What is Convalescent Plasma Therapy ? | UPSC

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What is Convalescent Plasma Therapy ? | UPSC

What is Convalescent Plasma Therapy ? | UPSC

      HEADLINES:

The plasma therapy debate

      WHY IN NEWS:

An ICMR study has found convalescent plasma was not associated with a reduction in progression to severe Covid-19 or all-cause mortality.

SYLLABUS COVERED: GS 3:Health

      LEARNING: 

For PRELIMS understand the procedure of the therapy and what are the components in deriving the plasma from the  donor’s antibodies.

For MAINS go through this controversy and understand the loophole . Let us dive in !

      ISSUE: 

Recently published findings on convalescent plasma therapy on Covid-19 patients have triggered a debate over its efficacy.

CONVALESCENT PLASMA THERAPY 

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

The Indian Council of Medical Research (ICMR) has been considering dropping this option from the national guidelines.

  • 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.

Convalescent plasma, extracted from the blood of patients recovering from an infection, is a source of antibodies against the infection.

  • 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.

What is Convalescent Plasma Therapy ? UPSC

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.

The risk of getting COVID-19 from convalescent plasma hasn’t been tested yet.

  • 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?

An ICMR study has found convalescent plasma was not associated with a reduction in progression to severe Covid-19 or all-cause mortality.

  • 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.

This did not translate into a reduction in 28-day mortality or progression to severe disease.

  • 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.

The scientific research trial and irrespective of the PLACID Trial findings, the PLATINA trial will continue.

CONSEQUENCES OF REMOVING PLASMA THEORY

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

The guidelines are not necessarily binding and it is too early to dismiss convalescent plasma therapy.
 

  • 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.

It involves resource-intensive processes such as plasmapheresis, plasma storage, and measurement of neutralising antibodies.

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

      IASbhai WINDUP: 

  • This is a new virus, and around the world evidence is still emerging on the best therapeutic options.
  • Remdesivir has been sanctioned as a drug of choice by the US drug regulator.

The World Health Organization’s Solidarity Trial has found it had little or no effect on 28-day Covid mortality.

  • And experts said use of convalescent therapy has saved some lives but concerns have been raised by the PLACID trial.
  • The task force had introduced some safeguards to check indiscriminate use of drugs such as remdesivir.
  • Covid care is individualised care.Use of the right drugs in the right patient does work.
  • Some of the therapies can be continued on compassionate grounds.
     SOURCES:THE IE | What is Convalescent Plasma Therapy ? | UPSC

 

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