Plasma therapy has potential to cause life-threatening complications: Health Ministry. (Representational)
New Delhi:
The convalescent plasma therapy is no “magic bullet” to deal with coronavirus, and only large-scale controlled trials can ascertain its efficacy as part of the treatment strategy, top medical experts said on Monday, even as several states are considering the use of the therapy to treat critically-ill COVID-19 patients.
The therapy involves taking antibodies from the blood of a person who has recovered from COVID-19 and transfusing those antibodies into an active coronavirus patient to help kickstart the immune system to fight the infection.
The Health Ministry last week warned against its use, saying that the plasma therapy for treatment of coronavirus patients is at an experimental stage and has the potential to cause life-threatening complications.
However, some state governments, including Rajasthan, Punjab, Maharashtra and Delhi have shown keenness for plasma therapy treatment, and the Centre has permitted few states to perform plasma therapy on a limited number of COVID-19 patients.
Top medical experts feel it should not be looked upon as something that could make a “huge difference” in the treatment of COVID-19 and only randomised controlled trials can prove its efficacy as an important treatment strategy.
Director of AIIMS, Delhi, Randeep Guleria said there have been very few convalescent plasma therapy trials as far as COVID-19 is concerned, and only in very few patients it has shown some benefit.
“It is just one part of the treatment strategy. It helps improve the person’s own immunity by giving what we call passive immunity because the antibodies in the plasma enter the blood and try to help fight the virus in the afflicted individual. It is not something which will dramatically make a difference,” Guleria told PTI.
There is no study to suggest that “it is a magic bullet” or it will make a dramatic difference, but it is part of the armamentarium of treatment that physicians have along with other drugs, the senior pulmonologist said.
ICMR has already called for a proposal and a large number of institutes have enrolled for the convalescent plasma therapy trials, he said.
“Important issue to remember is that not everyone’s plasma can be given, you also have to test the blood —-whether it is safe and also has enough antibodies. So, you have to have an antibody testing mechanism which is being done by NIV (National Institute of Virology), Pune, to show that the plasma you are giving has enough antibodies” Guleria said.
Research should be done on a multi-pronged treatment strategy and should not be focused on only one strategy, the AIIMS Director said.
“You will need to give it to a large number of individuals, more than 200 or 300 people and then analyse the data…We should go ahead in research mode giving it to more people and do a proper well conducted study so as to know one way or the other,” Guleria said.
Dr Vivek Nangia, Director Pulmonology, MICU and Sleep Disorders, Fortis Hospital, Vasant Kunj, said the therapy is only in the experimental stage, but it is promising as there is a clinical knowledge involved, and also some experiments and past experience behind it having been used for SARS and H1N1 epidemics in a limited manner.
“Dire circumstances require desperate measures, you need to have an out of the box thinking and this is one of those measures, when nothing else is working you want to try this, there is no harm. It has its pros and cons,” he told PTI.
Backing Mr Guleria, Mr Nangia also said, “larger randomized placebo-controlled trials are very essential only then we can make it a standard of therapy.”
These expert views come amid lack of definitive evidence in favour of or against the use of the convalescent plasma therapy.
As per reports, a patient who was administered plasma therapy for the first time at a private hospital here was discharged last week after being cured, while the first person to undergo plasma therapy in Maharashtra had died in Mumbai’s Lilavati Hospital.
Chief minister Arvind Kejriwal had said last week that the Delhi government will not stop clinical trials of plasma therapy to treat severely-ill COVID-19 patients as its initial results are good.
Rajasthan Chief Minister Ashok Gehlot on Sunday said that with the ICMR nod, SMS hospital in Jaipur will start convalescent plasma therapy on COVID-19 patients from Monday, while Maharashtra, which had started the trials last month after a nod from the ICMR, is considering to continue with it despite the Union health ministry warning.
Professor Rajesh Malhotra, Chief Trauma Centre AIIMS, said as of now, there is no concrete evidence of convalescent plasma therapy’s usefulness.
“It essentially relies on the assumption that the body fires up its resistance in the form of chemicals called antibodies to fight the infection and those who have recovered have sufficient numbers in their convalescent plasma to fight the infection,” Malhotra said.
However, the degree of antibody response that a person throws and the timing are variables, making it difficult to have a predictable standard protocol, he said.
It is too early to say if plasma treatment is the only way and it has its own risks also, the AIIMS professor said, adding that at present it is at best an experimental therapy and definitive answers cannot be obtained without large-scale trials.
Dr Pankaj Kumar, Head of Critical Care Unit Fortis Hospital, Shalimar Bagh, echoed similar views, saying trials till now are too small to clear doubts about the therapy and large-scale trials should be done.
“Theoretically speaking it should be helpful because we are taking the antibodies from a person who has had the infection. But it is still experimental… we have to weigh the risks and benefits,” he told PTI.
Dr Atul Kakar, Vice-Chairman, Department of Medicine, Sir Ganga Ram Hospital, said it is very important to pick the right patient for being the donor as he has to have a very severe infection so that the antibodies are quite high and should be free from other viruses.
World
35,26,344Cases
21,45,320Active
11,33,059Recovered
2,47,965Deaths
Coronavirus has spread to 187 countries. The total confirmed cases worldwide are 35,26,344 and 2,47,965 have died; 21,45,320 are active cases and 11,33,059 have recovered as on May 4, 2020 at 6:14 pm.
India
42,836 2573Cases
29,685 1615Active
11,762 875Recovered
1,389 83Deaths
In India, there are 42,836 confirmed cases including 1,389 deaths. The number of active cases is 29,685 and 11,762 have recovered as on May 4, 2020 at 5:00 pm.
State & District Details
State | Cases | Active | Recovered | Deaths |
---|---|---|---|---|
DistrictCases Mumbai3029 Pune660 Thane465 Nashik96 Nagpur76 Mumbai Sub Ur67 Yavatmal32 Aurangabad30 Sangli27 Ahmednagar27 Sholapur21 Buldhana21 Palaghar17 Akola17 Raigad17 Satara14 Kolhapur8 Latur8 Ratnagiri7 Amravati6 Jalgaon3 Osmanabad3 Sindhudurg (kudal)2 Chandrapur2 Dhule2 Beed1 Washim1 Parbhani1 Jalna1 Nandurbar1 Gondia1 Hingoli1 Details Awaited*8310 |
12974 678 |
10311 536 |
2115 115 |
548 27 |
DistrictCases Ahmedabad1298 Surat338 Vadodara188 Rajkot40 Bhavnagar32 Anand28 Bharuch23 Gandhi Nagar17 Patan15 Narmada12 Panchmahal11 Banaskantha10 Arvalli8 Chhota Udepur7 Kutch6 Mehsana6 Botad5 Porbandar3 Mahisagar3 Kheda3 Gir Somnath3 Dahod3 Sabarkantha2 Valsad2 Morbi1 Jamnagar1 Tapi1 Details Awaited*3362 |
5428 373 |
4096 199 |
1042 146 |
290 28 |
DistrictCases Tj From Quaritine1080 Central Delhi184 South East130 West Delhi122 South Delhi70 North Delhi60 Shahadara48 South West Delhi42 East Delhi38 New Delhi37 North West Delhi32 North East Delhi25 Details Awaited*2681 |
4549 427 |
3123 321 |
1362 106 |
64 |
DistrictCases Chennai303 Coimbatore133 Tiruppur109 Dindigul76 Erode70 Tirunelveli62 Chengalpattu53 Tiruchirapalli50 Namakkal50 Thiruvallur48 Thanjavur46 Madurai46 Nagapattinam44 Theni43 Karur42 Ranipet39 Villupuram36 Thoothukudi27 Thiruvarur27 Cuddalore26 Tenkasi26 Salem24 Vellore22 Virudhunagar19 Tirupattur17 Nagerkoil (kanyakumari)16 Sivagangai12 Tiruvannamalai12 Ramanathapuram11 Udagamandalam9 Kancheepuram9 Perambalur5 Ariyalur4 Kalllakurichi3 Pudukottai1 Details Awaited*1503 |
3023 266 |
1614 227 |
1379 38 |
30 1 |
DistrictCases Indore915 Bhopal277 Khargon41 Dhaar41 Khandwa (east Nimar)32 Ujjain29 Raisen29 Hoshangabad25 Jabalpur25 Barwani24 Dewas18 Vidisha13 Ratlam13 Morena13 Mandsaur9 Agar8 Shajapur6 Sheopur-kalan4 Alirajpur3 Gwalior3 Sagar2 Shivpuri2 Chindwara2 Betul2 Rajgarh1 Dindori1 Tikamgarh1 Details Awaited*1403 |
2942 96 |
1979 87 |
798 |
165 9 |
DistrictCases Jaipur537 Jodhpur228 Bharatpur102 Kota99 Tonk95 Banswara60 Iran Evacuees60 Nagaur58 Jhunjhunu37 Bikaner35 Jaisalmer32 Bhilwara28 Ajmer23 Jhalawar20 Churu14 Dausa13 Alwar7 Dungarpur5 Sawai Madhopur5 Udaipur4 Hanumangarh3 Karauli3 Pali2 Pratapgarh2 Sikar2 Dholpur1 Barmer1 Details Awaited*1410 |
2886 114 |
1459 |
1356 235 |
71 6 |
DistrictCases Agra241 Lucknow167 Gautam Budha Nagar98 Meerut75 Saharanpur72 Kanpur59 Firozabad58 Moradabad58 Ghaziabad41 Shamli26 Bijnor26 Basti19 Bulandshahar18 Sitapur17 Hapur17 Amroha17 Baghpat15 Rampur15 Varanasi14 Budaun13 Azamgarh7 Auraiya7 Sambhal7 Mathura6 Maharajganj6 Ghazipur6 Kannauj6 Pratapgarh6 Bareilly6 Muzaffar Nagar5 Jaunpur5 Lakhimpur Kheri4 Mainpuri4 Hathras4 Kanshi Ram Nagar (kasganj)3 Mirzapur3 Etah3 Etawah3 Kaushambi2 Banda2 Pilibhit2 Hardoi2 Rae-bareilly2 Unnao1 Sultanpur1 Bara-banki1 Sant Kabir Nagar1 Shahjahanpur1 Sant Ravi Das Nagar (bhadoi)1 Mau1 Gonda1 Allahabad1 Details Awaited*1566 |
2742 116 |
1939 54 |
758 60 |
45 2 |
DistrictCases Kurnool158 Guntur128 Krishna76 Nellore67 Prakasam44 Kadapa37 West Godavari35 Anantapur29 Chittoor28 East Godavari24 Visakhapatnam20 Details Awaited*1004 |
1650 67 |
1090 28 |
524 36 |
36 3 |
DistrictCases Sasnagar61 Jalandhar48 Patiala26 Pathankot24 Nawanshahr (sbs Nagar)19 Ludhiana16 Amritsar11 Mansa11 Hoshiarpur7 Moga4 Rupnagar3 Sangrur3 Faridkot3 Kapurthala2 Barnala2 Fatehgarh Sahib (sarhind)2 Muktsar1 Gurdaspur1 Firozepur1 Details Awaited*857 |
1102 330 |
964 324 |
117 5 |
21 1 |
DistrictCases Hyderabad472 Suryapet75 Nizamabad56 Vikarabad36 Hyderabad Rural (ranga Reddy)35 Gadwal (jogulamba)32 Medchal30 Warangal25 Adilabad19 Karimnagar19 Nirmal18 Yadadri15 Nalgonda15 Mahaboobnagar12 Kamareddy11 Sangareddy8 Khammam7 Medak6 Asifabad (komarambhim)5 Kothagudem (badadri)4 Jagityal3 Siricilla (rajanna)3 Bhupalpally (jayashanker)3 Nagarkurnool2 Peddapally2 Mulugu2 Janagoan2 Siddipet1 Mahabubabad1 Details Awaited*163 |
1082 19 |
563 |
490 32 |
29 1 |
DistrictCases Kolkata184 Howrah79 North 24 Parganas46 Purba Mednipur21 Hooghly12 South 24 Parganas9 Kalimpomg7 Paschim Burdwan7 Nadia6 Jalpaiguri5 Darjeeling4 Paschim Mednipur4 Diamond Harbour-hd3 Murshidabad2 Basirhat-hd1 Purba Burdwan1 Nandigram-hd1 Details Awaited*571 |
963 41 |
777 39 |
151 |
35 2 |
DistrictCases Bandipora81 Srinagar79 Baramulla43 Kupwara31 Jammu27 Shopian22 Udhampur20 Ganderbal14 Badgam13 Kulgam6 Rajouri4 Samba4 Anantnag3 Pulwama3 Details Awaited*351 |
701 35 |
406 2 |
287 33 |
8 |
DistrictCases Mysuru84 Bbmp66 Belagavi42 Vijayapura32 Kalburgi27 Bengaluru (u)23 Bagalkote21 Chikkaballapur16 Bidar15 Dakshin Kannada14 Ballari13 Mandya12 Bengaluru (r)12 Uttara Kannada11 Dharwad7 Gadag4 Udupi3 Tumakuru2 Davanagere2 Kodagu1 Chitradurga1 Details Awaited*234 |
642 36 |
312 13 |
304 22 |
26 1 |
DistrictCases Siwan29 Nalanda28 Munger20 Begusarai9 Patna7 Gaya5 Buxar4 Gopalganj3 Nawada3 Bhagalpur1 Bhojpur1 Lakhisarai1 Saran1 Vaishali1 Details Awaited*404 |
517 35 |
388 27 |
125 8 |
4 |
DistrictCases Kasaragode170 Cannanore(kannur)92 Ernakulam24 Kozhicode (calicut)20 Malappuram20 Pathanamthitta17 Thiruvananthapuram14 Thrissur13 Idukki10 Kollam9 Palakkad8 Alappuzha5 Kottayam3 Wyanad3 Details Awaited*92 |
500 |
95 |
401 1 |
4 |
DistrictCases Nuh57 Faridabad42 Gurgaon38 Palwal34 Panchkula18 Ambala12 Sonepat7 Karnal6 Panipat5 Sirsa4 Yamunanagar3 Bhiwani3 Kurukshetra2 Kaithal2 Jind2 Hissar2 Rohtak1 Fatehabad1 Charkhi Dadri1 Details Awaited*202 |
442 48 |
192 29 |
245 18 |
5 1 |
DistrictCases Khurda (bhuvaneshwar)46 Bhadrak8 Balasore3 Jajpur2 Kalahandi2 Kendrapara2 Sundargarh2 Cuttack1 Dhenkanal1 Puri1 Details Awaited*95 |
163 3 |
102 |
60 4 |
1 |
DistrictCases Ranchi25 Bokaro10 Hazaribagh3 Dhanbad2 Simdega2 Deoghar1 Giridh1 Koderma1 Details Awaited*70 |
115 |
90 |
22 |
3 |
DistrictCases Chandigarh26 Details Awaited*68 |
94 |
75 |
19 |
0 |
DistrictCases Dehradun24 Nainital9 Haridwar7 Udhamsingh Nagar4 Almora1 Pauri Garhwal1 Details Awaited*14 |
60 1 |
20 |
39 |
1 1 |
DistrictCases Korba28 Raipur5 Bilaspur1 Durg1 Rajnandgaon1 Details Awaited*21 |
57 14 |
21 14 |
36 |
0 |
DistrictCases Golaghat9 Marigaon6 Dhubri4 Goalpara4 Nalbari4 Kamrup Metro2 Cachar1 Hailakandi1 Kamrup1 Karimganj1 Lakhimpur1 S Mancachar1 Details Awaited*8 |
43 |
10 |
32 |
1 |
DistrictCases Leh (ladakh)14 Details Awaited*27 |
41 1 |
24 1 |
17 |
0 |
DistrictCases Una16 Solan9 Chamba6 Kangra5 Hamirpur2 Sirmaur1 Details Awaited*1 |
40 |
5 |
34 1 |
1 |
DistrictCases South Andaman16 Details Awaited*17 |
33 |
1 |
32 15 |
0 |
DistrictCases Gomati1 North Tripura1 Details Awaited*14 |
16 12 |
14 12 |
2 |
0 |
DistrictCases East Khasi Hills11 Details Awaited*1 |
12 |
11 |
0 |
1 |
DistrictCases Puducherry6 Details Awaited*2 |
8 |
3 |
5 |
0 |
DistrictCases North Goa6 South Goa1 |
7 |
0 |
7 |
0 |
DistrictCases Imphal West1 Thoubal1 |
2 |
0 |
2 |
0 |
DistrictCases Aizwal West1 |
1 |
1 |
0 |
0 |
1 |
0 |
1 |
0 |
Source link