Wanted: Plasma from recovered COVID-19 patients

To test a new hyperimmune plasma product – COVID-19 immunoglobulin – major biotech company CSL Behring needs 800 of the almost 6000 Australians who have recovered from the coronavirus to donate plasma at a Red Cross Lifeblood centre.  
 
That would provide enough immunoglobulin to treat up to 100 people in a future clinical trial.
 
‘GPs can encourage people to come forwards and donate at a Lifeblood centre,’ CSL Behring Chief Medical Officer Dr Charmaine Gittleson told newsGP.
 
‘We’re looking for people aged 18–75, over 50 kg, and 28 days after their symptoms have resolved, as we don’t want people to have the active virus in their system.’
 
Dr Gittleson said some patients might need encouragement or information about the plasma donation process.
 
‘Patients may not understand how plasma donation works,’ she said.
 
‘GPs can explain that it’s a straightforward procedure like a blood test, that only takes plasma and returns your red blood cells to you. You walk out feeling fine and it doesn’t deplete your antibodies, so you’re not at risk of infection.’
 
The plasma will be purified and concentrated into immunoglobulin before being put to work – first, by developing a test to detect whether antibodies against the SARS-CoV-2 virus are present.
 
If this is successful – and if enough plasma has been donated – a hospital-based clinical trial will be implemented to test the safety of the hyperimmune product.
 
Dr Gittleson said the goal is to help treat patients who are in hospital and worsening, with signs that their own antibody response is not strong enough.
 
‘The target population are those who have been confirmed to have the disease and are presenting with symptoms that could potentially progress to requiring mechanical ventilation,’ she said. ‘They will be in hospital and demonstrating lung involvement. That’s probably where you’ll get the greatest benefit.’
 
Patients who are already on ventilators with acute respiratory distress syndrome are less likely to be helped by the product, Dr Gittleson said, as they are more at risk from overstimulation of the immune system with a cytokine storm.
 
‘This is not a vaccine, but a treatment,’ she said. ‘It could potentially cure somebody – for those patients in the phase of viral replication where the virus is starting to infect the lung, it could prevent progression.’ 
 
The UK is ramping up its use of convalescent plasma, where plasma from recovered patients is given directly to those with the disease.
 
But Dr Gittleson said this approach is not a long-term solution, as the plasma would not be concentrated.
 
‘This approach … is when you don’t have the facilities to purify and concentrate the specific antibody, so all you can do is give [plasma] as a whole and hope it has enough in there,’ she said.
 
‘When you give fresh frozen plasma, it’s not optimal as it hasn’t had any other viruses in it inactivated and can cause transfusion reactions. It’s also not scalable. Once hyperimmune products become available, the UK would switch to those.’
 
Australia’s Federal Health Minister Greg Hunt said the announcement shows Australia is playing an ‘important role in the battle against COVID-19’.
 
‘CSL Behring’s manufacturing facility will be one of the first in the world to commence development of a COVID-19 immunoglobulin that may provide benefit to seriously ill Australians in need of treatment,’ he said.
 
Lifeblood CEO Shelly Park encourages anyone who has recovered from COVID-19 and who might be eligible to contact her organisation.
 
Donations began on 11 May. Visit the Lifeblood website for more information on donating plasma.
 
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