The Centre on Monday revised the clinical guidance for Covid-19 treatment, dropping the off-label use of convalescent plasma from the treatment protocol for adult patients. The development came after a meeting of the ICMR-National Task Force for Covid-19 wherein all members voted in favour of removing the use of convalescent plasma from the guidelines.
Dr Samiran Panda, Indian Council of Medical Research (ICMR) scientist who was also a part of the panel that dropped plasma therapy from Covid-19 management guidelines, told India Today that the decision was taken since anecdotal evidence was very weak, and added that it was not helping patients but only resulting in panic.
The top ICMR scientist cited ineffectiveness and inappropriate use of plasma therapy in several cases behind the decision, saying it wasn’t found beneficial in reducing the progression to severe disease or death. Speaking to India Today, Dr Samiran Panda said, “The anecdotal evidence doesn’t support any role of plasma therapy. We also had to think of context and here, if something doesn’t work but still there is continuity in terms of false hope then there will be unnecessary panic, anxiety and harassments.
he ICMR scientist, the head of Epidemiology and Communicable Diseases Division, also cited evidence published in BMJ that found no benefits of plasma therapy. He added that the ICMR had deliberated on the issue for months, after which the decision was taken on Monday.
The antibodies in plasma need to be in sufficient numbers and that was not being ensured, ICMR scientist Dr Samiran Panda added.
The ICMR scientist said the plasma therapy had to be administered in a hospital and this added to an already overworked healthcare system. ” Patients can recover within seven days. Plasma means hospitalisation, which is unnecessary,” Dr Panda said.
Plasma therapy dropped from Covid management guidelines
A government-appointed task force on Covid-19 removed plasma therapy from the treatment protocol for adult Covid-19 patients. In the revised clinical guidelines for the management of adult Covid-19 patients, the use of convalescent plasma therapy has been removed even as an ‘off label treatment.
The previous guidelines recommended off-label use of plasma therapy at the stage of early moderate disease, that is, within seven days of the onset of symptoms and if there is the availability of a high titre donor plasma.
The decision to remove it from the guidelines comes in the backdrop of some clinicians and scientists writing to Principal Scientific Advisor K Vijay Raghavan cautioning against the “irrational and non-scientific use” of convalescent plasma for Covid-19 in the country.
In the letter, public health professionals alleged that the guidelines on plasma therapy are not based on existing evidence and pointed out some very early evidence that indicates a possible association between the emergence of variants with “lower susceptibility to neutralising antibodies in immunosuppressed” people given plasma therapy.