As case numbers of COVID-19 continue to rise, scientists are working around the clock to develop and test treatments and vaccines in record time. In New York, where more than 25,000 cases of the coronavirus have been reported, trials of a rapidly available treatment – previously used to treat outbreaks of flu, SARS, and Ebola – are expected to begin later this week.
During a news briefing on Monday, Governor Andrew Cuomo announced plans to trial convalescent plasma. This process involves the collection of plasma from recovered patients' blood, which contains antibodies to SARS-CoV-2. In turn, this can be infused into people who are still fighting the virus to help contribute to the body’s immune response.
"There have been tests that show when a person is injected with the antibodies, that then stimulates and promotes their immune system against that disease," Cuomo said in the briefing. "It's only a trial. It's a trial for people who are in serious condition, but the New York State Department of Health has been working on this with some of New York's best health care agencies, and we think it shows promise, and we're going to be starting that this week."
Whilst this trial is awaiting approval from the US Food and Drug Administration (FDA), the body made a separate announcement yesterday. FDA’s rules regarding the use of investigational drugs for the COVID-19 pandemic has been updated to include the administering of convalescent plasma under particular circumstances and still with FDA authorization.
“Given the public health emergency that the expanding COVID-19 outbreak presents, while clinical trials are being conducted, FDA is facilitating access to COVID-19 convalescent plasma for use in patients with serious or immediately life-threatening COVID-19 infections,” the statement said.
“This process allows the use of an investigational drug for the treatment of an individual patient by a licensed physician upon FDA authorization.”
However, this treatment is not completely guaranteed to work. When studied in other respiratory infections, including the 2003 SARS epidemic and 2012 MERS epidemic, varying results were reported. Furthermore, there are risks associated with the plasma transfusions, such as giving a patient the wrong type of blood or inadvertently transmitting other pathogens. However, these procedures are relatively safe, provided the blood is screened for viruses and other components that could cause further infection.
In the case of COVID-19, trials for this method have already been conducted. In a pilot study from China, published on the pre-print website medRxiv, among the 10 severe cases who received plasma treatment, five showed rapidly increased levels of antibodies immediately post-transfusion, and within a week the virus was undetectable in seven patients.
Dr Arturo Casadevall, an immunologist at Johns Hopkins University, Baltimore, has also advocated this method for over a month. In a viewpoint article, published in The Journal Of Clinical Investigation, Casadevall and co-author Liise-anne Pirofski wrote that “as we are in the midst of a worldwide pandemic, we recommend that institutions consider the emergency use of convalescent sera and begin preparations as soon as possible.”
Further clinical trials are still needed to address questions about the treatment before being routinely administered, such as its effect in COVID-19 patients of varying severity and its use as a preventative measure for people in close contact with confirmed cases.
Only time will tell whether this treatment has the capability to help reduce the virus’ impact.