Convalescent Plasma Benefits Corona Patients With Low Immunity… But What’s Its Problem?

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DUBAI, United Arab Emirates (CNN) – A study published Thursday showed that convalescent plasma, which was praised at one point during the “Covid-19” pandemic, and which has largely lost popularity, works well in people with weakened immunity.

The report, published in JAMA Network Open, analyzed results from 9 studies and found that immunocompromised COVID-19 patients were 37% less likely to die when given convalescent plasma, an antibody-rich blood product derived from people who have recovered from the virus.

Although the use of convalescent plasma to treat immunocompromised coronavirus patients is legal, government guidelines are neutral on the effectiveness of the treatment, so some hospitals offer it, but others do not.

“Our concern is that many patients who need it (convalescent plasma) are not getting it,” said Dr. Arturo Casadevall, an infectious disease expert at Johns Hopkins University and one of the authors of the new study. . get better results with these materials if we can spread the word.”

It’s in everyone’s interest to treat immunocompromised patients quickly, Casadevall said.

People with weakened immunity sometimes suffer from “severe Covid” disease for several months because they lack the antibodies to fight it, which gives the virus many opportunities to mutate in the person’s body.

“These immunocompromised patients are essentially variant factories,” said Mayo Clinic anesthesiologist Dr. Michael Joyner, another study co-author.

About 7 million people suffer from low immunity in the United States, and treating them when infected with “Covid-19″ has proven difficult, as many of them cannot take the antiviral drug” Paxlovid” because it interferes with other medications they use.

But the National Institutes of Health’s (NIH) COVID-19 treatment guidelines say there isn’t enough evidence to recommend whether or not to use convalescent plasma for people with compromised immune systems.

Three times in the past year, Casadevall, Joyner and dozens of other doctors from Harvard, Stanford, Mayo Clinic, Columbia and other academic medical centers wrote emails to scientists at the National Institutes of Health, They sent in research papers urging them to change the guidelines, but they got no response.

Some patient advocates said they were angry.

“This lack of response pisses off researchers,” said Janet Handal, co-founder of an advocacy group for transplant recipients and immunocompromised patients.

Several large randomized clinical trials in the general population, including one in India and one in the UK, have found that convalescent plasma does not reduce COVID-19-related deaths or prevent serious illness, and the treatment is not no longer allowed in the states. healthy immune systems.

The nine studies analyzed in the new report are much smaller and study only immunocompromised patients.

Oxford University professor and co-lead researcher of the large UK study, Dr Peter Horby, said a large randomized clinical trial in immunocompromised patients would need to be conducted before clinical practice guidelines for this group can be changed.

History of convalescent plasma during the COVID-19 pandemic

At the start of the pandemic, there was great enthusiasm for convalescent plasma, and survivors of COVID-19 sought to save lives, donating antibodies against the virus to people who were sometimes on the verge of dead.

In August 2020, the US Food and Drug Administration (FDA) granted emergency use authorization for the treatment, but some questioned whether the decision was politically motivated and whether the data really showed it worked. .

Subsequently, large clinical trials indicated that convalescent plasma did not work, but there was one exception.

Horby said his study found “evidence of some benefit” in “Covid-19” patients who did not develop antibodies against the virus.

This likely includes immunocompromised patients because their faulty immune systems don’t always produce antibodies as they should, even after an infection.

When this group of patients received convalescent plasma, their hospital stay was slightly shorter and they were less likely to need ventilators, compared to similar patients who did not receive convalescent plasma.

Joyner and Casadevall note that this finding, and a similar result in a large trial in Australia, Canada, the United Kingdom and the United States, as well as results from smaller studies, indicate that convalescent plasma is worthwhile. to be tried when it comes to immunocompromised patients.

“I felt like half a person”

Immunocompromised patients who contract COVID-19 can obtain convalescent plasma relatively easily if they are patients of certain medical centers.

However, many people may have difficulty accessing treatment.

Bernadette Kaye, of Manhattan Beach, California, took months to seek treatment.

Kay, 64, who has a weakened immune system due to medication she takes for rheumatoid arthritis, contracted COVID-19 in July.

Although she used two types of monoclonal antibodies, in addition to the drugs ‘remdesivir’ and ‘paxlovid’, her Corona test results remained intermittently positive for months and she suffered from fatigue, congestion and aches. of head.

“I felt like half a person, Kay said. I was not a physically healthy person. I was handicapped due to lack of energy.”

Kay said she had met with several doctors and none of them suggested the use of convalescent plasma.

“We encountered many obstacles.”

Joyner said while he and a group of colleagues waited for a response to their letters to the NIH, the group formed the National COVID-19 Convalescent Plasma Project, and they hold a call every Thursday evening to discuss their progress.

“We encountered many obstacles,” said Dr. Liz-Anne Perofsky, chief of infectious diseases at the Albert Einstein College of Medicine. “It (convalescent plasma) is not considered part of the COVID-19 treatment arsenal.”

Perofsky, Joyner and Casadevall say they receive no financial benefit from convalescent plasma and believe that one of the reasons convalescent plasma is not widely used is that no pharmaceutical company spends money promoting it. .







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