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India likely to remove plasma therapy from its COVID-19 treatment guidelines : Here’s why

India likely to remove plasma therapy from its COVID-19 treatment guidelines : Here’s why
Plasma therapy involves transfusion of plasma from a convalescent coronavirus patient to a critical patient.

The largest plasma therapy study has found that this old medical procedure did not reduce mortality or severe illness in COVID-19 patients.

Written by Longjam Dineshwori |Updated : October 22, 2020 9:49 AM IST

In the absence of a vaccine or any effective drug to treat COVID-19, some medical practitioners have recommended the use of convalescent plasma therapy for fighting the infectious disease. It is an old medical procedure that uses antibodies found in the blood taken from a recovered Covid-19 patient to treat those with severe SARS-CoV-2 infection.

The U.S. FDA had recently approved the emergency use of convalescent plasma for the treatment of coronavirus patients in the country. India too has been allowing "off-label" use of the therapy, which means the hospitals may charge patients for the medical procedure. In fact, many doctors have raised concerns about the sale of plasma in the black market at exorbitant prices across the country. There are also reports of people seeking plasma donations for COVID-19 patients through social media platforms. But the largest plasma therapy study has found that this medical procedure did not reduce mortality or severe illness in COVID-19 patients.

Based on these findings, the Indian Council of Medical Research (ICMR) - the country's apex health research agency - is now considering excluding convalescent plasma therapy from its guidelines on COVID-19 treatment completely.

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Findings of the ICMR's plasma therapy study

Balram Bhargava, director-general of the Indian Council of Medical Research, on Tuesday, signaled the possibility of the plasma therapy being deleted from the national guidelines, citing the study results.

The ICMR's plasma therapy study, called PLACID, is claimed to be the first and largest randomised control trial to be completed in the world. The study that included 464 patients from 39 hospitals across the country was conducted between April 22 and July 14. The trial results indicated that though the use of convalescent plasma seemed to improve the resolution of shortness of breath and fatigue, there was no difference in 28-day mortality or progression to severe disease among moderately ill COVID-19 patients. The study report was published in Medrxiv, a pre-print server for health sciences, on September 9.

According to Bhargava, the research paper has also been accepted for publication in the British Medical Journal. Meanwhile, discussions are on for this procedure to be deleted from the national guidelines, he said at a briefing by the Union health ministry.

There is a possibility of reinfection

Studies have indicated that antibodies decline in COVID-19 patients after some months. If the antibodies reduce, then there is a possibility of reinfection, said Bhargava while highlighting the importance of wearing a mask and taking precautions even if one has recovered from the disease.

Bhargava also said an expert medical panel is also examining the findings of the World Health Organisation study that suggested that remdesivir and hydroxychloroquine do not prevent deaths in COVID-19 patients.

As part of its "Solidarity" trial, the WHO is evaluating the effects of four potential drug regimens, including remdesivir, hydroxychloroquine, anti-HIV drug combination lopinavir/ritonavir and interferon, in 11,266 adult patients from over 30 countries.

The WHO revealed the results last week and suggested that the regimens appeared to have little or no effect on 28-day mortality or the length of the in-hospital course among patients hospitalized with coronavirus.

Gilead Sciences Inc's remdesivir is among the first to be used as a treatment for Covid-19. It received emergency use authorization from the US FDA on May 1, and has since been authorized for use in several countries. The antiviral medication was also one of the drugs recently used to treat US President Donald Trump's coronavirus infection.