Blood plasma, a yellow viscose fluid, carries many essential nutrients, hormones and proteins across the body, aside from salt, water and enzymes. That’s why plasma aids in treatment for several serious health problems. It includes antibodies, clotting factors, and proteins like albumin and fibrinogen, which can be separated and used as therapies for those suffering from trauma, shock, burns, immune deficiency disorders (including HIV) and rare chronic conditions.
Right now, COVID patients are receiving symptomatic treatments for dehydration, flu and breathing problems. Drugs to treat Ebola, flu, malaria, HIV and SARS infections have been used to help alleviate medical issues for these patients. However, convalescent plasma therapy, which involves injecting blood plasma from recovered patients to others, can be the way out for the thousands who are struggling to find hospital beds.
“Convalescent Plasma Therapy has had a positive turn for patients, as it provides them with passive immunity until their immune systems are ready to take up the load. However, the ICMR and Indian government are still going slow on recognising the treatment for large-scale use”, said Dr Vinodkumar Bagdu, from Bagdu Health Services Pvt Ltd. His company distils blood plasma through a blood component separation process, from blood collected at blood banks.
Convalescent Plasma therapy revolves around collecting convalescent plasma or the liquid part of one’s blood from patients who’ve recovered from COVID-19. Their blood contains specific IgM, IgG antibodies for the COVID-19 virus, which were developed by the patients’ immune system. These patients, who now hold a clean bill of health, would help those fighting against the disease and prepare their immunity.
“Plasma collected from cured COVID-19 patients has been found to carry antibodies against the coronavirus disease. This will help high-risk patients or those impacted by comorbidities recover at a much faster pace”, said Dr Jayashree Todkar, Director, Department of Laparoscopic & Bariatric Surgery at the Apollo Spectra Hospitals.
Hospitals in Maharashtra, Uttar Pradesh and Madhya Pradesh have begun temporary treatments to help patients recover from plasma therapy. Kasturba hospital, Nair hospital and KEM hospital have been approved as sites for Plasma Therapy by the Municipal Corporation of Greater Mumbai. However, a long term course of action requires creating monoclonal antibodies specific for the COVID-19 virus. Dr Bagdu said we need a more abundant supply of artificial recombinant antibodies to treat everyone, as few patients come forward to donate their plasma.
The ICMR had begun discussions for clinical trials for plasma transfusions from recovered patients as early as March 25. The Delhi government had also announced that five critically ill COVID-19 patients have recovered from the disease with this treatment. However, a full-scale use of plasma therapy is still far from the horizon.
In India, blood plasma is likened to a body part, and there is very little awareness about donating the fluid for other patients. India currently imports 90 per cent of its total blood plasma needs. Fear, lack of knowledge, fewer blood banks and few plasma donors are significant challenges against this treatment.
Entrepreneur and social activist Prashant Karulkar has been championing the cause of promoting plasma therapy against COVID-19. “We need the government (and NACO) to spread the message about plasma donation in India as a possible way to combat against COVID-19. We’ve had more than 64000 patients who’ve recovered from the disease. With donations from these former patients, we’d fare better in this crisis. This is a case where we need to become Atmanirbhar”, said Karulkar.
“Blood banks, routine donation drives and pledges do help in procuring blood, but it’s far less than the demand at any point in time. In India, we have 2760 licensed banks though not all of them can fraction blood into plasma, platelets and red blood cells. While many recovered patients from the Tablighi Jamaat have donated their blood plasma, we need a lot more to help patients”, added Dr Bagdu.
“We need the government to provide infrastructural support as well in terms of more blood banks and plasma collection centres. We need quality support as well, like the US has been providing to its plasma collection centres.”
Dr Bagdu revealed that India was far from being self-sufficient in terms of the specific Human plasma proteins which can be extracted from blood plasma and the medicines that can be derived from it. He said, “Whole blood therapy leaves only 40% of plasma available for further medical use. In terms of meeting our country’s needs for plasma proteins, we can currently match 46% of our IVIG needs and 24% of our human albumin needs. For factor VIII, we meet 75% of our needs, though we are importing about 90% of this number.”