Skip to main content

Plasma transfusion in COVID-19

Plasma transfusion in COVID-19

(Dr Raheel Iftikhar, FCPS Medicine, FCPS Clinical hematology, FACP)


For information of general colleagues and health care providers. 
There is undue hype created for use of convalescent plasma in COVID-19. Few facts which we need to keep in mind 
1. Use of convalescent plasma in  severe and critical SARS-CoV2 disease is against basic principles of immunology. Passive immunization works early in disease and for post exposure prophylaxis. It is not helpful in full blown disease. For example if you give immunoglobulin to patients with full blown rabies , tetanus, polio it will not work.

2.  Median time for clearance of viremia is 11-14 days in studies , so if disease is this much old , no significant viral load will be available to be neutralized by convalescent plasma.

3. Cause of death in most of  COVID patients is CRS and HLH , virus sets proinflammatory pathways and itself clears away , so in these patients Convalescent plasma won't work. 

4. Currently there is no scientific evidence supported by randomized trial to suggest survival benefit of convalescent plasma in moderate to severe COVID-19. 

5. COVID-19 antibody titre is not done except 1-2 places in Pakistan and only IgG testing is done , which is insufficient to check whether sufficient antibodies are generated in donor. Moreover NAT screening ( essential to prevent viral transmission like HEPATITIS, HIV) is not done by majority of centres . We are likely to see a large number of patients recieving plasma  developing transfusion transmitted infections

6. Another thing is prothrombotic nature of COVID, giving plasma will be adding insult to injury

7. Use of Convalescent plasma is only allowed by FDA , and Govt of Pakistan as an investigational therapy as part of clinical trial, legally it cannot be administered without enrolling patient into that trial. 

Considering above facts , there is no rationale of use of plasma therapy as it is currently being offered in Pakistan. It can be potentially more harm ful to patient than beneficial. 






Comments

  1. An evidence based proof. This should be shared with people all over the world as we saw in Pakistan, many are busy promoting plasma transfusion as 1st line treatment.

    ReplyDelete

Post a Comment

Please don't comment Links, Addresses and Spam Comments.

Popular posts from this blog

China wants to see Pakistan lead Muslim countries

  China wants to see Pakistan lead Muslim countries China says Pakistan is the only Muslim country with a nuclear power that wants to lead the Muslim world, diplomatic sources said. China wants Pakistan to lead the Muslim world. According to the details, China raises its voice in support of Pakistan at every opportunity. Once again, China has raised its voice in support of Pakistan. Diplomatic sources say that China wants Pakistan, the only nuclear power among Muslim countries, to lead Muslim countries. It is currently circulating in the media that China is going to form a new bloc in the region and China's inclination towards Iran is also a link in the same chain. Beijing is close to finalizing a 25-year strategic partnership agreement with Tehran over a 400 billion investment. China has an important opportunity to increase its importance in Muslim countries in order to increase its influence in the region. Pakistan did not even attend the Kuala Lumpur summit under pressure

President Trump's re-offer of mediation to India and China

  President Trump's re-offer of mediation to India and China The first contact between the two countries' defence ministers in Moscow was that Russia could be a key player in a ceasefire because of the close ties between the two countries. Beijing has turned down an offer of US mediation, while India has also shown no interest. India and China are moving more aggressively than expected. US President talks to journalists. US President Donald Trump says US would be happy to help resolve dispute between India and China on the western Himalayan border. Speaking to reporters in Washington, President Trump said the situation between the two countries on the disputed border is extremely tense. He said that India and China were moving more aggressively than expected. Meanwhile, the British Broadcasting Corporation quoted senior diplomatic sources as saying that Washington was not in a position to mediate due to tensions in Sino-US relations. However, Russia has friendly relations w

Teacher should be like this: During exams, the student was busy in her paper and the teacher take care of her child.

  Teacher should be like this: During exams, the student was busy in her paper and the teacher take care of her child. A picture has been going viral in recent days, in which a teacher is holding a child in his arms in the examination hall while all the students present there are seen solving their papers. This picture is not an ordinary picture, people are calling it the best picture of the year 2020 of Afghanistan. This picture is actually of Kabul University. In one of the halls, the students are busy solving the exam papers. It so happened that a student had brought her four-month-old son with her but he was crying a lot, which made it difficult for the student to solve the exam paper. Instead of solving the exam paper, the student was trying to silence her child. When the teacher in the examination hall saw this scene, he came forward and picked up the child. At the same time, he grabbed the child's feeder, so that he could drink it calmly and be quiet, at the same time the