In the movie I am Legend, Will Smith’s character uses his blood to create a cure for a viral disease that killed 90% of the people and turned the rest into cannibalistic mutants.
That’s not only in the movies.
During a viral illness like Covid-19, the immune-competent can develop their own antibodies to kill the virus. The production of antibodies after exposure to a virus depends on their age, health status, and nutrition.
Not all who get sick with Covid-19 may develop enough immune response in time to fight the infection. The elderly and the ones with underlying diseases are at a disadvantage. That puts them at risk for severe complications and death.
Those who recover from the Covid-19 develop antibodies. Those antibodies are in the liquid part of the blood. Once extracted, it is called convalescent serum, or convalescent plasma
How does it work?
The Covid-19 virus is an antigen. Antigens are foreign substances or toxins that induce an immune response. By itself, the Covid-19 infection can elicit an immune response. But if an antibody binds to the antigen, a more robust immune response is triggered. The result is virus killing. That is good if there are enough antibodies.
Sometimes, the virus multiplication may outpace the antibody formation and causes disease. That is when the convalescent plasma steps in.
The infusion of the donated antibodies at an early stage or during the critical phase of the illness will help boost the virus-fighting capability of the body. The result can be the prevention of the start of disease or even a cure.
Has it been done before?
Yes, and for several diseases like polio, measles, mumps, and influenza. Recently it has been used for the H1N1 influenza epidemic in the US in 2009 and the Western Africa Ebola epidemic in 2013-2016.
It has also been used in a few cases of the deadly H5N1 and H7N9 influenza.
In previous coronavirus epidemics with the SARS in 2002 -2003 and MERS in 2012, convalescent sera have been used safely.
How Does it Work?
- Blood from patients who have a full recovery from Covid-19 are collected.
- The serum or the liquid part of the blood is tested for the presence of specific antibodies to the Covid-19.
- The serum is screened for toxins and blood-borne diseases like viral hepatitis and HIV and then filtered or rejected.
- The serum is then transfused to the sick patient.
Any Side Effects?
Fever, allergies, and a tiny chance of getting infections from the blood (Blood donors are screened).
There is no need for ABO and Rh cross-matching. Blood type is not an issue. That is why someone with a Type “O” blood can donate to someone with a Type “AB” blood.
Is it being used for Covid-19?
China has treated ten critically ill patients with convalescent plasma. Xinhua net reports.
According to clinical results, 12 to 24 hours after the patients received the treatment, they have shown improved clinical symptoms, with main inflammatory indexes decreased significantly and some key indexes such as blood oxygen saturation improving comprehensively.
Who can make the convalescent serum?
Takeda Pharmaceutical Company is developing antibody preparations from recovered patients. Their development may take months.
It can also be produced by local laboratories as long as there are enough recovered patients who will donate blood.
Possible Recipients of the Antibodies
- Health care workers have a high risk of exposure and infection because of close proximity to infected patients. Once infected, they will be put on quarantine. That will add to the stress to the already overwhelmed health system. Getting the antiserum may decrease that quarantine period and continued service to the community.
- The elderly and people with underlying diseases can have prolonged and complicated hospitalization. They also have a high risk of death. Shortening their hospital stay with faster recovery can help open up hospital beds for other patients.
- Caregivers of the elderly. Most elderlies need close assistance
- Individuals with exposure to confirmed cases to prevent infection.
As of now, there are no vaccines or specific medications for this pandemic. The convalescent serum can be a useful therapy for the prevention and treatment of Covid-19.
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Reference:
Arturo Casadevall, Liise-anne Pirofski. The convalescent sera option for containing COVID-19.J Clin Invest. 2020. https://doi.org/10.1172/JCI138003.
Image credit: https://en.wikipedia.org/w/index.php?curid=11659226
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