What Is Convalescent Plasma? New York Health Officials to Start Trial Using Blood of People Recovered From Coronavirus

A potential treatment for people with coronavirus is being trialed in New York. Convalescent plasma is a century-old technique that involves taking antibodies from the blood of a person who has survived an illness, in this case COVID-19, and transferring them into a person infected.

Andrew Cuomo, the governor of New York, announced a trial regarding convalescent plasma would involve people who are currently in a serious condition from the virus. "There have been tests that show when a person is injected with the antibodies, that then stimulates and promotes their immune system against that disease," he said during a news briefing. "It's only a trial. It's a trial for people who are in serious condition, but the New York State Department of Health has been working on this with some of New York's best health care agencies, and we think it shows promise, and we're going to be starting that this week."

New York is the state that has been worst affected by COVID-19 with more than 21,000 cases. Deborah L. Birx, the White House response coordinator for coronavirus, told the newspaper the virus "attack rate" in New York was five times higher than other parts of the U.S.

According to NBC, health officials in New York hope to get approval for the trial over the coming day. An FDA spokesperson told the broadcaster it was working to "facilitate the development and availability" of the treatment.

What is convalescent plasma treatment?

Plasma taken from a convalescent—someone who has recovered from an illness—contains antibodies that can fight said illness. Plasma containing the antibodies can be harvested from the blood of a person in recovery and injected into someone who is still suffering. This would help their body create the same antibodies and fight the virus.

The treatment was first used in the 1890s and helped stem a number of outbreaks until antimicrobial therapy, which kills or halts the microorganism, was developed in the 1940s.

In the early 20th century, convalescent plasma treatment was used during outbreaks of diseases such as measles, mumps and influenza. More recently, it was used during the H1N1 influenza pandemic, and again in 2013 during the Ebola outbreak in West Africa. In the case of the latter, two patients survived the disease after treatment. Following the Ebola outbreak, the World Health Organization issued guidance for its use in treating the disease, saying the small group it was used on showed "promising results."

Convalescent plasma for COVID-19

The idea to use this treatment for the new coronavirus was put forward by Arturo Casadevall, from Johns Hopkins University, and Liise-anne Pirofski, from the Albert Einstein College of Medicine, New York. They published a comment piece in The Journal of Clinical Investigation in March suggesting it could be a promising avenue.

They looked at the treatment from a historical perspective, finding anecdotal evidence it worked in curbing several outbreaks, with no known serious side effects. "Although every viral disease and epidemic is different, these experiences provide important historical precedents that are both reassuring and useful as humanity now confronts the COVID-19 epidemic," they wrote.

In their article, Casadevall and Pirofski set out how the treatment could work for COVID-19. They said timing would be the most important factor. Ideally the treatment could be used on a person with early symptoms for it to be most effective.

They do not say convalescent plasma would be used to stop the spread of the virus. Instead, it could be used to treat people at high risk of getting the disease. "Today, nurses, physicians, and first responders exposed to known cases of COVID-19, some of whom have developed disease, are being quarantined, which threatens to collapse the health care system," they concluded. "It is anticipated that convalescent serum will prevent SARS-CoV-2 infection in those to whom it is administered. If this is established, individuals who receive convalescent sera may be able to avoid a period of quarantine. This could allow them to continue their critical function as health care providers."

In an interview with Johns Hopkins' news portal The Hub, Casadevall said treatment could be set up in a matter of weeks, as "deployment of this option requires no research or development," and instead relies on blood-donation practices.

Will it work?

The treatment has been successful in other disease outbreaks. However, it will not necessarily be effective for COVID-19. Scientists in China trialed the treatment on 245 coronavirus patients in February, the state-run Xinhua News Agency reported at the time. Of these, 91 showed improvement in symptoms.

Japan's Takeda Pharmaceutical Company Limited also announced it was working to develop a plasma-based therapy for COVID-19 at the start of March: "Plasma-derived therapies are critical, life-saving medicines that thousands of people with rare and complex diseases rely on every day around the world," Chris Morabito, Takeda's Head of Research and Development, Plasma-Derived Therapies Business Unit, said in a statement.

Commenting on the possibility of convalescent plasma for treating COVID-19, Cedric Ghevaert, Senior Lecturer in Transfusion Medicine at the U.K.'s University of Cambridge and Consultant Haematologist at NHS Blood and Transplant, said Casadevall and Pirofski plan could work "in principle" but many other issues "are not discussed." He told Newsweek at the time: "Given the speed of spreading of the epidemics, arranging collection, distribution, quality control, dosage etc. may simply be a case of shutting the door after the horse has bolted," he said.

World Health Organization advice for avoiding spread of coronavirus disease (COVID-19)

Hygiene advice

  • Clean hands frequently with soap and water, or alcohol-based hand rub.
  • Wash hands after coughing or sneezing; when caring for the sick; before, during and after food preparation; before eating; after using the toilet; when hands are visibly dirty; and after handling animals or waste.
  • Maintain at least 1 meter (3 feet) distance from anyone who is coughing or sneezing.
  • Avoid touching your hands, nose and mouth. Do not spit in public.
  • Cover your mouth and nose with a tissue or bent elbow when coughing or sneezing. Discard the tissue immediately and clean your hands.

Medical advice

  • If you feel unwell (fever, cough, difficulty breathing) seek medical care early and call local health authorities in advance.
  • Stay up to date on COVID-19 developments issued by health authorities and follow their guidance.

Mask usage

  • Healthy individuals only need to wear a mask if taking care of a sick person.
  • Wear a mask if you are coughing or sneezing.
  • Masks are effective when used in combination with frequent hand cleaning.
  • Do not touch the mask while wearing it. Clean hands if you touch the mask.
  • Learn how to properly put on, remove and dispose of masks. Clean hands after disposing of mask.
  • Do not reuse single-use masks.
Andrew Cuomo
New York Governor Andrew Cuomo at the Javits Convention Center, which is being re-purposed as a hospital to help fight coronavirus. Spencer Platt/Getty Images