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Why do I wish there was more focus on the convalescent plasma preprint than the @NEJM remdesivir study? Let me give you 10 quick reasons to spread the news about convalescent plasma. #covid19 #statstwitter #methods #scicomm #research #covid4mds
1: convalescent plasma would be a back to basics 100 year old treatment that just makes sense. Once healthy people have recovered and have antibodies, these antibodies can often be transfused to those in need
2: if convalescent plasma works, it holds a lot of hope for the world. It makes it seem that #COVID19 is like other infectious diseases; most people's immune system works and we can build strong enough immunity so that it can even be passed to others with transfusion
3: there is also a discovery possibility for advancing a vaccine or a manufactured antibody. If we learn the correlates within plasma that help the most, this can give more insight about how we can fight #COVID19; If remdesivir works it doesn't really get us closer to a vaccine
4: there are often supply limitations with new therapies at the beginning. The more attention to remdesivir, the more demand for indications where there is likely little benefit. https://twitter.com/AndyBiotech/status/1263966165182922753
5: on the other hand, supply for plasma is modifiable and the more attention it gets, the more supply can go up . Even if the message gets so much attention that a groundswell of uninfected people want to donate, this can still help our blood supply.
6: the convalescent plasma study is admittedly small & not randomized and the largest benefit (80% less mortality) was in a subgroup. But, keep in mind, before this we had even weaker uncontrolled case series, and the subgroup points to earlier treatment https://www.medrxiv.org/content/10.1101/2020.05.20.20102236v1
7: The remdesivir results were randomized, larger, and encouraging that they achieved a clear mortality benefit, but it still seems like a modest benefit overall. Also, that good news was mostly already available from the early press release https://www.nejm.org/na101/home/literatum/publisher/mms/journals/content/nejm/0/nejm.ahead-of-print/nejmoa2007764/20200522-01/images/img_xlarge/nejmoa2007764_f2.jpeg
8: Apparently @NEJM does not allow preprints, so we had to wait a long time from initial press release about the remdesivir results until the full results were published. In the mean time, the drug was authorized for emergency use by the FDA, but without release of full results
9: Although we still need to wait for peer review for the convalescent plasma results, peer review can begin right now with scholars reviewing what has been posted in full text on @medrxivpreprint https://www.medrxiv.org/content/10.1101/2020.05.20.20102236v1.
10. Not only is this more transparent, but it also shows the value in giving the study more attention. Particularly for those who disagree with this thread, the more attention the preprint gets, the more feedback we can get in this early stage.
