KOLKATA: Convalescent
plasma therapy (CPT) could be very helpful in managing Covid-19 patients less than 67 years old: it can quell cytokine storm, significantly mitigate hypoxia, reduce hospital stay and provide greater chances of survival for patients with acute respiratory distress syndrome, a study at the state-run
Beliaghata ID Hospital, under the joint initiative of the Centre of Scientific Research (CSIR) and the Bengal government, has found.
The initial findings have enthused researchers, with Arturo Casadevall, professor of microbiology, immunology and infectious diseases at the prestigious John Hopkins School of Medicine, tweeting about the study’s findings. A scientist of repute, Casadevall is the principal investigator of a 35,000 patient-strong plasma trial in the US.
A recent CPT trial conducted by the Indian Council for Medical Research (ICMR) had found no benefits, prompting the Centre to contemplate removing the therapy from the official
Covid treatment guidelines. In its latest advisory about two weeks ago, however, the council did not ask doctors to discard the therapy altogether, but advised against its indiscriminate use, further suggesting when and how to administer it.
Principal investigator Dipyaman Ganguly, an associate professor at the Institute of Chemical Biology (IICB), said: “We knew that not all patients would benefit from the therapy. Our quest, therefore, was to identify patients who would be best benefited. We hope the result of our study would pave the way for more specific guidelines.”
ICMR had conducted the trial at 39 hospitals across the country on moderately infected patients. The trial in Kolkata, under the DCGI (
Drugs Controller General of India) was conducted on patients admitted at the ID hospital who had ARDS. Patients who received the therapy included those with co-morbidities, such as aplastic anaemia and kidney failure.
While the ICMR study examined the efficacy of plasma therapy, the one by CSIR and the Bengal government went into the immunological impact of CPT, the first such scientific study in India.
The randomized control trial in Kolkata had taken in 80 patients, half of whom received standard therapy while the other half got CPT. All the plasma units used in the study were collected at the plasma bank at Medical College Hospital, Kolkata. Each unit was screened not only for neutralizing antibody content but also the antibody level in the plasma.
“While across all age-groups, no statistically significant clinical benefit was registered for patients in the CPT arm, significant immediate mitigation of hypoxia, reduction in hospital stay as well as survival benefits were recorded in severe Covid patients with ARDS aged less than 67 years who received the therapy,” said the final finding of the study, published on Monday but yet to be peer-reviewed.
The team also analysed 48 cytokines, a group of proteins secreted by specific cells of the immune system. Many severely infected Covid patients undergo a ‘cytokine storm’, or an aggressive inflammatory response to the virus. The trial observed a calming of this cytokine storm in patients after receiving plasma, indicating the therapy’s anti-inflammatory role.
The study however, noted that although the administration of plasma led to an immediate reduction in hypoxia, the effect wore off in some patients from the third day onwards.
Funded and supported by CSIR, the clinical trial involved doctors from the ID hospital, Medical College and School of Tropical Medicine, including Yogiraj Ray, Shekhar Ranjan Paul, Bihbhuti Saha and Prasun Bhattacharya. Two other scientists from IICB — Sandip Paul and Shilpak Chatterjee — were instrumental in the study, led by Ganguly.
“We have submitted our findings to the state health department as well,” said infectious diseases specialist Ray, the clinical investigator.