Days after various studies and expert panels suggested that plasma therapy on Covid-19 patients was found ineffective in reducing the progression to severe disease or death, the treatment protocol has been dropped from the clinical management guidelines, sources said.
The decision was taken based on recommendations of experts from AIIMS, ICMR-Covid-19 National Task Force and Joint Monitoring Group of the Ministry of Health & Family Welfare, and the Government of India.
Last week, in a meeting of the ICMR-National Task Force for Covid-19, all members had ruled 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, they said.
The guidelines earlier allowed “off label” use of plasma therapy at the stage of early moderate disease, that is, within seven days of the onset of symptoms and if there is the availability of a high titre donor plasma.
The decision to remove it from the guidelines comes in the backdrop of some clinicians and scientists writing to Principal Scientific Advisor K VijayRaghavan cautioning against the “irrational and non-scientific use” of convalescent plasma for COVID-19 in the country. In the letter, 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.
A Lancet report has also said that patients hospitalised with severe symptoms of covid-19 administered with plasma therapy did not show improvement in survival or other prespecified clinical outcomes. The researchers enlisted 11,558 of 16,287 patients enrolled in recovery were eligible for the plasma therapy.
This raises the possibility of more virulent strains developing due to irrational use of plasma therapy which can fuel the pandemic, according to the letter signed by vaccinologist Gagandeep Kang, surgeon Pramesh C S and others. “We are writing to you as concerned clinicians, public health professionals and scientists from India about the irrational and non-scientific use of convalescent plasma for COVID-19 in the country.
“This has stemmed from guidelines issued by government agencies, and we request your urgent intervention to address the issue which can prevent harassment of COVID-19 patients, their families, their clinicians and COVID-19 survivors, said the letter. “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.
Families of patients run from pillar to post for getting plasma, which is in short supply. The desperation of patients and their families is understandable because they like to try the best for their loved ones when a doctor has prescribed this, the public health professionals said. In plasma therapy, antibodies from the blood of a patient who has recovered from COVID-19 are used to treat serious patients.
(With PTI inputs)