Plasma donation by patients with COVID-19
The effectiveness of plasma from COVID-19 patients is again called into question
A study by the US National Institute has shown that the use of blood plasma from citizens who have had coronavirus does not help patients with moderate severity of the disease – however, it does not harm them either. Meanwhile, in Russia, this method is used to treat patients in hospitals. The Moscow health department told Kommersant that with the introduction of donor plasma, the survival rate of patients with severe disease increased by 19%. Experts do not deny that the method can work, but emphasize that evidence-based medicine has not yet found its effectiveness.
The US National Institutes of Health (NIH) has conducted clinical studies on the effectiveness of plasma with antibodies to COVID-19 for treating moderately severe patients in the early stages of the disease. The Vademecum edition drew attention to the test results.
Even at an intermediate stage, scientists noticed that the plasma of those who had recovered practically did not prevent the progression of the disease.
The results showed that the coronavirus progressed in 77 patients (30%) who received plasma and in 81 patients (31.9%) in the placebo group.
“We hoped that convalescent plasma would result in at least a 10% reduction in disease progression, but instead we observed a reduction of less than 2%,” said study chief Clifton Callaway. As a result, the scientists were forced to stop the study.
“Using the principles of evidence-based medicine, based on placebo-controlled clinical trials of the third phase, an American study shows that the introduction of convalescent plasma at an early stage of coronavirus infection does not provide any benefit to patients at risk, such as overweight or diabetes,” says molecular biologist, professor Rutgers University and Skoltech Konstantin Severinov. – But, however, it does not harm them either. The percentage of patients with a severe course of infection, including deaths, is the same – both in the placebo group and in the group of people who received plasma. ” The expert notes that now in the USA additional studies are underway, where the time of plasma administration and its amount are changing, other groups of patients are used: “But it is obvious that this is not a panacea.”
In Russia, judging by the statements of the authorities, this method is used more actively – and is considered quite effective. Thus, the use of plasma appears in the temporary clinical guidelines of the Ministry of Health for the treatment of coronavirus. “According to published data, plasma obtained from COVID-19 convalescent donors was used in the PRC and other countries, which is reflected in the national guidelines for the treatment of COVID-19,” the document says. In addition, the Clinical Committee on COVID-19 of the Moscow Department of Health approved the use of donor plasma as one of the treatment methods back in October last year, and began using it in hospitals in April 2021. Prior to that, in Russia, as in most countries, this method was considered experimental. In August 2021, the capital's vice-mayor Anastasia Rakova announced that since the beginning of the pandemic, 24 thousand Muscovites have donated 18 tons of plasma with antibodies to COVID-19.
The Moscow hospital told Kommersant that “the method proved effective in the process of application”: “With the introduction of donor plasma, the survival rate of patients with a severe course of the disease increased by 19%, and the need to switch to artificial respiration using ventilators was halved. The transfusion effect is achieved due to the fact that the plasma contains specific antibodies that help neutralize the virus. ” The ministry added that plasma transfusion with antibodies to coronavirus is recommended for patients with moderate severity of the disease.
Finally, the department believes that “plasma from vaccinated donors is no less effective than plasma from those who have been ill”: “It is 70% more likely to have a high titer of neutralizing antibodies than plasma from those who have been ill.”
Earlier, the Ministry of Health allowed the use of a specific immunoglobulin intended for the treatment of coronavirus (COVID-globulin of the Natsimbio holding). The drug became the world's first registered drug against COVID-19, created on the basis of the blood plasma of those who have been ill. Natsimbio reported that by the end of 2021 they plan to process 15 tons of plasma in the production of a new drug: according to the company's calculations, this should be enough for 10-15 thousand patients. However, so far, according to Roszdravnadzor, only one series of “COVID-globulin” has been put into circulation.
Anticoid plasma is used to treat patients not only in Moscow. The Ministry of Health of the Volgograd Region told Kommersant that since May 2020, more than 4 thousand people have donated blood for its production. They emphasized that plasma is not an independent method of treatment, but is used only as an adjunct to the main treatment. “For the entire period of its application, antikoid plasma has shown itself only on the positive side,” the department said. As reported to Kommersant in the Ministry of Health of the Crimea , the republican blood center prepared for transfusion 1,055 doses (almost 288 liters) of “fresh frozen” plasma of citizens who have had coronavirus. 642 patients with COVID-19 have already received treatment using plasma therapy. Since the beginning of the year, 177.3 liters, or 665 doses of plasma with antibodies have been received in the Belgorod region. A little more than 150 people underwent treatment. “After the procedure, most of the patients showed positive dynamics in the form of a decrease in temperature, a decrease in the severity of respiratory failure, patients note an improvement in their general condition,” the regional department of health said. Konstantin Severinov did not comment to Kommersant on the Russian practice of plasma therapy and the use of immunoglobulin “without published research data.”
Biological sciences geneticist Kirill Volkov believes that “plasma can only be effective if it is taken from people who have neutralizing antibodies.” “And only when the virus got into the bloodstream, and this happens approximately in the second week of the disease, – said Mr. Volkov to Kommersant. from the British and Wuhan variants, and this leads to the fact that some of the neutralizing antibodies, although small, will not work correctly. “
Natalia Kostarnova, Alexander Osipov, regional network “b”
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