Considering the difficulties linked with obtaining donors, availability of adequate titres of neutralizing antibibodies from each donor and controversial results of the available studies, does it make sense to administer CP to patients with mild COVID disease?
Mild patients are likely to be recovered on their own and a more sensible approach could be giving CP to patients whose condition is deteriorating and are requiring intensive care. CP is considered as a good measure to reduce the mortality and it is not available in plenty so that it can be given to all COVID patients. This can deny the access of CP in ideal candidates who are presenting with severe disease. Moreover CP can lead to many adverse drug reactions , notably, transfusion-related events, involving chills, fever, anaphylactic reactions, transfusion-related acute lung injury, circulatory overload and hemolysis, etc . Meanwhile, the risk of transfusion-transmitted infections, such as human immunodeficiency virus, hepatitis B virus, hepatitis C virus and syphilis, also remains there. Hence, if we expose even mild patients to CP, we can end up doing harm rather than any clinical benefit. Kindly give your inputs. Thank you .
I think you are right. But in effect, there is currently no evidence that CP works. There is a large UK RCT that has started and need to wait for the results.
https://www.nhsbt.nhs.uk/how-you-can-help/convalescent-plasma-clinical-trial/
Please read question as
Why convalescent plasma (CP)should be given in patients with mild COVID -19 infection?**
First, let us discuss some important points regarding convalescent plasma to understand it;
Convalescent plasma is plasma from an individual who has recovered from an infectious disease, which can provide passive immunity to individuals who are ill from that disease or at high risk of developing disease following exposure.
It is a means of antibody transfer to provide passive immunity (neutralizing antibodies against the infectious pathogen) until the individual can develop an active immune response, with the hope that clinical outcomes can be improved in the recipient.
Convalescent plasma is not routinely available, nor is it a licensed FDA product; instead, it has been made available for specific agents at times of disease epidemics or pandemics.
Once an epidemic has subsided, convalescent plasma is likely to become unavailable.
During the 2019-2020 coronavirus disease (COVID-19) pandemic, community blood centers in the United States and around the world are establishing programs for recovered individuals to donate convalescent plasma and for clinicians to request (or to direct their patients to donate) convalescent plasma.
Second, regarding you question ( Why convalescent plasma (CP)should be given in patients with mild COVID -19 infection? );
I totally agree with you; Convalescent plasma should be given only for severe cases of COVID-19 due to limited resources. If we have enough resources and we need to give it for mild cases, I will give it to high risk patients e.g. old patients with multiple comorbidities.
Thank you for such important question
Regards,
Abdul Hadi Al-Qahtani, MD/MHA
I don't think CP is effective even with severe cases of COVID19. antibodies cannot reach viral particles inside cells. they only work on free viruses in body fluids. They may give immunity for short time and it is more important to be given for medical staff to avoid infection. COVID19 patients needs functional CD8+ T cells and NK to have real and effective immunotherapy.
SARS-CoV-2, the virus causing COVID-19 illness is surprising the world health community: Convalescent plasma from one patient may not help a patient from another area
LET US TALK SCIENTIFICALLY, NOT WHAT WE THINK
The beneficial effects of the convalescent plasma (CP) from a recovered patient of COVID-19 depend on the antibodies developed against the virus. However, one person may be infected with one strain of the virus while the other patient by another strain. Furthermore, the quantity of antibodies differ from one person to the other. This is the reason why one person may respond while other may not respond. The antibodies present in the COVID-19 recovered person may differ in one area compared to other area of a big country. Due to lack of voluntary donation of blood plasma, not sufficient plasma is available. As a result doctors will tend to use the plasma in serious or critically ill patients (1).
Due to mutations in the SARS-CoV-2, and sometime infections in the same person with multiple strains of this virus (2), strain of the SARS-CoV-2 may differ in persons infected from one area and country to the other. Therefore, efficacy issue of CP arise if it is sent to another country for use.
The only way to ensure efficacy of CP for treatment of COVID-19 is it the strain of the the donor is the same as the recipient and the antibody titres from CP of the recipient are quantitatively measured.
1. Article Treatment of 5 Critically Ill Patients with COVID-19 with Co...
2. Spike mutation pipeline reveals the emergence of a more transmissible form of SARS-CoV-2 https://www.biorxiv.org/content/10.1101/2020.04.29.069054v1
Convalescent plasma should be given in patients mild in covid 19 infection because convalescent plasma emerges at the first option of hospitalized patient with covid 19 transference of neutralizing antibodies helps to control covid 19 infection and modulates inflammatory response ,other plasma components may enhence the antiviral and antiinflammatory properties of convalescent plasma
Today, we are looking at the situation in Iran to reveal 19 secrets in the whole country. These diagnoses have been performed in 120 laboratories across the country. All of this is based on indigenous knowledge and at the height of sanctions.
With the possibility that you can have enough, we can be at your disposal and you can control it, you can also use this coach, you can use this coach.
Using the tests performed, you can perform this test with a molecular test. After doing this in laboratory tests, we tried to move in a direction that could be available to you and available to you. If you have tried to dedicate the brother of the nobles to you.
So you can have bad restrictions and be able to come up with different ways to identify a brother. We can do a service study to see how well the provinces of the country can be prepared.
By doing so, serological services cannot be detected in any way and can only provide another person by editing a secret. You can definitely diagnose a molecular test and serologize the test to identify the interface.
According to the decision, it is possible to change the image of the narrator in Iran in two or three months. It can also present itself as a Western official in the west of the country
DIAGNOSIS
If you develop symptoms of coronavirus disease 2019(covid-19)and you have been exposed to the virus contact the doctor.
Tell him or her if you have traveled to any areas with ongoing community spread of covid 19 according to CDc and WHO.Also let your doctor know if have had close contact with anyone who has been diagnosed with covid 19.factors used to decide whether to test covid 19 may need to be screened by your clinic to determine if testing is appropriate and available.
In the U.S ,your doctor will determine whether to conduct tests for covid 19 based on your signs and symptoms ,as well as have had close contact with someone diagnosed with covid 19 or travelled to or live in any areas with ongoing community spread of covid 19 in the past 14 days ,your doctor may also consider testing if you are at high risk of serious illness.
To test for covid 19,a health care provider uses a long swab to take a nasal sample .the sample is then sent to a lab for testing .if you are coughing up saliva (sputum),that may be sent for testing.
TREATMENT OF COVID 19
Currently ,no medication is recommended to treat covid19,and no cure is available .
Antibodies are not effective against viral infections such as covid 19.
Researchers are testing a variety of possible treatments.
The U.S food and drug administration granted permission for some medications approved for other diseases to be used to treat severe covid 19 when no other options are available.Two malaria drugs -hydroxy chloroquuine and chloroquine.An antiviral drug ,remdesivir have been approved for this used .Treatment that can be used to relieve symptoms may include.
-pain reliever,i(buprofen or acetaminophen),cough syrup or medication ,rest ,fluid intake etc
There is no evidence that ibuprofen or other nonsteroidal anti-inflammatory drugs (NSAIDS) need to be avoided.
If you have mild symptoms your doctor may recommend that recover at home .He or she may give you instruction to monitor your symptoms and to avoid spreading the illness to others.you may be asked to isolate yourself as much as possible from family and friends while you are sick ,wear a mask when you are around people ,and to use a separate bedroom and bathroom,your doctor may recommend to stay at home for some period of time.Eating healthy needs and get enough sleep.
DIAGNOSIS OF COVID 19
The most common test involves inserting a swab up the nose to take a sample of fluid for testing .
Sometimes a throat swab is done instead .A covid 19 saliva test ,recently approved by the FDA,is less risky for the health care worker to collect the sample the person's spits into a plastic tube back to the health care worker.
The FDA approved a keat home nasal swab kit after a doctor approves testing Medically appropriate ,the person sends the self collected.
Samples to a lab for testing with limited kits available at this time.health care workers and first responders get priority .the FDA warns consumers against buying unaproved home tests becos they may be inaccurate and unsafe .
Contact your doctor or other health care professional to discuss your situation and whether he or she thinks you need a covid-19 diagnostic test or antibody test .
Before seeking a covid 19 in person,contact your doctor to discuss
your situation and describe any symptoms
But no covid test is 100% accurate its possible to test negative later it turn to positiv .so its vital to continue to fellow covid 19 guidelines from centers for disease control and prevention,such as social distancing further notice.
Intext citation(William F.marshal and m.D smith).Edited by molly labrode and charly brown ,2nd ed,scribbr ,2019.
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Patient with mild symptoms--not required any kind treatment. Only home isolation with monitoring of warning signs. convalescent plasma (CP) for these patient cause more harm then benifit plus cost burden. convalescent plasma (CP) can be tried in severely ill patients requiring icu care and ventilator support and patients who are in multi organ dysfunction.