COVID management: ICMR finds plasma therapy ineffectiveness in reducing progression to severe disease
18 may 2021
The Indian Council of Medical Research (ICMR) amended clinical guideline for the care of adult COVID-19 patients on Monday (May 17, 2021), excluding the off-label use of convalescent plasma.
Remdesivir, Tocilizumab (off-label), and Convalescent plasma (off-label) were formerly recommended for the treatment of COVID-19 patients, but only Remdesivir and Tocilizumab (off-label) are currently recommended. Because the administration of convalescent plasma was proven to be ineffective in preventing the advancement of severe illness or death, the decision was likely made.
It should be mentioned that the ICMR-National Task Force for COVID-19 recently conducted a meeting at which all members were said to be in favour of eliminating convalescent plasma from the recommendations, noting its ineffectiveness and improper usage in some situations.
Previously, convalescent plasma (off-label) was only considered when the following conditions were satisfied, according to the ICMR advisory: Early moderate illness (ideally within 7 days of symptom start; after 7 days, do not use) and high titre donor plasma (Signal to Cut-Off Ratio (S/O) >3.5 or similar depending on the test kit used).
In a letter to Principal Scientific Advisor K Vijay Raghavan, various physicians and scientists warned against using convalescent plasma for COVID-19 in India since it was "irrational and non-scientific."
The public health specialists said that current plasma therapy guidelines are not founded on existing research, and they cited some preliminary research that suggests a link between the appearance of polymorphisms associated with lesser sensitivity to neutralising antibodies in immunosuppressed persons receiving plasma therapy.This increases the risk of more virulent strains emerging as a result of irrational plasma treatment usage, which might exacerbate the pandemic, according to the report
"As concerned doctors, public health experts, and scientists from India, we are writing to you about the illogical and non-scientific usage of convalescent plasma for COVID-19 in our country," it said.
According to the letter, all available research data suggests that convalescent plasma has no value in the treatment of COVID-19. However, it is still widely given in hospitals across India.
It was also forwarded to AIIMS Delhi Director Randeep Guleria and ICMR Chief Balram Bhargava.