Initial plasma therapy results promising: Delhi CM Arvind Kejriwal

Convalescent plasma therapy uses a blood component called plasma -- which contains the virus-fighting antibodies – from people who have recovered from the infection to treat those who are severely ill with Covid-19.

Delhi chief minister Arvind Kejriwal on Friday urged people who have recovered from the coronavirus disease (Covid-19) in the city to donate plasma to treat people hospitalised with severe forms of the infection. Plasma therapy has been administered to four Covid-19 patients admitted in a city hospital whose condition seems to be improving, Kejriwal said.

Chief minister Arvind Kejriwal said that Delhi would apply for wider use of the therapy in all severe patients admitted in Delhi hospitals (ANI photo)

“The initial results are very promising and I would request those who have recovered from corona infection to come and donate their plasma,” Kejriwal told reporters via video conference.

He added: “Many of you must have donated blood for dengue; for that too we do not take the blood, only the platelets are taken out and the rest of the blood goes back to your body. This is the same thing, we will just take out the plasma. You can save the life of a patient. We will call you for donation, we will arrange transport, and we will ensure that you are not harmed in any way.”

Convalescent plasma therapy uses a blood component called plasma -- which contains the virus-fighting antibodies – from people who have recovered from the infection to treat those who are severely ill with Covid-19.

Lok Nayak Hospital is the first Delhi government hospital to administer the therapy. Plasma therapy trials are also being conducted by the All India Institute of Medical Sciences and Institute of Liver and Biliary Sciences in Delhi. Max Hospital in Saket also administered the therapy to a Covid-19 patient on ventilator on compassionate grounds, who was later weaned off ventilator support and is improving.

Among other centres, the trials are under way at the Department of Biotechnology’s Sree Chitra Tirunal Institute for Medical Sciences and Technology in Kerala, which was the first to start them, and King George Medical University, Lucknow, where they started on Friday.

So far, 2,376 people have been infected and 50 have died of the coronavirus infection in Delhi.

Lok Nayak Hospital, Delhi’s biggest Covid-19 facility, in collaboration with the Institute of Liver and Biliary Sciences received permission to conduct a randomised control trial from the Indian Council of Medical Research and the drug regulatory body Central Drugs Standard Control Organisation (CDSCO) last week.

“This therapy is not new, it has been used for several other diseases before. We are conducting a trial for the effectiveness of this treatment in Covid-19 cases. The trial will include ten patients who receive the therapy and should be completed within the next 10 or 15 days,” said Dr SK Sarin, director, Institute of Liver and Biliary Sciences, which chooses the donors and conducts the plasmapheresis process to derive the blood plasma for treatment.

The process

The first patient to receive the therapy was a 60-year-old man admitted to the intensive care unit of the hospital. He was not on ventilator, but had low oxygen saturation of 85%, a condition that indicates his organs were not receiving an adequate amount of oxygen. The normal oxygen saturation for healthy individuals is between 95% and 100%.

His respiratory rate was also high at 30 per minute – meaning he was breathing rapidly. The normal respiratory rate is 12 to 20 breaths per minute in adults. He was administered plasma therapy on Tuesday.

“His respiratory rate has come down to 20 per minute and the oxygen saturation has improved to 98%. The patient is likely to be moved out of the ICU today. And, there have been similar improvements in the condition of the other patients who received the therapy as well. This is promising,” said Kejriwal.

The doctors are performing a randomised control trial of 20 patients, where half of them will get the plasma and the other half will get a placebo (devoid of any therapeutic value).

“We do not know who among these four patients received the plasma and who received the placebo. Only after the trial is complete we will be able to analyse the results. The first two patients have been taken off oxygen support and are now able to ingest food. They will likely be shifted out of the ICU tomorrow. We are observing the other two patients who received the therapy yesterday,” said Dr Suresh Kumar, principal investigator and head of the plasma therapy project at Lok Nayak hospital.

The patients are given two plasma transfusions of about 250 ml each over two days.

Another patient who was to receive plasma therapy on Tuesday died before it could be administered. Two other recipients have been identified by the hospital. So far, seven plasma donations have been done and eight to 10 other donors being screened.

The CM said Delhi would apply for wider use of the therapy in all severe patients admitted in Delhi hospitals. “For now, we have the permission from the central government to perform a limited trial only on serious patients in Lok Nayak hospital. They had asked us for the results of the limited trial to grant permission for the use of the therapy in others. Next week, we will apply for plasma therapy for all serious patients in Delhi,” said Kejriwal.