Plasma is ‘Most Promising Treatment We Have,’ But More is Needed
Dr. Sarah Dilley was the first Hoosier COVID-19 survivor to donate plasma.
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As a subscriber you can listen to articles at work, in the car, or while you work out. Subscribe NowThe scramble to find a reliable treatment for COVID-19 that works for every patient continues, but an Indianapolis infectious disease doctor says, “The only option we have now is convalescent plasma, and our overall impression is we finally have something that works.” Ascension St. Vincent in Indianapolis is leading the pack, dosing the largest amount in the state of the “Hoosiers helping Hoosiers” blood-based treatment. But Versiti Blood Center of Indiana, the state’s largest blood provider, is hopeful more COVID-19 survivors will donate.
Antibodies are the immune system’s natural response to invaders. Patients who have recovered from COVID-19 have developed these warriors for this particular virus and can donate their antibody-rich blood plasma to hospitalized patients trying to beat COVID-19. The U.S. Food and Drug Administration approved the treatment as an emergency investigational new drug in late March, and the use of convalescent plasma has been ramping up in Indiana since mid-April, when the first Hoosier received the therapy. Ascension St. Vincent Infectious Disease Chairman Dr. Markian Bochan says, at the time, need drastically outpaced supply, and the situation felt “disastrous” as a result.
“Back then, we were trying to save [convalescent plasma] for our sickest people. When you only have a few doses, and you’ve got people dying in the ICU fairly frequently during that period, you’re going to use it on them first,” says Bochan. “We’re probably the largest user of this product in Indiana right now. Currently, if you’re sick enough to be admitted and you’re requiring oxygen…we don’t even waste time anymore. Those people are considered candidates for this particular treatment.”
Ascension St. Vincent is part of the national convalescent plasma trial led by the Mayo Clinic, which has tracked the treatment of more than 16,000 patients in the U.S. Bochan says the Indianapolis hospital has dosed 85 COVID-19 patients with convalescent plasma. While the Mayo Clinic trial will provide a broader picture of the treatment’s effectiveness, Bochan says, “We feel pretty strongly that this has impact.”
“There have been more than a handful of cases where patients have, for example, been on 15 liters of oxygen, which is very close to being ventilated or requiring mechanical ventilation. Within 48 hours, they’re down to two liters after they get [convalescent plasma],” says Bochan. “There’s significantly more cases where they’re kind of teetering; we give the product, and within two to four days, there’s steady, slow improvement, and ultimately, they go home and avoid intubation. So as a whole, we feel this is probably the most promising treatment we have.”
In the first days the hospital began giving patients the plasma, Bochan says about half of its usage was for critically-ill patients on ventilators; that group “did have some success stories in it, albeit a fairly small number.”
Bochan notes crediting the improvements to the plasma can be a gray area: are the outcomes better due to the plasma, other support measures delivered in the ICU or a combination of factors? Regardless, due to convalescent plasma’s promise and its status as “certainly the only treatment we have that we give right upfront,” Versiti is hungry for more of it to supply Hoosier hospitals.
“We’re only seeing a small fraction of the people who have recovered from COVID-19 come in as plasma donors,” says Versiti Senior Medical Director Dr. Dan Waxman.
At the time of publication, 139 recovered COVID-19 patients in Indiana had donated plasma; because one donation can create at least three blood products, 700 products have been generated to help Hoosiers battling the virus. To swell the supply, Versiti is encouraging more Hoosiers who have beat COVID-19 to give plasma
Versiti was previously the Indiana Blood Center; in 2019, the Milwaukee-based nonprofit merged five blood centers in the Midwest to become the 5th largest blood provider in the U.S. and enhance its “discovery, diagnosis and treatment” capabilities. “We’re able to do things much more on the cutting-edge, due to being a larger group. [The merge] really does bring expertise as a collaborative force, being a larger entity and a more diverse one,” says Waxman. “One of the really cool things about [convalescent plasma], in particular, is we can take local donors and create a therapy to treat our local patients—so it’s something we’re doing right here in Indiana, which is really neat. Now, Hoosiers can participate in helping other people get well. It’s a real personal touch.” Editor’s note: Potential recovered COVID-19 donors can learn more about Versiti’s program and register at http://www.versiti.org/covid19plasma or call 1-866-702-4673. Because Versiti spans five Midwestern states, Waxman says that collaborative force helped the organization be among the first to use convalescent plasma to battle COVID-19. Waxman says, as elective surgeries ramp back up in Indiana and eased stay-at-home orders produce more emergency situations—such as car accidents—the need is also great for routine blood products. Bochan says Ascension St. Vincent is feeding the most donors to Versiti, because the hospital team quickly created a website to help patients navigate the process of donating convalescent plasma.