Have you been diagnosed with COVID-19?
Are you eligible to donate blood?
Then two Kansas City doctors need to speak to you, urgently.
Last week, HCA Midwest Health—Kansas City’s leading healthcare provider—announced that it’s among the first hospitals in the Midwest to work on what could be a groundbreaking treatment for COVID-19: transfusing donated blood plasma from fully recovered patients into critically ill patients.
If you’ve been diagnosed with COVID-19 and made a full recovery, they need to talk to you about donating blood. Please call HCA’s COVID-19 research study line at 833-582-1971 and follow the prompts to complete the survey.
Now, for some deeper background on what could be a groundbreaking development in the battle against this virus.
Why is it so hard to treat COVID-19 patients?
The reason SARS-CoV-2, the bug that causes the disease COVID-19, is so deadly is that it’s a novel disease—a bug that has never before infected the human population.
“As an infectious disease specialist, I’m directly taking care of these patients and it was really hard to not have any effective treatment options,” says Dr. Marjorie Wongskhaluang, infectious disease expert at Research Medical Center, part of of HCA Midwest Health. “I was reading up on any sort of treatment modality that people were trying out in China and then in Italy… and there was almost nothing coming out.”
Throughout history, some of the most deadly epidemics have come from viruses like SARS-CoV-2, which jump from animals to humans, because our bodies have no blueprints for making antibodies optimized to battle the bug.
“This has been a horrible disease to try to treat,” says Wongskhaluang. “The majority of people do OK and it’s not a problem. It’s just for this minority of patients—they don’t do OK, and we see a rapid decline.”
How do antibodies work?
When our body battles a virus or bacteria, antibodies flow through our blood to fight the offending pathogen. After developing an antibody that’s effective against a specific virus, our bodies store a blueprint to make more should the need arise.
Vaccines work by introducing harmless versions of viruses so that our body makes blueprints without having to battle illness.
How can we get antibodies into patients battling the disease?
Convalescent plasma short-cuts the time it takes a patient’s immune response to respond on its own via blood transfusion.
When doctors take blood from a patient that has recovered and introduce it to a patient battling the illness. The antibodies from the recovered patient remain active for a time, attacking the virus where they find it.
Those antibodies will not reproduce in the transfused patient’s body, but they do seem to buy the patient more time to develop their own antibodies.
“Our goal with the convalescent plasma is to get them this product earlier rather than later,” says Wongskhaluang. “We can use our clinical judgment to have an idea of which patients are probably not going to do as well.”
Small, early studies have shown that the treatment is effective.
This’s why Wongskhaluang and transfusion medicine specialist Joseph Restivo started preparing to study it.
“There was one article [about convalescent plasma] that came out of China that talked about five patients—it was extremely limited data,” says Wongskhaluang. “I was quick to get on board with trying something with convalescent plasma. I think it seems like a very promising option for our patients. Before the FDA even approved it, we were kind of dabbling, thinking about how to get that started.”
So why do these doctors need recovered patients to call?
Because of health privacy laws.
Even if your doctor knows about this study—and with the flood of information out there, that’s no guarantee—federal law prohibits your doctor from ringing up Wongskhaluang and Restivo to pass along your name as a potential donor.
That means they’re entirely dependent on recovered patients reaching out to them to offer plasma donations using the hotline they’ve set up to screen calls (That number again: 833-582-1971).
Could this be the treatment breakthrough that gets us back to work?
No one is sure quite yet, but there’s a chance.
Right now, convalescent plasma is in the earliest stages of being studied, and in use on patients who are critically ill.
The next step could be preventative treatment—for example, giving transfusions to front-line healthcare workers who have been exposed or to spouses of patients, what doctors call “prophylactic” treatments.
“There are some spin-off studies that are going to happen down the road or one of those is a prophylaxis study for this would be giving convalescing plasma to people who were exposed to their spouse or healthcare workers exposed in the workplace, you could give them convalescent plasma,” says Restivo.
When should you call?
The sooner, the better.
The issue is that no one yet knows how long our body continues to produce antibodies for the novel coronavirus. And the current tests for antibodies are not very reliable—in fact, Wongskhaluang and Restivo are not using those tests.
“The antibody tests that are available right now, they’re not really very good,” says Restivo. “There’s some cross-reactivity [with other coronaviruses, which cause the common cold]… The FDA allows us to do them, but we have to use them in conjunction with some other testing to confirm that diagnosis.”
Rather, they’re looking for a positive COVID-19 diagnosis and the patient’s subsequent recovery.
“We’re really relying on COVID-19 tests from nasopharyngeal swabs to confirm the diagnosis that a patient has had COVID-19,” Restivo says. “And then, at 14 days, if they’re negative, they can be eligible to donate.”
So far, tests have shown that recovered patients almost all have the number of antibodies doctors are looking for in blood to transfuse, which is known as the “titer level.”
“For persons who have had COVID in China, thirty-nine out of forty had an acceptable titer level,” says Restivo. “Only one out of forty did not have the acceptable titer level that we feel is important for dosing convalescent plasma.”
That means that if you’ve had the virus and recovered, you’re very likely able to help.
What could the ultimate result be?
This is very premature but coronavirus antibody therapy could eventually be a shot instead of a transfusion.
For some viruses, patients are treated with an injection of antibodies.
“I think it could eventually be something like a shot,” says Wongskhaluang. “If you look at other infectious diseases where basically [they are treated] post-exposure like hepatitis B, or tetanus, where you actually give people antibodies.”
“If this ends up being as effective as we hope, we’ll need all the convalescent plasma we can get our hands on,” says Restivo.
One more time: If you’ve had the coronavirus please call HCA’s COVID-19 research study line at 833-582-1971 and follow the prompts to complete the survey.