Explained: Why Karnataka has not used plasma therapy on a second patient

The first patient who had undergone plasma therapy to treat COVID-19 succumbed to his comorbidities on May 14.
Blood donation
Blood donation

Doctors in Karnataka said that they have not tried the experimental convalescent plasma (CP) therapy for the second time in the state to treat COVID-19 simply due to lack of an eligible patient.

Incidentally, the first patient who had undergone this treatment succumbed to his comorbidities on May 14. The state Health and Family Welfare Department had said that the 60-year-old man was suffering from multiple comorbidities and could not be revived after he suffered a cardiac arrest.

It may be recalled that Karnataka was one of the first states in the country to get approval from the Indian Council of Medical Research (ICMR) to use this form of treatment on April 22.

The treatment involves injecting plasma of patients who have recovered from the disease to vulnerable patients. The Health Department had earlier said that only patients who are in critical support will be given this treatment— like patients in Intensive Care Units (ICUs) or on ventilator support.

Speaking to TNM, Dr CR Jayanthi, Dean and Director of the Bangalore Medical College and Research Institute (BMCRI) dismissed that the death of the patient had any role to play in this.

“So far, we have only tried to treat the (one) patient using plasma therapy and no one else. The inclusion and exclusion criteria for the patients is very clear as per the direction of the Directorate General of Healthcare Services. We cannot violate the criteria,” she told TNM.

As reported earlier, Bengaluru-based HCG Cancer Hospital, which had got the regulatory approval, had partnered with BMRCI for the controlled study.

Dr Gururaj, director of iCREST, the head researcher for this treatment at HCG Hospitals, said plasma therapy is targeted for patients who have already reached the midphase of infection but not with much acute respiratory symptoms and distress or pneumonia.

He also said, “We have treated one patient but unfortunately the patient passed. We now are evaluating what happened with that particular patient and what were the scenarios at every stage of the treatment.”

He said that this, however, did not mean that the experiment has failed.

He explained, “The therapy has shown positive response across the globe, not only in combating COVID-19 but also other diseases as well. Unfortunately for us, the first plasma patient did not survive, even though he initially responded to the treatment. It is obviously a complex issue in the clinical scenario. I can always sit in the lab and tell you what exactly we should do but, when it comes to clinical practice, doctors are bombarded with a number of things depending on patient-to-patient. Especially in the pandemic situation, it is far more complex. We have continuous discussions with clinicians to get the right patient profile to use this treatment procedure.”

Dr Gururaj explained that through this therapy, doctors are trying to mimic an efficient memory response like a vaccine would do.

He said, “The plasma therapy works on the memory response. It will appear as if the patient’s immune system will remember that this is what the infection looks like and combat the infection as if he has been given a vaccine or already has recovered from the disease.”

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