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How plasma treatment works, a hope in the fight against coronavirus

2020-06-23T20:40:29.539Z


A GBA hospital pioneered recovery of transfusions for critically ill patients. Now donation campaigns are multiplying and they are promoting a law.


Fiona González March

06/22/2020 - 16:18

  • Clarín.com
  • Zonal

In a few months, the coronavirus went from being an unknown disease that plagued China's daily life and hospitals to become one of the greatest challenges for world science.

With more than 460,000 deaths around the planet, the so-called silent enemy reminded the most terrible of pandemics, such as smallpox, HIV and cholera, as doctors and specialists work against the clock to stop it. 

In thousands of laboratories, vaccine projects, drug treatments and clinical trials seek to stop Covid-19. And an old therapy has become a powerful hope for the most serious patients in the last two months: convalescent plasma transfusions  .

In Argentina , this old treatment re-emerged as a spearhead after the impressive recovery of a patient injected with plasma at a health center in the Conurbano Bonaerense.

Since the Trauma and Emergency Hospital Doctor Federico Abete , of Malvinas Argentinas , began to experiment until the mayor Martín Insaurralde (Lomas de Zamora) was treated with plasma, in the corridors of the building of Pablo Nogués they redoubled their efforts to check if the therapy is effective for coronavirus. The investigations are multiplied throughout the country, and only in the Province of Buenos Aires there are already some 150  recovered who were injected with plasma extracted from other patients who overcame the disease.

Plasma therapies emerged in Argentina in the mid-1950s, to combat hemorrhagic fever.

The method is not new. It was in the  1950s , when the hemorrhagic fever epidemic was hitting Argentine society, that it was discovered that the plasma (which could be described simply as the liquid part of the blood ) of convalescents could be applied to infected patients to help their antibodies to resist disease.

More than half a century later, our country's health system reactivated this treatment based on the premise that no one saves themselves: those who beat the coronavirus with their own antibodies can donate plasma to help those who do not.

"When someone survives a virosis, they inadvertently become the only tool for those who are infected," summarizes Dr. Patricia Méndez, Head of Hemotherapy at the Trauma Hospital in Malvinas, the first to use this therapy in the GBA.

The method consists of injecting plasma rich in antibodies, donated by patients who had coronaviruses, to those more serious cases awaiting intensive care or whose clinical symptoms are complicated, as was the case of Insaurralde. 

Plasma is the liquid part of the blood. When you have antibodies from people recovered from an illness, you can help another patient overcome the same pathology.

Hope yes, cure no

"On May 18 one of our patients with coronavirus presented an extremely critical condition, and we decided to ask the Ministry of Health for permission to treat it with plasma," says Patricia Méndez.

“At that time it remained to confirm some protocols of the Provincial Hemotherapy Plan, but they gave us authorization to do so. At 48 hours he was already evolving , and a few weeks later he was discharged, "adds the doctor. Today, in the hospital located on Miraflores and Bailen streets, 5 kilometers from the descent of route 197 in the Panamericana, 12 patients from 16 treated have already recovered .

Being effective in the majority of treated patients, many confuse plasma therapy with a cure . The specialists clarify that it is a "passive immunization" , which means that the plasma does not produce antibodies, but helps the organism of the infected patient to create them.

In the United States , for example, a Johns Hopkins University project brought together 34 hospitals and universities in 17 states to do clinical plasma testing on Covid-19 patients. Colombia and the United Kingdom are other countries where they promote plans to study effectiveness.

The donation campaign

In many ways, the plasma donation process is similar to that of blood: you must be between 18 and 70 years old, and weigh at least 50 kilos. In addition, the donor must be in good health.

In mid-April, the CUCAIBA (Single Coordinating Center for Ablation and Implant of the Province of Buenos Aires) began receiving people recovered from Covid-19 willing to donate plasma rich in antibodies. From its headquarters in Capital Federal, the Coordinating Center administers and distributes the doses to those hospitals in need of plasma.

“The patient has to be recovered, have the approved blood studies and a minimum of 14 days of discharge . Before donating, check that you have the optimal amount of antibodies. There are 30% of recovered patients who do not develop them ”, details Daniel Fontana, coordinator of the Directorate of Blood and Transfusion Medicine of the National Ministry of Health.

Before donating plasma, the patient should be screened for the optimal amount of antibody to be produced. 30% of those recovered do not develop them.

An intense campaign to attract plasma donors was installed throughout the Province of Buenos Aires. In addition to Malvinas Argentinas, Escobar, Florencio Varela and Almirante Brown are some of the districts that armed with the motto “donating plasma saves lives”. The UBA Faculty of Medicine also joined the call.

At the El Cruce hospital, by Florencio Varela, they receive plasma donations like the one they used to treat Martín Insaurralde.

In Malvinas and Escobar, for example, they managed to streamline the donation process. Before, the patient had to go to CUCAIBA to carry out the corresponding studies, confirm that he was fit and then donate. Now, the Hemotherapy departments of the Trauma Hospital and the Néstor Kirchner Hospital , in Maquinista Savio , can carry out all the previous studies in their facilities and then accompany the patient to CUCAIBA to donate.

At Almirante Brown, on the other hand, they implemented a system of calls : they communicate by phone with each recovered patient and invite him to donate.

Once the age, health and medical history of the volunteer is approved, the volunteer is referred to the El Cruce Hospital in Florencio Varela , where the plasma that helps the residents of the surrounding areas is administered. The plasma with which they treated the communal chief of Lomas de Zamora, Insaurralde, was derived from there.

From solidarity to the excitement of coming home

The first donor, a Banfield doctor

Fernando Fernández is a doctor, and works in Avellaneda and Recoleta. When he caught the coronavirus, he was traveling in Europe - a journey he had dreamed of for years.

Fernando Fernández caught coronavirus from traveling in Europe, recovered in Argentina and became the first plasma donor.

In March, with the quarantine decree for the pandemic and the fearful world, he returned to his  native Banfield . Only then did he know that he was ill. 

With a little sore throat, he decided to go to his place of work, the Sanatorium Finochietto, to have it checked. "I was diagnosed with pneumonia. But two days later I had the swab result: positive for coronavirus, ”he says.

Fernando recovered from the Covid-19 on his own. And when few spoke of plasma transfusion, he became the first donor in our country .

“When I returned to work, they told me that they were starting to receive plasma in the Hemotherapy center. It was mid-April, the tests were just beginning, "says the doctor, who upon learning of the campaign approached as a volunteer. “I had the news that two people who received my plasma had been with a more serious picture and recovered. It was a huge satisfaction, "he says.

"The virus was eating him up inside"

Julio Fabián is 59 years old, lives in Grand Bourg and, according to his family, "never suffered anything worse than the flu." Because of his clean medical history and compliance with mandatory social isolation, it was an unpleasant surprise to learn that he had coronavirus.

"It had a little temperature the first days of May, but we thought it was a temporary flu, one of those that come with winter," explains his son, Carlos, who was infected by his father and then "passed" the virus to him. his two brothers.

Julio Fabián (left) was the first patient treated with plasma in the Province of Buenos Aires, after 40 days in critical condition. Now he returned home with his son Carlos.

For several weeks, Julio was hospitalized in intensive care and, on more than one occasion, "he seemed to be leaving us," explain the intensive care staff at the Trauma Hospital in Malvinas, where he was admitted. His own son describes: "The virus was eating him up inside."

After  40 days in critical condition , the doctors decided that his strength deserved a last try: they administered convalescent plasma. It was the first in a public hospital in the Province.

Within 48 hours, it began to respond and within a few days, its antibodies had defeated the virus. Due to an in-hospital infection, Julio's stay in Trauma was prolonged, but his body was already clean of Covid-19.

After Julio's successful therapy, more patients from the Malvinas Argentinas hospital were treated with plasma, including his son Carlos . Now, recovered and grateful to his donor, Julio waits from Grand Bourg for the necessary days to come closer to donate and contribute to the system that saved his life.

They met in therapy and recovered together

Julio Fabián's son, Carlos Arapa (40) , also became infected with Covid-19 and became seriously ill. It was in therapy at the Malvinas hospital that he met José Iturbe (43), a construction worker just like him, and a victim of the pandemic. 

Both were admitted in the first days of May, and spent 15 days in the infected patient area of ​​the health center. With similar symptoms and symptoms that worsened over the days, Carlos and José were offered, like Julio Fabián, plasma treatment.

Carlos Arapa learned that he had a coronavirus after taking his father, Julio Fabián, to be tested. He ended up receiving the same therapy as him: plasma.

“I was in a terrible state, I don't wish it on my worst enemy. I was weak, almost surrendered, until one of the doctors asked me for permission to undergo convalescent plasma treatment. Obviously I said yes, and luckily my body did not reject it, "says Carlos.

“I shared the therapy with other people who were on the road. They gave me a chance . I'm not a believer, but I think that the one above did something for me ”, José is sincere. It is that 48 hours after the transfusion, the residents of Malvinas improved. "The virus receded," they say.

José Iturbe became friends with Carlos Arapa in therapy at the Trauma hospital. And they were released at the same time.

By April 24, colleagues by profession and colleagues in intensive care were already outside. Now, grateful and from their homes, they chat on WhatsApp about the experience they had to live and they agree: "For us it was miraculous."

Advancement of the Compulsory Donation Law

Two weeks ago, when the first plasma treatments were beginning to show favorable results, from Malvinas Argentinas they started to push for a bill to make treatment visible, increase research, and make all those recovered from coronaviruses donate their plasma .

It was presented by Luis Vivona , a Buenos Aires senator from the Frente Para Todos and a political leader allied to Mayor Leonardo Nardini in the district. And it has already obtained approval in the Buenos Aires Senate, as well as support from the Buenos Aires Legislature and various municipalities of the AMBA.

The Buenosairean senator Luis Vivona, of Malvinas Argentinas, promotes the project of the plasma law so that all those recovered from coronavirus donate.

"The objective is to disseminate plasma-related issues and make available to the Governor and the Executive Power the importance of plasma from patients recovered from Covid-19," explains the legislator.

As it is an urgent matter, the Health Commission of the Buenos Aires Senate has already discussed the bill, and there was unanimous approval from the senators. The president of the Health Commission, Gustavo Traverso, even referred to treatment as an "important resource for the health system." Now, the endorsement of the upper house of the legislature is missing , when it returns to session.

“The situation in Malvinas is an example: of the 16 people treated with plasma, 6 were discharged, 4 are in intensive care and 6 in medical clinics. In other words, 12 people out of 16 responded well to the treatment ”, Vivona details. "The law regulates, but what it serves is the dissemination and the Municipalities of the Province are already carrying out awareness campaigns."

Source: clarin

All news articles on 2020-06-23

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