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How does plasma therapy help in treating people with COVID-19?

Importance of Plasma in Human blood

The human body, on average, has 5-6 liters of blood. Nearly 45% of human blood comprises red blood cells (RBC), white blood cells (WBC), and platelets (thrombocytes) and 1% blood fraction is formed of buffy coat. These blood cells are suspended in a liquid called plasma that comprises 55% of blood composition. 

Plasma is a straw-colored clear liquid consisting of 92% of water, ions, nutrients and has a density of 1025 kg/m3.

What is plasma?

Plasma transports the blood cells (RBC, WBC, Platelets) to the different body parts and maintains the oxygen and carbon dioxide supply. WBC is responsible for immune responses, while platelets help in blood clotting at the injury site and reduce active bleeding.

Vital proteins, mainly albumin, fibrinogen, and immunoglobulins that help maintain oncotic body pressure, blood clotting and immunity, respectively, are present in the plasma. It also carries crucial nutrients like glucose, amino acids, and fatty acids along with the electrolytes like sodium, potassium, and magnesium that helps in maintaining the body's pH and fluid balance.

By removing body wastes in the form of urea, creatinine, lactic acid helps in excretion. Also, plasma regulates the body temperature by heat absorption and transports chemical messengers in hormones.

Function of plasma | MediMagic 3D medical video

Why should you donate plasma?

Plasma performs vital functions in the body, and hence donating plasma can help in saving many lives. 

Plasma carries essential proteins and antibodies crucial for immunity and is used to treat multiple rare diseases such as cancer, hemophilia, and primary immune deficiencies.

Importance of plasma donation- MediMagic

Some of the disorders are listed below:

Alpha-1 Antitrypsin Deficiency: 

Also called genetic emphysema is a hereditary disorder that causes fatal liver diseases in children and lung diseases in adults. Plasma donation helps in Alpha-1 proteinase Inhibitor therapy for such disorders.

Hereditary Angioedema: 

This disorder leads to obstruction in the airway and occurs due to a lack of C1 Esterase inhibitor protein (C1-INH) that regulates inflammation. Plasma-derived C1 esterase inhibitor is used to treat the recurrent episodes of subcutaneous and submucosal edema.

Hemophilia: 

A hereditary disorder caused due to lack of clotting factor VIII (hemophilia A) or factor IX (hemophilia B). In the 1960s, a method was developed to extract the blood clotting factor VIII and factor IX from fresh frozen plasma. This plasma was allowed to thaw in the cold, called cryoprecipitate plasma and used for treatment during elective surgeries in patients with hemophilia.

Von Willebrand Disease: 

It is a common bleeding disorder due to the abnormality of von Willebrand factor (VWF) that helps in hemostasis. This disorder is associated with excessive menstrual bleeding and nose bleeding. VWF carries plasma factor VIII that helps in preventing extra blood loss as vascular injury. Therefore, transfusion of plasma therapy is the choice of treatment for this disease.

Kawasaki Disease: 

It is an acute multi-system vasculitis syndrome and is the most leading cause of heart disease in children below five years. Studies have shown plasma exchange as the safe therapy for prophylaxis of coronary artery lesions in such patients.

Primary immunodeficiency disease:

It is a genetic condition causing dysfunctionality in the immune system that makes a person prone to more severe infections. Plasma therapy is an effective treatment for such disorders. 

How to donate?

Plasma can be donated by two methods. 

Firstly, the donor can give his whole blood, which the laboratory will separate.

The second method is the donation of just plasma by a process called plasmapheresis. With the help of a machine, blood is drawn from veins into a centrifuge that spins rapidly and separates the plasma from red blood cells and other components of blood. These components are returned to the donor. Plasma naturally is lighter in weight than other components and hence floats at the top of the machine. Plasma is frozen to be stored and can be saved for a year.

Plasma 3D medical videos | MediMagic Function of Plasma | Plasma Donate

Mechanical blood separation is when a blood bag is attached to a machine being used to separate blood components by pressure filtration. This is donor blood that has been labeled as blood group O, the universal blood donor group. The components of blood are of different sizes, allowing them to be separated by filtration for more efficient use of the blood. This automatic method is quicker and less labor-intensive than traditional filtration methods (hanging bags on hooks to drain the blood through filters) and centrifuge separation. Further blood processing produces components to treat various blood disorders or replace blood lost through surgery or an accident.

Who can donate?

Healthy individuals in the age range of 18 to 69-year, the weight of 110 pounds, and who have not donated plasma in the last 28 days are good choices for donation.

People with blood group AB are universal donors as they can donate blood to the person with all blood group types. A person with blood group O negative is a universal acceptor.

Plasma therapy for Covid-19

Plasma therapy for Covid-19

Comparing the pre-COVID and COVID periods we observed no significant differences in the total number of donor adverse reaction (P = 0.477), donor deferral (P = 0.093), and transfusion-related patient adverse reaction (P = 0.183).

With the increased surge of contagious coronavirus cases and lack of basic medical amities, patients struggle for appropriate and immediate treatment. However, doctors believe that reports have suggested noticeable improvement with convalescent plasma therapy for covid patients.

In this therapy, blood is extracted from the recovered Covid-19 patients who had fever, cough, cold, etc., and injected into the active covid patients. This blood is rich in SARS-Cov-2 IgG antibodies against the coronavirus, which helps in reducing the infection progression and severity.

The recovered patients in the age range of 18-60 can donate blood after 28-30 days of recovery. In addition, a person who has received COVID vaccination can also donate plasma 28 days after the date of vaccination.

Women who have been pregnant are not eligible to donate their plasma.

In a statistical analysis of a covid study, it was observed there was a total of 4295 WB (whole blood) and 104 SDP (single donor platelets) donations. Where 2878 WB and 78 SDP were collected in the pre-COVID period; the COVID period observed 1417 WB and 26 SDP donations (P < 0.05). Accordingly, blood components prepared and issued for transfusion in pre-COVID period were 8090 units and 5386 units respectively which were significantly higher compared to only 4117 and 2706 units respectively in the COVID period (P < 0.03).

However, on 18th May 2021, the ICMR-National Task Force for COVID-19 dropped convalescent plasma therapy from the treatment prescribed to manage adult COVID-19 patients. It was allowed to be used among patients with an early moderate disease with preferably within seven days of symptom onset, with high titer donor plasma availability. It was mentioned that the therapy had no use after seven days.

As per the resources, Plasma therapy has not been found effective in reducing the progression to severe disease or death and is likely to be dropped from the clinical management guidelines.

What are the risks of Plasma donation?

Plasma donation is a very safe process and is conducted in the presence of a medical professional. If the donor and the receiver are evaluated effectively before the process, there is no risk involved. Donating plasma is often associated with common and minor side effects like dehydration, lightheadedness and fatigue. Very rarely, serious side effects may occur as well.

By donating plasma, one can save many lives. In addition, research has shown that donating plasma is safe, and the process has been authorized by the Food and Drug Administration (FDA) and other critical regulatory bodies.

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