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Is blood plasma a cure for COVID19?

Treatments

A. The evidence suggests it’s still not clear.

For today’s #TBT, we’re revisiting our previous post from May 12 which summarized the history, rationale, evidence to date around the use of blood plasma (also referred to as convalescent plasma) to treat COVID19. This was also a popular question from our weekly roundup, *and* it’s been the subject of major news headlines these days.

The National COVID-19 Convalescent Plasma Project (NCCPP) is an outstanding resource of all the ongoing clinical trials, the key scientific papers to date, and it includes information about how to donate blood or to receive plasma as treatment. It was created by group of physicians and scientists from 57 institutions in 46 states who assembled to investigate the use of plasma as treatment for COVID-19.

Some key takeaways:

• Convalescent plasma is a treatment that’s more than a century old and was used to treat other infectious diseases, including the 1918 Pandemic Flu, MERS, and the 2003 outbreak of SARS, but with varying results.
• While it has shown some promise based on several observational studies, other studies have found no benefit.
• Of note, there is currently still no evidence of its efficacy from randomized clinical trials (RCT). As noted by the NCCPP, “Until randomized trials are completed in the future…we will not know for sure that it works and, if it does, in what circumstances, and for whom.”
• Several RCTs studies are currently underway. Some of these studies include investigations of synthetic antibodies that can be reproduced in a laboratory.

Why did the FDA recently withhold emergency authorization for blood plasma as treatment for COVID19?

–Based on the weak evidence that it works; however, the agency noted that as trial results are reported, this decision may be reversed
-Interestingly enough, FDA authorization can also make it more difficult to carry out the RCTs necessary to determine if a treatment really works. This article talks about why that is.

What does this mean for doctors and patients who still want to try plasma as treatment for COVID19?

Not a whole lot. Blood plasma is still accessible as a treatment option through the FDA’s expanded access program.  Emergency use authorization would’ve minimized the paperwork and approvals needed to access this treatment, but it remains available if a doctor deems it necessary.

BOTTOM LINE: We still don’t have strong evidence that blood plasma is effective for treating COVID19. Randomized clinical trials will be needed to ultimately settle this question, and the Nerdy Girls will be here to deliver (and interpret) those results as they become available!

LINKS:
TBT post on convalescent plasma (May 12)
National COVID-19 Convalescent Plasma Project (NCCPP)

Link to original FB post