|A paper titled, “Convalescent Plasma Therapy in Coronavirus Disease 2019: a Case Report and Suggestions to Overcome Obstacles,” was recently published in the Journal of Korean Medical Science.
A local hospital said it has cured a Covid-19 patient by using plasma from a previously recovered patient with a different blood type.
Plasma therapy refers to administering blood plasma minus red cells, white cells, and platelets to Covid-19 patients from those who recovered from the disease. The treatment has been drawing attention as an alternative treatment to fight Covid-19 because vaccines or treatments are still not available.
A medical team, led by Professor Lee Jin-soo of the Infectious Disease Department of Inha University School of Medicine, recently published the case report of a 68-year-old man who recovered from Covid-19 through convalescent plasma (CP) therapy, in the Journal of Korean Medical Science.
The patient was diagnosed with Covid-19 on March 27 and admitted to Inha University Hospital. On the first day of hospitalization, he showed pneumonia symptoms and received hydroxychloroquine and lopinavir/ritonavir (brand name: Kaletra) every 12 hours.
Medical workers detected pneumonia in his chest X-ray on the third day of hospitalization. On day five, the patient received oxygen therapy. On day nine, his symptoms deteriorated, and the medical team began the plasma therapy.
Having blood type B, the patient received 250 ml of plasma from a donor with blood type A for two consecutive days. During the next three days, the patient’s respiratory distress and fever showed definite improvement. “There was no evident adverse effect of the ABO mismatch,” the research team said.
However, the patient showed respiratory distress four days after the plasma transfusion. The doctors began heparin infusion for pulmonary vein thromboembolism. He could leave the hospital after receiving extracorporeal membranous oxygenation (ECMO) for 12 days.
When the patient was discharged, he did not have any complications or the Covid-19 virus.
“ABO blood group mismatching can be a major problem for whole blood transfusion, but not for plasma transfusion,” the research team said. The most critical concern in the use of plasma therapy is transfusion-related acute lung injury (TRALI).
“Some clinicians have vague concerns about TRALI when performing ABO-mismatch CP, but TRALI is rarely associated with ABO mismatch,” they said.
In May, Russia’s Federal Biomedical Agency under the Ministry of Health said recipients and donors of plasma must match when using CP therapy for Covid-19 treatment.
The research team said it was difficult to evaluate the effects of plasma therapy. Still, their experience highlighted several points to be addressed for the widespread use of plasma therapy.
The nation’s Blood Management Law makes it difficult to collect plasma from a donor in a nearby hospital and send it to the hospital where the patient is located, the team pointed out. Thus, the government should revise relevant laws to help facilitate the transport of plasma between medical institutions and introduce systems such as plasma banks eventually, the researchers said.
As plasma therapy is regarded as a temporary and limited treatment, there is no randomized controlled study of plasma therapy, they went on to say. However, new emerging infectious diseases might spread without established treatments, and plasma therapy could be one of the few available options.
The research team recommended establishing an effective plasma therapy system that can fight other infectious diseases that may emerge in the future.
As of Tuesday, 229 people have registered as plasma donors for the development of plasma therapy to combat Covid-19, according to the Korea Centers for Disease Control and Prevention (KCDC).