Plasma therapy ineffective, likely to be dropped from India's COVID treatment guidelines

Nearly a year after it was introduced as a potential treatment to the COVID-19, plasma therapy is likely to be dropped from India's clinical management guidelines, PTI sources reported on Saturday. The plasma therapy, which includes transfusion of COVID-19 antibodies from the blood of a recovered patient to the one being treated, has not been found effective in reducing the progression to severe disease nor has a decrease in the fatality rate been observed, sources added. The development comes just days after a group of medical practitioners wrote Principal Scientific Advisor (PSA) K VijayRaghavan cautioning against the 'irrational and non-scientific use' of convalescent plasma for COVID-19. 

Members of the ICMR-National Task Force for COVID-19 met on Friday to deliberate upon the effectiveness of plasma therapy which gained momentum last year just during the onset of the pandemic. However, in the recent meeting, all members of the task force were in favour of removing the use of convalescent plasma from the Clinical Guidance for Management of Adult COVID-19 patients citing its ineffectiveness and inappropriate use in several cases. The Indian Council of Medical Research (ICMR) has said that they will issue an advisory on the matter soon. 

Plasma therapy effective or not?

As per the current guidelines in force, 'off label' use of plasma therapy has been allowed at the stage of early moderate disease, that is, within seven days of onset of COVID-19 symptoms and if there is an availability of a high titre donor plasma. While it is said that plasma therapy has worked in certain cases, the lack of availability of conclusive evidence and the efficacy rate has suggested otherwise. In October last year, a study published in the British Medical Journal (BMJ) showed that convalescent plasma was not associated with a reduction in progression to severe COVID-19 or all-cause mortality, however, it seems to reduce symptoms such as shortness of breath and fatigue. 

In the letter to PSA Raghavan, which was also marked to ICMR chief Balram Bhargava and AIIMS Director Randeep Guleria, public health professionals alleged that the current guidelines on plasma therapy are not based on existing evidence and pointed out some very early evidence that indicates a possible association between emergence of variants with “lower susceptibility to neutralising antibodies in immunosuppressed" people given plasma therapy.

"The current research evidence unanimously indicates that there is no benefit offered by convalescent plasma for treatment of COVID-19. However, it continues to be prescribed rampantly in hospitals across India,” the letter said.

COVID-tally in India

As per the Union Health ministry's data updated on Saturday, the country registered 3,26,098 new infections and 3,890 fatalities, taking the total tally of COVID-19 cases to 2,43,72,907 and the death toll to  2,66,207, and with this, the fatality rate has come down to 1.09 per cent while the national COVID-19 recovery rate has risen to 83.83 per cent. The active cases have come down to  36,73,802 comprising 15.07 per cent of the total infections.