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We know these are desperate times and everyone wants to do everything within their abilities to save their people. But, convalescent plasma should be avoided by all means now, as it’s doing more harm rather than any good. Here is a thread on it, why it shouldn’t be used anymore
Let’s see how it works,
Plasma is nothing but ready antibodies derived from a recovered patient which are induced in a patient to neutralise the virus and curtail the infection.
As we know over the time SARS COV-2 had went through multiple mutations and with more
(2/n)
Plasma is nothing but ready antibodies derived from a recovered patient which are induced in a patient to neutralise the virus and curtail the infection.
As we know over the time SARS COV-2 had went through multiple mutations and with more
(2/n)
Spread, major significant mutations are taking place and that too at swifter pace.
Now with changes in spike protein and structural change in receptor binding domain of virus the antibodies produced against a certain earlier variant may not be able to neutralise
(3/n)
Now with changes in spike protein and structural change in receptor binding domain of virus the antibodies produced against a certain earlier variant may not be able to neutralise
(3/n)
More evolved newer variants. Thus, providing no benefit.
When a patient is induced antibodies from convalescent plasma which were developed against a preceding variant and the patient is right now infected with different variant and their is major divergence
(4/n)
When a patient is induced antibodies from convalescent plasma which were developed against a preceding variant and the patient is right now infected with different variant and their is major divergence
(4/n)
between the two variants, antibodies which are not able to effectively neutralise the virus gives it an opportunity to evolve. This selection pressure on virus can lead to mutations and emergence of more new variants more rapidly thus laying foundation of future outbreaks.
(5/n)
(5/n)
Convalescent plasma therapies with change in variant can also lead to antibody dependent enhancement ADE. At times when certain antibodies are not able to neutralise the virus they end up helping in binding of the virus to receptor which rather than neutralising the virus
(6/n)
(6/n)
Thus ends up increasing infection in patients. ADE had already been observed in SARS, MERS and other respiratory virus infections including RSV and measles.
Trials in Maharashtra had shown higher mortality in plasma group, and trial was stopped
https://timesofindia.indiatimes.com/city/mumbai/maharashtras-plasma-trial-stopped-as-data-reveals-higher-mortalities/articleshow/80162802.cms
(7/n)
Trials in Maharashtra had shown higher mortality in plasma group, and trial was stopped
https://timesofindia.indiatimes.com/city/mumbai/maharashtras-plasma-trial-stopped-as-data-reveals-higher-mortalities/articleshow/80162802.cms
(7/n)
In Brazil’s Second wave with P.1 which has E484K mutation,
2.7 times higher fatality rate was observed in younger age group which had high seroprevalence from from first wave, this higher fatality is now being attributed to ADE.
Multiple trials had shown that
(8/n) https://twitter.com/maneesh312/status/1379400589373665280
2.7 times higher fatality rate was observed in younger age group which had high seroprevalence from from first wave, this higher fatality is now being attributed to ADE.
Multiple trials had shown that
(8/n) https://twitter.com/maneesh312/status/1379400589373665280
Convalescent plasma therapy provides does not improves survival or any other clinical outcome.
Here is a meta-analysis published in JAMA of 4 peer-reviewed and published randomized clinical trials including 1060 patients and 6 unpublished
(9/n) https://jamanetwork.com/journals/jama/fullarticle/2777060
Here is a meta-analysis published in JAMA of 4 peer-reviewed and published randomized clinical trials including 1060 patients and 6 unpublished
(9/n) https://jamanetwork.com/journals/jama/fullarticle/2777060
clinical trials with 10 722 patients.
So, please don’t trouble yourself with finding donors for plasma, it ain’t worth your efforts.
There is no magic remedy for covid yet. Nothing helps more than early diagnosis and early intervention.
(n/n)
So, please don’t trouble yourself with finding donors for plasma, it ain’t worth your efforts.
There is no magic remedy for covid yet. Nothing helps more than early diagnosis and early intervention.
(n/n)
