Barely a month after its chief said he would recommend removal of convalescent plasma therapy from guidelines for Covid-19 treatment, the Indian Council of Medical Research (ICMR) has come out with an advisory to prevent its indiscriminate use in the country.
More importantly, it recommended the minimum concentration of antibodies that should be present in plasma of donors, as lower concentration of specific antibodies against SARS-CoV2 virus makes it a futile exercise, the advisory issued on Tuesday night said.
Plasma therapy should done in early stages of the infection, preferably between three-seven days since the onset of symptoms and not after 10 days.
The ICMR, which carried out the world’s largest randomised controlled trial on effectiveness of plasma therapy in Covid-19 management and found that it failed to stop disease progression or mortality, clearly mentioned this evidence-based advisory was meant to address ‘inappropriate use of convalescent plasma in Covid-19 patients’.
A number of hospitals, mostly private healthcare facilities, in the country have been pushing a substantial number of Covid-19 patients so indiscriminately that a high-level meeting chaired by Home Minister Amit Shah on Sunday urged an expert committee, consisting of ICRM Director General Balram Bhargava, NITI Aayog Member (Health) Vinod K Paul and All India Institute of Medical Sciences-New Delhi Director Randeep Guleria to come out a protocol to regulate its abuse.
The ICMR advisory has clearly mentioned that its trials as well as those carried in China and the Netherlands have failed to establish that plasma therapy can improve clinical outcomes.
Apart from having sufficient concentration of antibodies in donor plasma, it is also important that the potential recipient has no specific antibodies (IgG) against SARS-CoV2 in his or her blood. This, the advisory said, was important as this could then nullify the procedure.
It also said that anyone between the age of 18 and 65, excluding pregnant women, and those weighing over 50 kg can donate plasma after 14 days of vanishing of symptoms (testing negative for Covid-19 is not necessary).
Meanwhile, close 38,600 people tested positive with Delhi reporting 6,396 cases — the highest among the States — in the last 24 hours. During the same period, 44,739 people recovered, bringing down the number of active cases in the country to 4,46,805. As many as 474 people died since Tuesday morning taking the total Covid-19 death toll to 1,30,993.