The Indian Council of Medical Research (ICMR) released an advisory note urging all state governments and health authorities to use convalescent plasma therapy (CPT) sparingly, as it is only beneficial in specific cases.
This news comes after a large-scale research trial named PLACID, conducted by the ICMR, confirmed that CPT does not reduce the severity of infection or prevent mortality in Covid19 patients. “Despite all this evidence, inappropriate use of convalescent plasma is taking place, and we thought the right way to address this issue was through this advisory,” Dr. Samiran Panda, head of epidemiology and communicable diseases division at ICMR, told The Indian Express.
Convalescent plasma therapy (CPT) is a procedure in which doctors extract Covid19 antibodies from recovered Covid19 patients and inject them into sick patients. This procedure has been used previously to treat SARS, swine flu, and Ebola, and helps build immunity against a disease. After India authorized CPT for Covid19 treatment in April, plasma therapy became so sought after that it led to frequent calls for plasma donors on social media and black market plasma sales.
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The specific criteria that ICMR suggests revolve around the characteristics of donors and recipients. Health authorities should only consider individuals aged 15 to 65, weighing more than 50 kgs, who have tested positive via RT-PCR tests for Covid19 as potential donors. The ICMR also specifies that only women who have never been pregnant can qualify as donors. For recipients, ICMR specifies that individuals should be in the early stages of Covid19 — not more than 10 days from the onset of symptoms.
The advisory specifies, “It is speculated that convalescent plasma having a low concentration of specific antibody against [the novel coronavirus] may be less beneficial for treating Covid19 patients as compared to plasma with a high concentration of such antibodies. This advisory, therefore, embraces the principle that a potential donor for convalescent plasma should have a sufficient concentration of antibody working against Covid19 as narrated in the matrix below.”
While the ICMR advocates caution regarding CPT, others have questioned its conclusions given the absence of placebo controls and neutralizing antibody tests in the PLACID trial.
“Covid care is individualized care. The use of the right drugs in the right patient does work. Some of the therapies can be continued on compassionate grounds,” Dr. Shashank Joshi, a member of the Maharashtra task force on Covid19 and the dean of the College of Physicians, told the Indian Express.
