Blood of the recovered could give weapon against COVID-19 as Mich. institutions join effort to mine plasma
A growing number of influential physicians and scientists are getting behind an effort to use the blood of those who have recovered from COVID-19 to help others battle the deadly disease.
For more than 100 years, health care providers have used the liquid part of the blood, known as plasma, from those who have recovered from illnesses to help those stricken with the Spanish Flu, H1N1, SARS and more.
That's why a group of physicians and scientists from 57 institutions in 46 states including Michigan are hoping plasma will help prevent and treat COVID-19 — especially since there have been 1.8 million confirmed cases and more than 113,000 deaths around the world as of Sunday afternoon.
Mobilization has begun with massive recruitment nationally of patients who have recovered from COVID-19. The National COVID-19 Convalescent Plasma Project is asking these people to donate their plasma. Michigan had 433 confirmed cases of recovery as of Friday, the most recent state data available.
Leaders of the effort say plasma donations from those who have recovered from COVID-19 could be used to help those who are battling the virus now since there are no official treatments.
Researchers also want to launch a clinical trial in tandem with the plasma intervention to avoid relying on anecdotal accounts. They expect to determine efficacy within weeks and possibly inform care by summer.
Nigel Paneth, a professor of epidemiology, biostatistics and pediatrics at Michigan State University who's part of the project's leadership, emphasized it's impossible to know if plasma will help patients with COVID-19 until a clinical trialis complete.
"But everything points in the direction that it’s promising,” Paneth said. “It’s more promising than anything else we have to offer.”
The push now is to get those who are no longer infected with the virus to donate their plasma, also known as convalescent sera, at the American Red Cross or a center affiliated with the American Association of Blood Banks. The project is also recruiting health care workers willing to administer the plasma that contains antibodies to sick patients.
"The way it works is simple," said Arturo Casadevall, chair of the Department of Molecular Microbiology and Immunology at Johns Hopkins University and key leader of the project. "If you or I get coronavirus, and we recover, our blood has antibodies that kill the virus.The people (recovered from COVID-19) carry in their blood anitibodies that can be used on those sick or in danger of getting sick."
Already, plasma from those who have recovered from COVID-19 has been used successfully in 10 sick people in China, according to a March 18 article in the journal Proceedings of the National Academy of Sciences of the United States of America.
A March 27 article in the Journal of the American Medical Association showed five COVID-19 patients in China who were on ventilators improved after they got plasma, three of whom were discharged from the hospital.
Health care providers are starting to give plasma to patients with COVID-19 in the U.S., including to a handful of patients in New York and Texas.
The federal Food and Drug Administration announced last week that it would facilitate access to plasma for treating COVID-19.
"This is an important area of research — the use of products made from a recovered patient's blood to potentially treat COVID-19 in those affected by this illness," FDA Commissioner Dr. Stephen M. Hahn said.
Those lobbying recovered virus patients to donate their plasma include Dr. Mona Hannah-Attisha, who helped uncover the Flint Water Crisis and has had COVID-19.
Gov. Gretchen Whitmer highlighted on social media last week the need for donated plasma.
And Kayleigh McEnany, national press secretary for President Donald Trump's 2020 campaign, recently tweeted: "Convalescent plasma with antibodies from recovered coronavirus patients is another potentially effective treatment."
Health care workers on the front lines are hoping for anything as they continue to care for COVID-19 patients, sometimes having to intubate them and watch them die. "It's a nightmare," said Reem Atshan, a nurse who works at Beaumont Hospital in Grosse Pointe.
Convalescent plasma is the liquid part of the blood that health care providers have used medically for more than 100 years in other coronaviruses such as SARS and MERS. It also has been used to help patients with measles, mumps, polio and pneumonia, according to Casadevall, who co-authored a March 13 paper in the Journal of Clinical Investigation that launched the national plasma project.
"When you look at the 100-year use of convalescent sera, the data is encouraging," Casadevall said. "It’s worked more often than it’s not."
The reports of plasma use in COVID-19 that have come out of China are also encouraging, Casadevall added, but they are anecdotal. That's why he and other scientists want to do one of the first major clinical trials to show if it works.
Sites are being set up across the country now that the FDA approved a clinical trial involving plasma with those who have recovered from plasma. He predicted a trial, involving patients who get the plasma and those who don't, could be known within six weeks.
"This is going to go on for months," Casadevall said. "We could know by summer how best to use this: what’s the dose, when to use this, when to give it, when it's going to be effective."
Nearly 4,000 people had signed up to donate their plasma as of last week, Paneth said, including 177 people in Michigan.
The pandemic continues to sweep across the country, infecting so many patients that it is crippling health care systems. Last week, Whitmer ordered people to stay in their homes until the end of April to mitigate the spread of the virus.
The biggest issue for the Detroit-based Karmanos Cancer Institute, which is participating, is getting the plasma, said spokeswoman Kristine Kilbourne. That is why it's referring recovered COVID-19 patients to the Red Cross to donate.
"The main limiting factor is the availability of convalescent plasma. We are urging people who have recovered from a COVID-19 infection to check with the Red Cross to see if they could donate their plasma."
This comes during the first large-scale study in the country to find out if a drug commonly used to treat lupus, hydroxychloroquine, can prevent COVID-19. The study is being limited to 3,000 first responders and health care workers on the front lines.
Meanwhile, Wayne State University and the Detroit Medical Center are considering a clinical trial involving plasma that is part of the project, said Dr. Robert Sherwin, director of ResearchOne at WSU's School of Medicine.
This is exciting to Sherwin, who is also an emergency room physician at Sinai-Grace Hospital in Detroit, because he is taking care of patients in a world he likens to a war zone at a hospital that has been among the most overwhelmed.
“There is essentially no specific proven therapies right now, and we really have nothing to offer these patients with any definitive confidence that it will improve their outcome," Sherwin said.
"It's frustrating and heartbreaking. Everyone is an emotional wreck because of this right now. Not because of lack of efforts, but out of pure frustration. The disease is winning."