What is Convalescent Plasma Therapy ? | UPSC

• After the country’s largest such trial, known by the acronym PLACID, found that convalescent plasma was ineffective in arresting Covid-19.

• However, in several most-affected states -Maharashtra and Delhi, health authorities continue to push the option .
• While those running plasma blood banks promote it with anecdotal accounts on social media.

WHAT IS THIS THERAPY?

• Plasma is the liquid part of the blood.

• The therapy involves using their plasma to help others recover.
• For Covid-19, this has been one of the treatment options.
• The donor would have to be a documented case of Covid-19 and healthy for 28 days since the last symptoms.

DURING THE PROCEDURE

• When the plasma arrives, the sterile plasma bag is attached to the tube and the plasma drips out of the bag and into the tube.
• It takes about one to two hours to complete the procedure.

AFTER THE PROCEDURE

• The patient will be closely monitored after they receive the convalescent plasma.
• Thee doctor may record how long the patient needs to stay in the hospital.

RISKS

• Blood has been used to treat many other conditions. It’s usually very safe.

• But researchers believe that the risk is low because donors have fully recovered from the infection.
• The risk of such infections is low. Donated blood must be tested for safety.
• Some people may have mild complications or none at all.
• Other people may have severe or life-threatening complications.

Convalescent plasma therapy has some risks, such as:

• Allergic reactions
• Lung damage and difficulty breathing
• Infections such as HIV and hepatitis B and C

WHAT HAS HAPPENED TO SPARK THE DEBATE?

• The results of the PLACID trial at multiple centres were published in the peer-reviewed British Medical Journal on October 22.
• Recently , ICMR Director said they were deleting convalescent plasma as a definitive therapy from the national guidelines for Covid-19 treatment.

WHAT ARE THE TRIAL FINDINGS?

• While use of convalescent plasma seemed to improve resolution of shortness of breath and fatigue in patients with moderate Covid-19.

• PLACID was a randomised controlled trial in 39 hospitals spread across 14 states and Union Territories and representing 25 cities.
• It covered 464 adults admitted to hospital (screened April 22 to July 14) with confirmed moderate Covid-19.
• Of whom 235 were assigned to convalescent plasma therapy while 229 were randomised to receive the best standard of care.
• The group of 235 received two doses of 200 ml convalescent plasma, 24 hours apart.
• Progression to severe disease or death at 28 days after enrolment occurred in 44 (19%) of the participants in the intervention arm as compared to 41 (18%) in the control arm .
• The resolution of fever and cough did not differ between the two arm.

CONTROLLED TRIALS ELSEWHERE

• In China, a controlled trial of 103 patients with severe Covid-19 reported no effect of convalescent plasma treatment.
• In the Netherlands, the ConCOVID trial, prematurely terminated after 86 patients had been enrolled, could not find any effect on mortality at 60 days.

WHO IS PUSHING THIS THEORY?

• Delhi Health Minister Satyendra Jain has said convalescent plasma played a big part in his recovery and many lives have been saved.
• In Maharashtra, the government has been conducting the Platina trial in severely ill patients.
• Officials said that there is no order or letter from ICMR regarding stopping use of convalescent plasma.

CONSEQUENCES OF REMOVING PLASMA THEORY

• The ICMR has been cautious because of the trial findings.

• The authorisation of convalescent plasma as treatment for Covid-19 in India has led to questionable practices.
• Calls for donors on social media, and the sale of convalescent plasma on the black market.
• Convalescent plasma is a safe form of treatment when transfused in accordance to the regulations.

• A limited number of institutes in India have the capacity to undertake these procedures in a quality-assured manner.