COVID-19 in Uganda: Could convalescent plasma treatment save us?

Today, Uganda, in an exciting move, is going to start treating COVID-19 patients with convalescent plasma. According to Dr. Aceng and Ministry of Health, commencement of this trial will determine the efficacy of the treatment and inform our next steps. According to the minister, writes Amamukirori Betty of New Vision, the treatment trial is starting today, Thursday 17th 2020, at Mulago National Referral Hospital. Well, this is an exciting move. But we aren’t the only ones!

Apparently, two African countries, South Africa and Ghana, are already using the treatment. On 23rd August 2020, President Trump of the United States enforced the same measures when he announced emergency use of the treatment and, at the same time, ‘pointing fingers’ at FDA for delaying to authorize COVID-19 medicines, a move he suspects is related to ‘deep state’ conspiracy.

As you can see, the question of who is using the treatment option isn’t important now. But the most important question is, does it work?

Before we can dive deeper into the available evidence regarding efficacy and effectiveness of convalescent plasma treatment, let us first understand what it is.

What is convalescent plasma treatment for COVID-19?

In medical science, the word ‘convalescent’ simply means ‘recovery’. Plasma, on the other hand, means the fluid part of the blood. Actually, it is the largest part of blood. Blood cells are usually suspended in the bigger fluid part. This fluid is usually rich in salts, water, and enzymes. Anyway, in layman’s language, let us keep it ‘the fluid part of blood, in which blood cells are swimming or suspended’. Now, convalescent plasma must be the plasma of a recovering patient. For COVID-19, it means the blood plasma of the person who has recovered from COVID-19. Are we together? Good!

The concept of using the blood is this: When a person gets COVID-19, his or her blood produces antibodies (or soldiers) to fight off COVID-19. And when this person survives or recovers from the disease, it is true the antibodies he had generated against COVID-19 are still there in his blood plasma. Scientists, thank science, are able to pick out these antibodies or ‘antibodied’ plasma and give (transfuse) them to another sick person, thereby boosting his immunity against the same disease. But does it really work? Let us explore some evidence.

A prospective cohort study (published in Lancent) on 49 COVID-19 patients who were treated with plasma revealed improvement and recognizable reduction in death-rate. Importantly, the study revealed that the treatment has no serious side effects. In this regard, I think, it is re-assuring to try it. Also, reveals Mayo Clinic’s study on about 35,000 patients, those who started on it sooner (4 days) after COVID-19 diagnosis performed better than those who started on it late (10 days). On a sad note, A JAMA study published a little earlier had shown no ‘big’ benefits of the treatment. However, notes Beusekom of CIDRAP, the trial was cut-short and, also, the patients involved were very ill. Maybe,  I suppose, the treatment is of little or no help to those who are very sick. And, generally, in relation to science, this is logically okay. If someone is very sick, it simply means the disease is beyond the fight of ‘just antibodies’.

Conclusion

In USA, about 72,000 patients have been treated with kind of treatment. Safety data on about 5,000 of them reveals no serious side effects. Actually, severe adverse events are reported in less than 1% and do not necessarily relate to the specifics of the treatment but to usual side effects of normal blood transfusion, for example, cardiac overload, allergies or reaction, and others. With this, I strongly suggest we move ahead with the move. And, please, if you got COVID-19 and recovered, it is your time to be a hero by donating your blood plasma. How about that?

NB: Maybe I would strongly call upon the Ministry of Health to be careful with data or information. Let everyone and everything be documented well. This will give us big data for further study and analysis. Don’t take any information for granted, just write it down. Thank you