While scientists race to find a vaccine for the coronavirus, countries including Malaysia are resorting to convalescent blood plasma transfusion to treat patients severely ill with COVID-19. The treatment includes administering blood plasma from patients who have recovered from COVID-19 to patients critically ill with the novel respiratory illness. We asked experts to comment on the effectiveness of this method to treat newly-infected patients.
Associate Prof. Dr Chan Yoke Fun, Virologist & Senior Lecturer at the Department of Medical Microbiology, Faculty of Medicine, University of Malaya, said:
“Plasma contains neutralising antibody. Plasma from a recovered patient can be transfused to another infected patient for treatment. This has been used for diseases such as for SARS, MERS, chickenpox, enterovirus A71, chikungunya, Ebola etc. Neutralising antibody in plasma of recovered Covid-19 patients will bind to the SARS-CoV-2 in the infected patients, leaving no virus to infect the cells in our body. These neutralizing antibodies which are produced 10-14 days after infection will offer some protection.
“Convalescent plasma is being investigated for the treatment of COVID-19 because there is no approved treatment for this disease and there is some information that suggests it might help some patients recover from COVID-19.
“Some promising evidences:
- 10 patients in China. The treatment shortened the presence of virus in the body.
- 2 patients in Korea. Both patients with severe pneumonia showed a favourable outcome after the use of plasma in addition to systemic corticosteroid.
- 5 patients in Shenzhen, China. Administration of convalescent plasma containing neutralizing antibody was followed by improvement in their clinical status.
“Many countries have similar call for plasma donors eg. USA, Italy, Switzerland, Indonesia etc. I believe is timely Malaysia start recruiting plasma donors. So far, we have collected 12.
“For more information on the deployment of plasma for the prevention and treatment of COVID-19, this article provides a good summary.”
Dr Vinod RMT Balasubramaniam, Virologist & Senior Lecturer at Jeffrey Cheah School of Medicine & Health Sciences, Monash University Malaysia, said:
“On February 27, researchers in China published a short note in the journal Lancet Infectious Diseases citing some evidence of the success of convalescent plasma in treating Ebola and previous respiratory viruses, including SARS, MERS, and influenza H1N1. That same day, Arturo Casadevall, an infectious disease expert at Johns Hopkins School of Public Health, published an article in The Wall Street Journal about the use, to treat measles in the 1930s, of what was then called convalescent serum.
“The theory is simple. Take the blood of people who’ve recovered, let the red blood cells clot and remove them, and transfuse what’s left – the ‘serum’ into people in the early stages of the disease. (You have to match their blood types.) Not only does this process ease symptoms and potentially save lives, but it also accelerates the path to immunity, like something in between a drug and a vaccine. In addition to measles, it was used against polio, mumps, and even the 1918 influenza pandemic. However, the key to this treatment is to know how much of neutralizing antibodies are present in a recovering patient in order to use their plasma.
“Recently, a research team led by Florian Krammer, PhD, Professor of Microbiology at the Icahn School of Medicine at Mount Sinai, began working on the serologic test in January 2020, before COVID-19 had been seen in the United States. To make the test, the researchers used animal cells to produce copies of the telltale ‘spike’ protein that is present on the surface of SARS-CoV-2. That protein is highly immunogenic, meaning that people’s immune cells see it and start making antibodies that can lock onto it. The test involves exposing a sample of blood to bits of the spike protein. If the test ‘lights up,’ it means that person has the antibodies.
“Similar to the most commonly used tests for other viruses, such as hepatitis B, this test shows whether a person’s immune system has come into contact with SARS-CoV-2. This is important because we can identify those donors with a high amount of antibody who would most likely benefit the patients receiving this plasma. The more antibodies, the greater the boost to the treatment’s efficacy. However, the main challenge lies in waiting for enough patients to fully recover and develop immune responses.”
Dr Tommy Tong, Immunologist & Senior Lecturer at the Department of Biological Science, Sunway University , said:
“This is only effective if the blood from recovered COVID-19 patients contains the appropriate antibody/antibodies that can kill COVID-19 virus. Furthermore, blood should be collected from selected recovered individuals who show no COVID-19 virus at least 14 days after discharge, to minimize the possible risk of the presence of COVID-19 virus in the blood.”
|Disclaimer: These comments were complied to provide journalists with a range of expert perspectives on the subject. The views expressed here are the personal opinions of the experts. They do not necessarily reflect the views of the Science Media Centre or any other organisation unless specifically stated.|
Bionotes of experts
Associate Professor Dr Chan Yoke Fun is a virologist focused on the epidemiology and pathogenesis of enterovirus A71, an emerging virus that causes severe neurological disease. She leads a laboratory with research interests in epidemiology and pathogenesis of emerging viruses such as enterovirus A71, chikungunya, and respiratory viruses. With more than 20 years of research experience, she has over 80 publications, and has been involved in many research programs and grants at both national and international levels. Dr. Chan also served as an Associate Editor of BMC Infectious Diseases and guest editor in PLOS Neglected Tropical Diseases. She has multiple joint publications with collaborators from Asia, Europe, and the USA. Her studies have led to a better understanding of how viruses spread and infect humans.
Dr Tommy Tong graduated from Monash University, Australia with PhD in Immunology. He was working on vaccine development against human immunodeficiency virus (HIV) for his PhD dissertation, before joining Professor James Binley at San Diego for Biomedical Research (SDBRI) in USA to continue his passion in HIV research for 4 years. He is now a lecturer at the Department of Biological Science, Sunway University, and has started his own laboratory to work on HIV vaccine for Malaysians.
Dr Vinod RMT Balasubramaniam graduated from Asian Institute of Medicine, Science and Technology (AIMST) majoring in Biotechnology in 2007. During this period, he managed to publish several papers on plant genetic engineering, especially on genetically engineered orchids which have resistance towards fungus. In 2008, he worked as a research assistant with Associate Professor Sharifah Syed Hassan in her newly formed infectious disease laboratory in Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia. He embarked on his PhD course working on the various host cellular genes infected with Avian Influenza Virus H5N1 and their protein-protein interactions with viral genes. Graduated with merit in 2014, he continued to work as a post-doctoral fellow before joining Professor Adolfo Garcia-Sastre’s laboratory in Mount Sinai hospital New York, which is one of the leading Influenza research laboratory in the world. He has co-authored various publications (Cell Host Microbe, Nature Microbiology, Plos Pathogens) on various aspects of host response towards different types of viruses.
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