One option that has been trending in the news is convalescent plasma, which simply means the fluid component of blood from someone who has recovered from an illness. In the case of COVID-19, recovered patients have antibodies within their plasma that can attack the coronavirus and can potentially help the sickest patients get better.
Historically, plasma has been transfused between recovered and ailing patients when new diseases or infections develop quickly, and no other options are available. The U.S. Food and Drug Administration has authorized limited use of plasma to treat critically ill COVID-positive patients in conjunction with regional blood and plasma donation centers and health systems. This technique is known as it was used in similar, more recent situations, like SARS.
As a physician who works with vulnerable patients, I placed an order for plasma with our blood supplier Versiti Blood Center, who have begun actively collecting plasma from recovered COVID-19 patients. As physicians, we have specific criteria for which of our patients would be the best candidates for this plasma based on their clinical diagnosis, symptoms and presence of two chronic diseases or conditions. The team’s first patient was an elderly man who fit the criteria and would be the best option for him to avoid needing a ventilator due to his other medical conditions. We made sure the family and patient understood what this option entailed, answered their questions and got their consent before proceeding.
Once we receive the plasma, we administer it like how other plasma or blood transfusions are normally done in our hospital and system. The plasma transfusion procedure entails an IV inserted into the patient’s vein. Through the IV the patient begins to receive the new plasma, approximately 250cc of plasma (one unit) over a period of 2-3 hours. Usually it takes a few days to see if the plasma has offered any benefit to a patient.
The COVID-19 convalescent plasma protocol calls for 2 doses on 2 consecutive days, however we hold the second dose if dramatic improvement occurs after 1 dose. Our patient only needed one dose as he stabilized and began improving. Since then several more patients in our system have received plasma and several more are waiting for plasma to be available.
The biggest need is to have more patients who have recovered from COVID-19 donate plasma so the sicker patients in our hospitals can have a chance at recovery and eventually going home to their families.