Treatment of 5 critically ill COVID patients with convalescent plasma (JAMA)

[octoberlib]

Link to tweet

*Preliminary* #COVID19 study in
@JAMA_current

- 5 critically ill pts. on mechanical ventilation
- All treated w/ convalescent plasma w/ #SARSCoV2 antibody
- In 4/5, SOFA score⬇, viral loads⬇, ARDS resolved
- All 5 stabilized, 3 at home
* Need an RCT

https://jamanetwork.com/journals/jama/fullarticle/2763983?utm_source=twitter&utm_campaign=content-shareicons&utm_content=article_engagement&utm_medium=social&utm_term=032720#.Xn5LBtcTflo.twitter

[badseedboy]

1. This

is huge!

[FarPoint]

2. Only the rich will get this treatment...

I don't see it being readily available...it makes sense to do this....just saying...money is the determining end all factor.

[totodeinhere]

9. Due to privacy considerations thye cannot release the names of the patients so we really

don't know if they are rich or not.

[ck4829]

16. Of course it will be extremely expensive to purchase... even though it would be cheap to produce

For those who don't know; how you produce blood plasma is not a complicated procedure, you get blood, you run it through a centrifuge, you draw the yellow liquid in the separated mixture... blood plasma acquired.

Heck, you could get blood plasma yourself if you have 250 dollars lying around.

https://www.pulmolab.com/product_info.php/scientific-fixed-centrifuge-place-with-timer-p-222?gclid=EAIaIQobChMIrrqmhZW96AIVWf_jBx0w7QiPEAkYAiABEgIaVvD_BwE

We're going to watch another AZT, epi-pen, or daraprim situation unfold.

[Hortensis]

19. :) Now, now. That's as realistic as saying no rich people will get it,

and this is GOOD news. Be glad. Anyway, one of the qualifying criteria was impending death. You don't want to qualify.

On to trials.

Link to tweet

[BComplex]

3. But it's something!

n/t

[FarPoint]

4. Trump could mandate the production......

There are thousands of Plasma Centers that could collect the specimens...and process the end product with the needed IgG antibody.

But then...it is trump.....

Nah...it is so way over his head...beyond the scope of his comprehension...

[Lochloosa]

5. Now if we only knew who had the virus and recovered.

Maybe we should test them.

[Wednesdays]

6. Hopefully, they can refine that into a cure!

[Jirel]

7. So, no useful conclusion.

A sample size of 5 is not enough to tell us anything. Also, with no control group, there is no way to compare outcomes.

[totodeinhere]

10. We could use some good news and the fact that those patients are doing better is good news. n/t

[octoberlib]

11. This is preliminary. Encouraging results mean they can move on to a clinical trial

[drmeow]

17. not true about control groups

Single arm historical control trials are legit and are what I think we are going to have to rely on for this.

[Wounded Bear]

18. Yeah, you can't have a control group testing for a cure for a fatal disease...

Promising news, though.

[Hortensis]

21. :) Publication in JAMA suggests it is of interest to professionals,

who already know a great deal about this century-old kind of treatment. At least we can reasonably assume there would be no shortage of antibodies to harvest from patients if needed.

Treatments: Next, we have treatments, that can kill or stop the virus in infected patients. Many anti-virals have been developed for treating HIV, Ebola, Hepatitis, cancer and SARS and many of them are being tried in China (and S. Korea and Italy) on an experimental basis. Some of the anti-virals are being modified based on an understanding of the genetic and protein structure of the new virus. Even the malaria drug Hydroxychloroquine is proving effective is some cases. The diary mentioned above lists 24 different efforts to develop SARS-CoV-2 treatments.

Antibodies: In between these two approaches lies a method that has been used since the 1890s to treat various diseases — the injection of virus antibodies into the bodies of patients or healthy individuals. In other words, unlike vaccines where the immune system generates antibodies to fight the virus, we can develop or harvest anti-bodies and inject them into patients and healthy individuals. Unlike vaccines, the period during which the antibodies will be effective is shorter (weeks to months), but these antibodies can be developed in a much shorter time than vaccines and can save lives until a vaccine is available.

There are two different approaches to developing antibodies — one is to develop them based on knowledge of the SARS-CoV-2 virus structure and to grow them in lab animals; the other approach is to “harvest” antibodies from recovered Coronavirus patients. The 2nd approach is also known as plasma therapy, convalescent serum treatment and passive antibody therapy .

Plasma or Convalescent Sera Treatment

Here is an article published more than a week ago that provides some background on plasma treatment for COVID-19.

Link to tweet

[emmaverybo]

8. They were all also treated with anti-virals and prednisone. It was NOT a randomized control study.

Last edited Fri Mar 27, 2020, 07:12 PM - Edit history (1)

How were the three at home on a ventilator?

Anyone able to translate this info into layperson terms?

Edited it. NOT RCT.

[octoberlib]

14. I'm guessing that doctors were throwing

everything at patients in hopes that it would work and when it didn’t tried plasma. Off of these results Mt Sinai is starting an RCT so would should get a better idea of how well this works.

[emmaverybo]

15. Ah. Good.

[pat_k]

12. Kick

[uponit7771]

13. My understanding this technique was used in 1918 pandemic too

[Hortensis]

20. Not even a new treatment, though new antibodies, trials, etc.,

needed. This DailyKos article from Mar 15 actually seems pretty informative and includes this treatment.

https://www.dailykos.com/stories/2020/3/15/1927475/-Some-Novel-Coronavirus-Treatments-in-the-Pipeline-Antibody-Harvesting-and-Plant-Based-Vaccines