Plasma therapy may have helped save lives, but not everyone is eligible to donate to banks. People who have recovered from COVID-19 and wish to donate their plasma should be in the 18 to 60 age group. Besides this, donors should either be male or women who have not given birth. All donors must weigh over 50 kg. This is to mitigate the risk of transfusion related to acute lung injury.
These are some of the eligibility criteria laid down by the State government in the guidelines specified for convalescent plasma therapy. The guidelines also state that a recovered COVID-19 patient should have preferably had symptoms such as fever, cough and cold as there is a greater possibility of the presence of anti-SARS-CoV-2 IgG antibodies compared to an asymptomatic patient. That said, plasma from asymptomatic donors can be accepted if the antibodies are present.
‘Limited evidence’
While laying down the guidelines, the government in its circular dated August 22 however said that the therapy is based on ‘limited available evidence’. “As the situation evolves, and when more data becomes available, the evidence will accordingly be incorporated and recommendation upgraded,” the circular issued by Jawaid Akthar, Additional Chief Secretary, Department of Health and Family Welfare, stated.
Donors have also been advised not to donate more than twice a month. The maximum number of times a person can donate is 24 times a year. Written consent needs to be obtained from the donor.
Meanwhile, if the donor has complete resolution of symptoms at least 14 days prior to the donation, they are ‘preferably’ asked to produce an RT PCR negative report for SARS CoV 2 infection. If the donation is done after complete resolution of symptoms 28 days prior or post-discharge, a negative report is not necessary.
Counselling for patients
To ensure that more people sign up for plasma donation, the State government has said that patients admitted at COVID-19 Care institutions or hospitals for treatment should be counselled about the procedure for plasma donation during their stay.
All blood banks have been asked to identify potential donors from the list of COVID-19 recovered patients.
₹5,000 towards care
The State government has also decided to provide the donor ₹5,000 for nutrition and care. The timing of when plasma therapy is given to a patient battling COVID-19 is also crucial. ‘Plasma transfusion should be done on patients with ‘moderate disease with increasing oxygen requirements,” read the circular. It needs to be done before the patient goes into multiple organ failure. One or two units should be administered to patients on two consecutive days. The plasma transfused should be preferably from two different donors.
A senior doctor on COVID-19 duty in the State said that the medical fraternity has welcomed the guidelines. “A few States are using plasma therapy effectively to treat COVID-19 patients with co-morbidities. However, in Karnataka plasma therapy has not picked up pace and there are very few donors who have signed up. Hopefully now, the State government will give an impetus to this,” he said.
