Since the first confirmed COVID-19 case was reported in the United States on January 20, the outbreak of the virus has not slowed down.

 With the total number of cases in the country approaching two hundred thousand, and the total number of deaths surpassing four thousand as of April first, doctors and medical researchers across the US are desperately working to find a treatment [1].

Until now, the only thing doctors could provide for COVID-19 patients was supportive care, but on March 21, the Food and Drug Administration (FDA) approved the use of blood plasma donated by recovered patients to treat those in critical condition.

Now, a hospital in Houston, Texas, has become the first in the nation to use the treatment.

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An Old Therapy for a New Virus

Blood transfusion therapy, also referred to as convalescent serum therapy, has been applied by doctors as an infectious disease treatment for over a century, its use dating back to the Spanish Flu pandemic of 1918 [2].

The process involves using the donated blood of recovered COVID-19 patients to help heal critically ill patients, and prevent the disease in high-risk populations, such as frontline healthcare workers [3].

Any time a person gets sick, their immune system releases proteins called antibodies that attach to the virus and destroy it. These proteins are highly specific to the antigen (in this case, a virus) that is attacking your body, which means that the antibodies your immune system releases to fight the common flu will be different than those that are released to fight COVID-19.

Research has already shown that recovered COVID-19 patients have high levels of antibodies in their blood, so doctors are now beginning to use that plasma as a treatment. According to Yuan Shi, Ph.D., MD, of the Chongqing Key Laboratory of Pediatrics in Chongqing, China, not only does the treatment appear to be working, but it has very few negative side effects.

“Evidence shows that convalescent plasma from patients who have recovered from viral infections can be used as  a treatment without the occurrence of severe adverse events,” he said. “Therefore, it might be worthwhile to test the safety and efficacy of convalescent plasma transfusion in SARS-CoV-2 infected patients.” [5]

Yuan Shi et. al – Convalescent plasma as a potential therapy for COVID-19 – The Lancet: Infectious Diseases

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How is this Different from a Vaccine?

The basic principle behind convalescent serum therapy and a vaccine is the same: use antibodies naturally produced by the immune system to prevent or treat an infection or disease. The difference is timing.

Active vaccination involves introducing a small amount of the virus into your body, which then triggers an immune response. This means that your body’s immune system will begin to make its own antibodies against the pathogen that was introduced [6].

This response, however, takes time, and the length of time it takes will vary from person to person. Convalescent serum therapy, by contrast, uses antibodies that have already been created against the virus, and so can begin working immediately [3].

Houston Hospital is the first in the US to Administer the Treatment

On Saturday, March 28, Houston Methodist Hospital became the first facility in the United States to use convalescent serum therapy to treat a COVID-19 patient. The treatment was used for a second patient the following day [2].

While it is still too early to say definitively whether or not the procedure is benefitting the patients, Dr. Marc Boom, Houston Methodist’s president and chief executive officer, believes that the hospital has no choice but to try.

“There is so much to be learned about this disease while it’s occurring,” he said in a statement. “If an infusion of convalescent serum can help save the life of a critically ill patient, then applying the full resources of our blood bank, our expert faculty, and our academic medical center is incredibly worthwhile and important to do.” [2]

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The Treatment’s Success has Varied Over the Years

Convalescent serum therapy was used during the Spanish flu pandemic in 1918, a diphtheria outbreak in the 1920s, a flesh-eating bacteria epidemic in the 1930s, and the Ebola outbreak in Africa at the beginning of the decade, all with varying levels of success [2].

A recent and very encouraging report was published in The Journal of the American Medical Association in which Chinese researchers used the therapy in five patients, all of whom showed improvement after receiving the transfusion. Three of them have since been released from the hospital, while the other two are in stable condition [7].

Due to the small size of the study, it is difficult to draw any definitive conclusions from the research, but they do suggest that it is a viable option to treat COVID-19 patients.

“The results highlight the possibility that antibodies from convalescent plasma may have contributed to the clearance of the virus and also the improvement of symptoms,” the Chinese researchers wrote [7].

 Dr. John Roback and Dr. Jeannette Guarner from the Center for Transfusion and Cellular therapy at Emory University’s medical school, believe that if a large-scale randomized clinical trial of the treatment comes back positive, it could help change the course of the pandemic [7].

Read: Antibodies Identified With Aim to Treat Coronavirus

The Need for Blood

One critical challenge for the procedure will be getting enough blood donations in order to treat the number of people who need it. As the number of recovered cases gradually begins to increase, there will be more people available to donate, but healthcare workers must encourage their patients to donate once they have recovered [7].

Doctors at Mt. Sinai Hospital in New York City are also set to begin using the therapy, but there will be strict criteria to determine who is allowed to donate blood.

Dr. Bruce Sachais, chief medical officer of the New York Blood Center, is hopeful that the treatment will be effective.

“We think this is going to be an effective treatment for at least some patients, but we don’t really know yet,” he said. “Hopefully, we’ll get some data in the next few weeks from the first patients, to see if we’re on the right track.” [8]

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