Coronavirus: Doctors urge government to approve plasma therapy trials for Covid-19 patients

Trials of blood transfusion treatment already underway in Germany, France and United States

Donated blood and plasma samples are checked if they can used for the production of therapeutic plasma to treat seriously ill coronavirus patients in Germany (Reuters)

Frustrated doctors are urging the government to approve plasma therapy trials for coronavirus patients, after encouraging results in Chinese hospitals suggested it can reverse the fortunes of severely ill patients.

Transfusions of recovered patients’ blood plasma – containing antibodies which have learned to successfully fight a virus – have been used experimentally since the 1800s, notably during the 1918 Spanish flu epidemic.

“Convalescent plasma” therapy has since been used to treat Sars, Mers and Ebola, and was recently found to be “a promising rescue option” for severely ill Covid-19 patients in Wuhan and Shenzhen pilot studies.

Trials are now taking place in Germany, France, India and the United States, but the UK government is yet to approve its own programmes.

Dominic Raab – who is deputising for the prime minister while he recovers from coronavirus – has reportedly written to Matt Hancock asking about the treatment, after a prominent UK physician urged him to begin trials.

The health secretary is yet to respond, however, leaving doctors increasingly concerned that precious research time is being wasted.

“It’s incredibly frustrating,” said Dr Colin Hamilton-Davies, who has spent 30 years looking at plasma therapy, and wrote to both Mr Raab, who replied, and Mr Hancock imploring them to start trials and offering his assistance.

He told Sky News that lives could be saved if the government takes action.

“We have a national health service and blood service that is the envy of the world, we have a very substantially-sized department of blood transfusion, and for people harvesting blood plasma, we could step it up within a week,” said Dr Hamilton Davies, who leads Bart’s Hospital’s acute cardiac critical care unit.

“We could be administering it, not just to one or two people, but hundreds of patients.”

He added: “It’s not only myself, but many colleagues are saying ‘why aren’t we looking at this in greater depth and in a faster timeframe?’

“There is a research framework which is up and running, which it may or may not become part of. I very much hope it does. This is something we could get up and running very quickly indeed.”

Trials are already taking place in New York, Paris, India and Germany, after the promising – albeit small and informal – pilots in China.

Wuhan doctors last week published their findings after treating 10 severely ill patients.

The single dose of plasma was well tolerated by the patients and, within three days, all of their symptoms – especially fever, cough, shortness of breath and chest pain – either improved or disappeared, the paper says.

Shenzhen medics had previously released similarly encouraging findings from a pool of five patients. Three were able to come off ventilators within 10 days and all five noticed improved symptoms.

Despite the hopeful results, scientists have also cautioned that the small trials were not randomised and that all patients were receiving a number of additional experimental treatments at the time.

“Plasma treatment is an interim solution and should be done at all costs because what we’re looking into is a vaccine for next year,” Dr Muhammad Munir, a virologist at Lancaster University, told Sky News. ”The plasma is something we can offer and it is in our hands.

“It would be extremely disappointing if this effort shouldn’t be made in place – and especially at a time when so many people are recovering and they can be a valuable source of collection of the plasma.”

It is also thought the treatment can be used to bolster health workers’ immune response to the virus, as a protective measure.​

While there is yet to be an official starting date, some work is already underway in the UK.

NHS Blood and Transplant (BT) has already started to screen blood from Covid-19 patients to find suitable, antibody-rich plasma to be used once trials commence.

However, one expert at the University of Glasgow – whose application to the UK’s largest funder for health research to run two trials was recently rejected – suggests the apparent delay could be rooted in safety concerns.

While it is hoped that antibody-rich plasma could help severely ill patients, there are concerns that giving them plasma with low antibody levels could make their condition worse.

Professor David Tappin told The Independent that, although many laboratories are currently developing and assessing potential antibody tests, “at present there is no antibody test recognised by NHS BT to assess antibody level”.

He added: “As I understand, until this antibody test is available, convalescent plasma production will not increase and plasma will not be released by NHS BT.”

Professor Tappin also suggested that without a reliable antibody test, the most modern and efficient method of collecting plasma from recovered patients would not be used, further hindering efforts to scale up production.

He said it is likely that, once they are approved, future trials will likely be carried out by Recovery and Remap-Cap, two of the UK’s three key programmes.

Co-ordinated by Oxford University, Recovery is the largest world's largest trial of potential coronavirus treatments, including HIV drug lopinavir-ritonavir, the steroid dexamethasone, the commonly-used antibiotic azithromycin, and hydroxychloroquine – the drug heavily touted by Donald Trump.​

Having signed up 1,000 patients from 132 different hospitals in its first 15 days, this has since grown to at least 3,000, making it the fastest-growing trial in UK medical history.

The Department of Health did not respond to a request for comment.