India dropped blood plasma therapy from the clinical management protocol for COVID-19 on Monday. The blood plasma therapy or CPT (convalescent plasma therapy) was regularly made in use for clinical management of those who have been suffering from COVID-19.
Plasma is a clear liquid found in human blood that remains after all other components like RBCs, WBCs, platelets are taken away. Convalescent plasma is taken from the blood of COVID-19 recovered patient and the plasma is used as a source of antibodies against the virus for those suffering from the disease. CPT was allowed for patients suffering from moderate disease (within 7 days of symptoms showing).
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On Monday, the Centre issued revised guidelines of COVID-19 clinical management and the guidelines do not present convalescent plasma therapy in any of its treatment courses. The guidelines were jointly issued by the ICMR (Indian Council of Medical Research)- COVID-19. National Task Force, AIIMS and MoHFW (Ministry of Health and Family Welfare).
In the past few months, patients across the nation have been running aimlessly to get plasma to save their near and dear ones. In the plasma therapy, blood plasma is used as a source to get antibodies from the patients who have recovered from COVID-19.
However, in the recent development it was found that the CPT has no therapeutic benefits to those who are suffering from COVID-19 and are admitted to hospital.
It should be noted that earlier, the ICMR conducted trials at 39 COVID-19 treatment centers across the nation. The data from those trails was released in September and indicated that plasma therapy did not show signs of preventing infection progression or reduce fatalities.
After the development on Monday, Hindustan Times quoted a man familiar to the matter saying-
“ICMR has made it public in the past also that the therapy isn’t of much use based on the evidence that we have, and the earlier revised guidelines were also drastically modified for reference of those wanting to administer it, with clear cut dos and don’ts mentioned under which it can be given. But now it has been deleted from the list of therapies altogether.”
The decision comes after some virologists and medical experts wrote to the Principal Scientific Advisor, Mr. K. Vijay Raghavan and cautioned him against some of the “irrational and non-scientific use of plasma therapy”. The letter was also directed to the ICMR head Balram Bhargava and AIIMS chief Dr. Randeep Guleria.
“We are writing to you as concerned clinicians, public health professionals and scientists from India about the irrational and non-scientific use of convalescent plasma for COVID-19 in the country…This has stemmed from guidelines issued by government agencies, and we request your urgent intervention to address the issue which can prevent harassment of COVID-19 patients, their families, their clinicians and COVID-19 survivors,”
-stated the letter.
In the letter, the medical experts shared the results of an ICMR-PLACID trial which was the 1st randomized trial on CPT’s effect. The data indicated that-
“convalescent plasma was not associated with a reduction in progression to severe COVID-19 or all-cause mortality. This trial has high generalizability and approximates convalescent plasma use in real life settings with limited laboratory capacity.”
Studies from China also emerged that stated that there were no evident benefits of plasma therapy in the outcomes of the COVID-19 patients who were severely infected and had to be hospitalized.
Earlier in April, the Centre had issued new clinical guidelines for clinical management of COVID-19 infected patients. Under the new guidelines, the Centre suggested that Remdesivir, a broad-spectrum antiviral medicine, should only be considered for patients with severe to moderate diseases (those who require supplemental oxygen) within the 10-days of the evidence of symptoms.
The Centre also stated that use of plasma is only preferable within 7 days of symptom and stated that convalescent plasma had “no use after 7 days”.