States, with little solid evidence to date that this makes a difference. A recent study from China was unclear, while another from New York offered an indication of benefit.
Dr. Starts Stricter Plasma Treatment Tests Shoham is a nationwide study that poses the next logical question: could administering plasma to survivors immediately after exposure to the high-risk virus prevent disease?
To say it, researchers at Hopkins and 15 other locations will recruit health workers, spouses of the sick, and nursing home residents who have just become sick and "they are trying to nip it in the bud," Shoham said.
It's a rigorous study: the 150 volunteers are randomly selected to receive either plasma from COVID-19 survivors that contains antibodies against coronaviruses, or normal plasma that is used daily in hospitals and that is frozen before the pandemic has been. Scientists will track whether there is a difference between who gets sick.
If it works, the survival plasma could have important effects before a vaccine arrives – increasing the prospect of potentially protecting people at risk with temporary immune-boosting infusions from time to time.
"They're medics, they're cops, they're poultry workers, they're submarine officers," Shoham ticked off.
"Can we provide blanket protection for them?"
The new corona virus has infected more than seven million people worldwide and killed more than 400,000 people, according to official estimates that are underestimated.
With no good treatments yet, the researchers are desperately investigating everything from anti-viral drugs to survival plasma – a centuries-old means of fighting infections before modern drugs came onto the market.
The yellowish, liquid component of blood, plasma (picture) contains immune cells, including antibodies. Antibodies can both fight and block infections, so plasma from COVID-19 survivors can help prevent infections
The corona virus has triggered a barrage of rapid research and development, but in a way it has taken the world back to pre-modern medicine. There are no proven treatments (though remdesivir seems to help) and no medication to prevent this.
Scientists are rapidly working to change this. Hydroxychloroquine is being studied both as a treatment and as a prevention – and was taken for this purpose by President Donald Trump.
WHAT IS PLASMA DERIVED THERAPY?
The therapy derived from plasma is based on the blood plasma of people who have recovered from the coronavirus.
Plasma is the fluid that transports blood cells, nutrients and hormones through the blood vessels and makes up about half of the total blood.
It also contains antibodies, proteins that the body makes to destroy bacteria or viruses when they cause an infection.
If someone has never been exposed to a virus or bacteria – as is the case with anyone who is infected with the corona virus – they have no antibodies and become ill during the time it takes for their body to manufacture them.
Injecting antibodies from someone who has already made them saves time and helps the patient fight off the disease more quickly.
So far, the evidence for hydroxychloroquine has not been encouraging.
Researchers at the University of Minnesota found that people who were treated prophylactically with the malaria drug were no less likely to develop coronavirus. In addition, the drug has potentially dangerous cardiac side effects.
At least plasma has a long track record of safety, if not consistent effectiveness.
Historical evidence is sketchy, but the best-known use of convalescent plasma was during the 1918 flu pandemic, and reports indicate that recipients are less likely to die.
Doctors are still dusting off the approach to tackling surprise outbreaks such as SARS, a cousin of COVID-19, in 2002 and the Ebola epidemic in West Africa in 2014, but even the most recent applications have lacked rigorous research.
When the body encounters a new germ, proteins, known as antibodies, are created that are used specifically to fight the infection. The antibodies float in the plasma – the yellowish, liquid part of the blood.
Since it takes a few weeks for antibodies to form, there is hope that transfusion of other patients' antibodies can help patients fight the virus before their own immune systems start working. A donation is usually split into two or three treatments.
And as more and more people survive COVID-19, they are increasingly being asked to donate plasma so that there are enough supplies if it fails.
In addition to conventional infusions, donations can be combined into a high-dose product. The manufacturer Grifols is producing cans of this "hyperimmune globulin" for a study that is expected to start next month.
Convalescence plasma appears to be safe, Dr. reported Michael Joyner from the Mayo Clinic last month.
His team tracked the first 5,000 plasma recipients in a program sponsored by the Food and Drug Administration to help hospitals apply the experimental treatment and found few serious side effects.
Not every plasma is the same. Scientists are testing vials of donated blood and plasma like this to determine which ones are the richest in antibodies
Researchers at Mt Sinai Hospital in New York compared each of the 39 plasma recipients with four other COVID-19 patients who did not receive plasma, but were of the same age, were just as sick, and received the same amount of oxygen.
People who received plasma before they needed a ventilator died less than non-plasma receivers, Dr. Sean Liu, the lead author of the study.
"We really tried to address patients who were beginning their course, preferably within the first week or two of their illness," said Liu.
"As a doctor, you just feel helpless during this time," Liu added, stressing that more stringent studies were needed, but he was glad to have tried this first research study.
“Seeing people die is heartbreaking. It is scary and heartbreaking. & # 39;
His work has made him optimistic about plasma treatment, but the results of the first strictly controlled study have been disappointing.
Hospitals in the severely affected Chinese city of Wuhan compared seriously ill patients who were randomly given plasma or regular care but had no new patients when the virus subsided.
With only half of the 200 planned patients, more plasma recipients survived, but the researchers were unable to determine whether it was a real difference or a coincidence last week, according to a report in the Journal of the American Medical Association (JAMA).
The real evidence will come from ongoing, rigorous studies comparing patients who have been given either survival plasma or sham treatment.
COVID-19 survivors further complicate the search for answers and contain very different amounts of antibodies. And while researchers want to use what Hopkins & # 39; Shoham calls "the high octane stuff," no one knows which dose is best to test.
"Approximately 20 percent of recovered patients and donors have very strong immunity," estimates Dr. Michele Donato of Hackensack University Medical Center is studying how long they can maintain this level of protection.
These are the people who want researchers to become repeat donors.
"I think it is our job as people to move forward and help in society," said Aubrie Cresswell, 24, of Bear, Delaware, who has donated and counts three times.
A donation was sent to a friend of a friend in the hospital and that brought me to tears. I was overwhelmed just because the family was really grateful. & # 39;
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