Antibodies taken from people who have recovered from COVID-19 could hold the key to helping new patients beat coronavirus.
- Two Australian clinical trials are using plasma from recovered COVID-19 patients
- Doctors hope the plasma will boost patients’ immune systems and help them recover
- One former COVID-19 patient and plasma donor says the trials help people like her “be part of the solution rather than the problem”
As research on a vaccine continues around the world, scientists are also working on treatments to help boost patients’ immune systems to improve their chances of recovery.
Two clinical trials starting in Australia will be using plasma donated by patients who have recovered — known as convalescent plasma — to help patients being treated in hospital.
Avi Susskind is one of the all-important donors who have overcome COVID-19 and are now well enough to donate plasma.
“It is a fantastic experience to know you can help out other people,” he told 7.30.
His plasma is rich with antibodies — a protein formed in the blood when a person recovers from a disease, which can help them fight off the infection if they are exposed to it in future.
Australian Red Cross Lifeblood has so far collected convalescent plasma from about 400 of the almost 7,000 Australians who have recovered from COVID-19.
It separates the plasma from the red and white blood cells, freezes it, and then distributes it to research institutes and biotech companies involved in the clinical trials.
Sara Kernick, who contracted the coronavirus while holidaying in Canada at the start of the year, said donating plasma for the clinical trials helped people like her “be part of the solution rather than the problem”.
“I think we all feel pretty powerless, but this is something I felt I could do to help the situation,” she said.
‘It is important we are prepared for future outbreaks’
James Daly, medical director of pathology services at Red Cross Lifeblood, says convalescent plasma is known to be effective in treating other infections.
But the jury is still out on how strong it is against COVID-19.
“We don’t have information about what is the best dose and what is the best timing of treatment, so using convalescent plasma in well-structured clinical trials will help answer some of those questions,” he said.
In one of the trials, run by Monash University, researchers will transfuse the plasma into COVID-19 patients in intensive care.
Associate professor Zoe McQuilten, a haematologist at Monash University, is heading up the trial. It will begin as soon as the next COVID-19 ICU patient is admitted at Monash Medical Centre.
“It is difficult with these pandemics. By the time you are ready to get the study up and running, you may not have cases to test the product in a clinical trial, so that might explain why we don’t have an answer based from previous infections.”
Monash University already had the framework for this clinical trial in place prior to the outbreak of COVID-19, which meant it was able to get approval for the plasma trial and start it a lot faster.
That is because it is involved in REMAT-CAP, a global network of experts and institutions who work together to evaluate various treatments for community-acquired pneumonia, especially in virus outbreaks.
“It might be a treatment we will look at earlier in future pandemics because we will have learnt a lot about how to set up a study and the processes you need to put in place to rapidly develop the product.”
Dr McQuilten said having the clinical trial in place would make Australia better prepared for a second wave of infections.
“Hopefully, with the measures already put in place, we won’t have a second peak of infections,” she said.
“But we think it is important that we are prepared for future outbreaks and more cases, so patients here in Australia will be able to access this product through a clinical trial if cases re-occur.”
She said the trial could also help researchers get a better understanding of how long COVID-19 antibodies may last in a person who has recovered.
“We are still relatively early in this pandemic so we do not know how long antibodies will persist in donors, but we will learn from setting up the trial of convalescent plasma, because people will come in for repeated donations.”
‘The hope is the infection will resolve quicker’
Using convalescent plasma to treat patients in an epidemic is not new. It goes back to the 1918 Spanish flu, according to Dr Daly.
“More recently it has been used particularly for the coronavirus [outbreaks] like the outbreak of SARS in 2003,” he said.
“There was some evidence [that it worked], but they were small studies and typically not controlling for biases. We have some suggestions it reduced the mortality and fatality in that outbreak of SARS but we don’t have good evidence for [the new] coronavirus or COVID-19 yet,” he explained.
Another clinical trial is being conducted by biotech company CSL, one of the leading players in the race to develop a vaccine for COVID-19.
While Monash will transfuse the collected plasma directly into patients, CSL will go one step further by making a product containing concentrated antibodies from the plasma of multiple donors.
“We take that plasma and we turn that into a product that is very specific to the treatment of COVID-19 disease,” Ms Gittleson said.
“You know exactly what you are giving them, because we measure it, and we can know the neutralising activity of the product.
“The hope is the infection will resolve quicker and [the patient] won’t then go on to develop a very devastating consequence of COVID-19, so those people hopefully will not be admitted to ICU or need to go onto ventilators.”
The raw plasma used by Monash also contains water, salts, enzymes and other proteins, whereas the CSL product will be a hyperimmunoglobulin — a concentrate containing pure antibodies.
“If you take that plasma and you process it you can separate out the plasma, all the various proteins that are in there … from that you can select a solid or protein that you wish to use.”
Ms Gittleson maintained that developing a treatment was just as important as a vaccine, especially as cases in Victoria have increased over the past week amidst a threat of a second wave.
“That is why we are here, we are doing this because we believe it is imperative that, for those people, there is a treatment.”
Australian Red Cross Lifeblood is calling on people who have recently recovered from COVID-19 to donate their plasma to help advance the clinical trials.