A COVID-19 patient at the University of Wisconsin Health University Hospital received plasma transfusions from an individual who recovered earlier this month as part of an ongoing nationwide effort to explore treatment options while doctors await the discovery and mass-production of a vaccine.
UW joined the National COVID-19 Convalescent Plasma Project, along with 56 other institutions spanning across 46 states, shortly after the group’s inception in March, and completed the first of multiple transfusions in mid-April.
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While UW researchers said it is too early to determine precisely how effective plasma transfusions will ultimately prove to be in treating COVID-19, Dr. William Hartman, a UW health anesthesiologist spearheading UW’s efforts against the virus, said those who received plasma from donors generally responded well to treatment.
“[Response to transfusions] looks different in different people,” Hartman said. “But in general, we see the severity of respiratory symptoms have been reduced.”
Hartman said the Convalescent Plasma Project’s COVID-19 study is restricted to treating two groups of patients—those experiencing severe symptoms and those who are life-threateningly ill. Hartman said the criteria to be labeled severely symptomatic included a respiratory rate of over 30 breaths per minute and a blood oxygen saturation level below 93%. To be classified as life-threateningly ill, a patient must experience organ failure or require a ventilator to breath.
As COVID-19 continues to spread throughout the U.S., health experts fear the number of confirmed cases may explode as anti-social distancing protesters swarm cites across America. The fight to develop an effective treatment for the deadly virus is a race against time.
Consequently, UW professor of pathobiological sciences and zoonotic disease expert Kristen Bernard said researchers rely on the empirical data obtained from previous pandemics—many of which differ greatly from COVID-19—to draw up potential treatment options for the rapidly-spreading disease—and blood transfusions are a historically successful method.
“This type of therapy [plasma transfusions] has been used before,” Bernard said. “Transfusion of blood or plasma from survivors was used to treat Ebola. Another similar type of therapy uses intravenous immunoglobulin and it was used to treat patients with West Nile Virus.”
There is cause to be optimistic about the potential of blood treatments to combat COVID-19. Hartman said plasma transfusions proved effective in combating a variety of coronavirus strains, including the MERS outbreak which began in 2012 and the SARS pandemic of 2003.
Hartman said transferring donor blood from those who recovered from a pathogen to a patient battling an illness delivers antibody proteins to the patient’s bloodstream that recognize and attack the virus.
UW professor of immunology and viral infections expert Dr. Marulasiddappa Suresh said significant health risks are associated with blood transfusions if done improperly, including the development of a condition which renders plasma recipients more susceptible to coronavirus infections.
“One major risk is the possibility of acquiring other infections from the donor plasma,” Suresh said. “Other risks are possible reactions of the patient to the transferred plasma. Another possibility is that antibodies might enhance virus infection by a phenomenon called antibody-dependent enhancement.”
Obtaining the COVID-19 antibody does not guarantee a patient will not contract the virus again. In fact, multiple cases were reported throughout Asia in which patients who already beat the illness tested positive a second time. Though, Hartman said these cases could prove to be anomalies and many of those who tested positive twice were asymptomatic before their second diagnosis.
Suresh said in conjunction with widespread efforts to implement plasma transfusions, medical experts are exploring medicinal remedies for the potentially lethal symptoms of COVID-19, including Hydroxychloroquine.
“Hydroxychloroquine and Remdesivir are used as antivirals to help patients fight the infection,” Suresh said. “Recent promising evidence suggests that the anti-viral drug Remdesivir might be helpful in treating COVID-19.”
Hartman said UW Health is intrigued and excited by the early indicators of success witnessed in patients who received plasma transfusions and said other institutions participating in the National COVID-19 Convalescent Plasma Project reported similar results.
Hartman said UW Health intends to continue offering plasma transfusions to patients, and he believes the nationwide coalition will do the same in the coming months and can do so because of the dedication of his colleagues.
“We wouldn’t be at this point without the hard work done,” Hartman said. “The efforts by the people involved in this project were monumental. They worked tirelessly.”