Antibodies, Serums and Advanced Treatments of Covid-19
- Any therapy that doesnt fully cure or prevent is still helpful
- Plasma Serums 100+ year old
Any therapy that doesnt fully cure or prevent is still helpful
Front line workers need more than PPE
Even without a vaccine a handful of early treatments could make a difference.
If you can protect people that are vulnerable and you can treat people that come down with the disease effectively .. then I think it will change the trajectory of this pandemic. - Dr. Borio
One or two antibody treatments may also become available, providing limited protection to health care workers.
Antivirals - ?how do they work?
Remdesivir if successful in trials may become more widely used. - https://www.nytimes.com/2020/04/29/health/gilead-remdesivir-coronavirus.html
Plasma Serums 100+ year old
Blood from people who have recovered can be a rich source of antibodies, proteins made by the immune system to attack the virus. The part of the blood that contains antibodies, so-called convalescent plasma, has been used for decades to treat infectious diseases, including Ebola and influenza.
The use of convalescent plasma is “a classic approach that is a really effective way to treat” — if there are enough donors with enough of the right antibodies.
However, blood is complex fluid, and a risk is that the patient’s immune system could react against something in the plasma, and cause additional illness.
How it Works
Screening of volunteers to meet strict criteria. The donors will include people who tested positive for the virus when they were ill, recovered, have had no symptoms for 14 days, now test negative — and have high levels, also called titers, of antibodies that fight the virus.
Process to donate plasma called apheresis. While similar to giving blood, except that the blood drawn from the patient is run through a machine to extract the plasma, and the red and white cells are then returned to the donor. Needles go into both arms: Blood flows out of one arm, passes through the machine and goes back into the other arm. The process usually takes 60 to 90 minutes, and can yield enough plasma to treat three patients. People who have recovered have antibodies to spare, and removing some will not endanger the donors or diminish their own resistance to the virus. The process get say 20 percent of their antibodies, but and a couple days later they’ll be back to full levels naturally.
Testing and possible rejection of Plasma. The plasma will be tested to make sure it is not carrying infections like hepatitis or H.I.V., or certain proteins that could set off immune reactions in the recipient.
Storage of plasma if it passes the tests, it can then be frozen, or used right away.
Plasma Donor-Recipient Matching Rules. As with blood transfusions, plasma donors and recipients must have matching types, but the rules are not the same as those for transfusions.
Distribution and infusion. Each patient to be treated will receive one unit, about a cup, which will be dripped in like a blood transfusion.
Regulation, Emergency FDA Approval
The Food and Drug Administration gave permission for the plasma to be used experimentally on an emergency basis to treat coronavirus patients.
Now, some hospitals are also administering plasma from recovered patients to people who are sick with Covid-19, in the hopes that the antibodies of survivors will give the patients a boost.
- Chinese are the leaders. There were reports from SARS and MERS that patients improved. Now in Covid-19 Chinese experience in using plasma from Wuhan, is that most people who get better have high-titer antibodies. Most patients who recover will have good antibodies in a month. However, Chinese plasma "studies" were neither controlled or definitive. Also all Chinese data sharing is censored and suspect.
If you can drive the virus replication down tenfold to hundredfold, that can be the difference between life and death. - In studies in mice by Vineet Menachery, a virologist at the University of Texas Medical Branch.
US NYC Blood Centers
- Mount Sinai Hospital would try as a treatment for hospitalized patients who had a moderate form of the disease and had trouble breathing, but not for those who are in advanced stages of the disease. The goal is to transfer beneficial antibodies from recovered patients to preempt progression to severe forms that need ventilators to prevent death. Hospitals in New York quickly began asking to participate, said Dr. Bruce Sachais, chief medical officer of the New York Blood Center, which will collect, test and distribute the plasma.
Since it all has to be done in an anti-septic process it like dialysis can be extremely expensive as well.
Propagation to Other regions and Blood centers
In East US, the NY Blood center would help other centers in New England, Delaware and the Midwest