Mumbai has received a go-ahead to try out plasma therapy on COVID-19 patients, soon after its civic body issued a call for recovered patients to donate blood for this purpose.

Four hundred and twenty-five patients have now recovered in Mumbai, the third most after Delhi (724) and Tamil Nadu (662)--so its pool of potential donors is large. Meanwhile, Mumbai has 3,754 COVID-19 patients--the highest concentration in any Indian state--as of April 22.

“Recovered COVID-19 patients… can now donate their blood & plasma 4 weeks after recovery or post negative swab tests & contribute in the fight,” the Brihanmumbai Municipal Corporation (BMC) said in a call for donors on April 20

On April 22, Maharashtra’s health minister Rajesh Tope confirmed that the Indian Council of Medical Research (ICMR) has given permission to try out plasma therapy on COVID-19 patients in Mumbai. “Anti-bodies from the recovered patients will be extracted and given to patients who are critical,” he said.

Blood plasma therapy uses the antibodies that recovered patients’ bodies have created to fight off the virus, SARS-CoV-2. Antibodies are harvested from the blood plasma of recovered patients who have developed an immunity towards the virus, and are injected into the body of an infected patient. The “treatment aims at using the immune power gained by a recovered person to treat a sick person”.

Antibodies are a “particular type of proteins secreted by immune cells called B lymphocytes”, which tackle any foreign presence in the body. A recovered patient is eligible to donate blood/plasma four weeks after recovery, when they have been asymptomatic and have had at least one negative lab test for at least 28 days before donation.

Civic body identifying eligible donors, list being prepared

Nair Hospital, run by Mumbai's civic body, has got a plasmapheresis machine to facilitate a trial, The Hindu reported on April 21. “With this machine, we can take the plasma from the donor instead of taking blood and later separating the plasma,” said Jayanthi Shastri, head of microbiology at Nair Hospital. A list of 70 eligible donors has been prepared, and the BMC is in the process of reaching out to them, the report said.

Earlier, ICMR had called for applications to participate in ‘A Phase II, Open Label, Randomized Controlled Study to Assess the Safety and Efficacy of Convalescent Plasma to Limit COVID19 Associated Complications’ on April 12.

The Drugs Controller General of India (DCGI) had approved clinical trials of convalescent plasma on April 17, just a few days before BMC’s call. Institutions and organisations interested in conducting trials as per the protocol can do so in consultation with the ICMR, the DCGI release said.

Several states such as Kerala, Punjab and Gujarat are also reported to be using the experimental therapy.

Meanwhile, Delhi’s first patient treated with plasma therapy has shown positive results. A 49-year-old patient who was administered plasma therapy at Max Hospital in Delhi on “compassionate grounds” has shown positive results and has been weaned off ventilator support, Max Healthcare said on April 20, 2020.

“We are delighted that the therapy worked well in his case, opening a new treatment opportunity during these challenging times,” Sandeep Budhiraja, group medical director at Max Healthcare, said. “But it is important that we also understand that plasma therapy is no magic bullet. During the patient’s treatment at Max Hospital, Saket, other standard treatment protocols were followed and we can say that plasma therapy could have worked as a catalyst in speeding up his recovery. We cannot attribute 100% recovery to plasma therapy only, as there are multiple factors which carved his path to recovery.”

In the past, such therapy has been used for the treatment of several diseases such as measles, Ebola, influenza A (H1N1) or swine flu, and the Middle East respiratory syndrome (MERS).

“Several studies showed a shorter hospital stay and lower mortality in patients treated with convalescent plasma than those who were not treated with convalescent plasma,” The Lancet reported on February 27.