In a development with huge ramifications concerning the treatment protocol for coronavirus infection, India has decided to delete convalescent plasma as an investigational therapy from its treatment protocol guidelines. Indian Council of Medical Research (ICMR) Director General Professor Balram Bhargava on Tuesday said "discussions are on in the national task force on Covid-19 for deletion on plasma therapy from the national treatment guidelines".
This is a major setback given the fact that states were hugely reliant on plasma therapy in case of severely ill Covid-19 patients. Governments in states and Union Territories like Delhi's AAP-led political dispensation had touted this as an effective strategy against Covid-19. "Donate plasma" drives and plasma blood banks were promoted in the National Capital and elsewhere with anecdotal evidence suggesting it was saving lives.
In April itself, the Union government had opined that convalescent plasma therapy can create life-threatening complications in a Covid-19 patient and is still experimental. Joint Secretary in Ministry of Health and Family Welfare, Lav Agarwal, had gone to the extent of saying that the use of this therapy is "illegal" unless the medical facility administering it is part of a study being conducted by the ICMR.
A study done by ICMR showed the therapy failed to benefit coronavirus patients. This was the largest trial conducted across 39 hospitals in India, spearheaded by the ICMR. It took place between April and July and enrolled 464 hospitalised patients with moderate Covid-19 and administered convalescent plasma. Plasma in this case was antibodies derived from plasma filtered from the blood of those who have recovered from coronavirus. This study involved 464 patients and 350 doctors.
At a press briefing earlier, Professor Bhargava had said that the study demonstrated no benefit in mortality in moderate to severe cases of Covid-19. "It also did not arrest the progression of Covid-19 from moderate to severe," he had said.
The ICMR can see an alternate in horse sera, containing antibodies against Covid-19, as a potential alternative to plasma therapy. This is being done in collaboration with the Hyderabad-based firm Biological E.
The government's decision to discard plasma therapy also comes at a time when there is a rethink on Remdesivir. The solidarity trials done by WHO, in which India was a participant, showed Remdesivir was not effective in reducing mortality in Covid-19 patients. India on Tuesday said solidarity trial results are interim, not peer reviewed.
"Debate and discussion is ongoing and we will take the results of these trials into consideration," said Professor Bhargava.