Donating plasma for COVID patients new push in fight against deadly virus

By Kati Blocker
UCHealth Today

Julie Christen, a labor and delivery nurse for the last 28 years, witnesses life’s miracles almost every day.

“It never gets old to me — to see a brand new baby enter this world — every one is a miracle,” said Christen, a nurse at UCHealth Poudre Valley Hospital in Fort Collins.

And now — as someone who’s fought off COVID-19 — she has another opportunity to assist others by donating her plasma in hopes of helping COVID patients.

Christen tested positive for COVID-19 a month ago, and she now has antibodies against the virus in the plasma component of her blood. That convalescent plasma, or CCP, is now being used to treat other patients with COVID-19.

On Wednesday, Christen donated her plasma at UCHealth Garth Englund Blood Donation Center.

“It’s perfectly safe to donate blood, and a little time and discomfort — if it can save someone’s life — is totally worth it,” she said.

What is CCP, and how could it help COVID-19 patients?

Convalescent plasma is one treatment option available to help doctors tackle the novel coronavirus, for which there is currently no cure.

People who convalesce (recover) from COVID-19 have antibodies to the virus, and early research shows that these antibodies, if transfused into a person suffering from COVID-19, may boost that person’s immune system and help them battle the invasion.

“Conceptually, it makes a lot of sense, but we are somewhat in the research realm,” said Dr. Steven Schuster, a hematologist and medical director of oncology research for UCHealth in northern Colorado, who is helping coordinate the process from the provider side.

Testing positive for COVID-19

Prior to getting sick, Christen had not been in contact with any person known to have COVID-19, so she’s not quite sure where she got the virus. It was early in the novel coronavirus spread — March 18 — and she had the day off. She took her grandson to the park and visited friends to help them celebrate getting keys to their new home. Then she dropped her grandson off at her daughter’s house and gave everyone lots of hugs and kisses before heading to her home, where she lives and cares for her 97-year-old mother.

That night Christen started to feel tired. Then a dry cough developed, and by 10 p.m., she had a fever of 100.7.

“I was like, ‘Oh, no,’” she recalled.

Like many other COVID-infected people, Christen thought she might just have the flu. Only a day before, her brother had tested positive for Influenza A. She’d been with him the week before, and their symptoms were identical.

Despite her skepticism, she immediately started to follow CDC self-quarantine guidelines and UCHealth protocols for an employee with COVID-19. The next morning, she got a COVID-19 test at the drive-up testing site at the UCHealth Emergency Room – Harmony Campus and headed home to wait for her results.

On March 23, her COVID-19 test came back positive.

When can I donate convalescent plasma?

While quarantining in the basement of her home, Christen learned of a woman from Evergreen, Colorado, who was looking for a CCP donor for her father, who was very ill with COVID-19 at UCHealth University of Colorado Hospital in Aurora.

The use of convalescent plasma as a COVID-19 treatment falls under the FDA’s Expanded Access Protocol, which provides a pathway for patients to gain access to investigational therapies for serious diseases or condition for which there is no comparable or satisfactory therapy options available outside of clinical trials, according to the Colorado Convalescent Plasma Consortium.

“I wasn’t able to donate then because I was still sick,” Christen said. “But then I saw an article about how we were getting ready to do this at our hospital.”

She reached out to Garth England Blood Donation Center, just down the street from Poudre Valley Hospital. Her name was added to a list of COVID-positive people interested in donating plasma once they tested negative for the novel coronavirus.

Convalescent plasma in the past

“There is early evidence that if someone has had (COVID-19), becoming a donor for this product could potentially help three to four patients,” said Dr. Michael Walts, medical director for Garth Englund. “We are collecting that data as to how often (CCP) is used and what other factors are involved, as we just don’t know.”

However, he said, past research shows that the potential benefits of CCP for a person fighting COVID-19 outweigh small risks associated with a blood transfusion. With past use of convalescent plasma for other coronaviruses, such as SARS and MERS, as well the H1N1 (2009), there has been no evidence of transmission of this type of respiratory virus by transfusion, Walts added. And with H1N1 (2009), transfusion of the plasma appeared to reduce mortality rates.

To prevent spreading the novel coronavirus between COVID plasma donors and others at the center, the FDA is requiring that donors have a negative COVID-19 test or have waited 28 days after their symptoms subside to be eligible to donate convalescent plasma.

Do I have the antibodies to COVID-19?

Currently no reliable antibody tests are available to determine if someone does have the antibodies — and how strongly present they may be — in their plasma. People can find antibody tests online, but many have a false-negative rate of up to 40%, and for that reason, blood donation centers will not accept those tests. (Please check back with UCHealth Today’s COVID-19 updates as reliable antibody tests are on the horizon.)

Convalescent plasma donors must have tested positive for COVID-19, and then waited the 28 days or have a negative COVID-19 test. They must also meet the normal blood donation requirements set by the FDA, which includes requirements for age, weight and other health factors.

The need for convalescent plasma donors

Plasma can be stored and used up to a year after it is donated.

“We aren’t even close to that situation. The demand for (convalescent) plasma is so much more than the supply,” Walts said. Currently, plasma that has been donated is usually administered to a COVID-19 patient within 24 hours.

The plasma is going to the sickest of patients, but in the future, the hope is that plasma will be more plentiful and given to patients earlier in their illness to keep them from getting severe COVID-19.

The good news is that one CCP donor can potentially help two to four COVID-19 patients. How much plasma a COVID-19 patient might need is based on their plasma type and other factors, including weight.

Time should also help, Schuster added. Many COVID-19-positive patients aren’t enough days into their recovery to donate. With reliable antibody tests on the horizon, those who think they may have antibodies but unable to get a COVID-19 test could soon be eligible to donate.

Taking care of each other

Christen liked the idea of being able to help. In 2009, she lost her 20-year-old daughter, Rachel, in a car crash. Because Rachel had been on a mission in Nicaragua the year before and had a vaccine for malaria, it was impossible for the family to donate her organs, though they were able to donate her corneas.

“Someone got their sight back because of her, and there is this huge satisfaction to that,” Christen said. “I look at (blood donation) the same way as organ donation or anything else where you can give someone something, giving them a chance they might not otherwise have.”

Serendipitously, when a bad infection recently threatened the sight of Christen’s sister-in-law, she received a cornea from a donor.

“Someone else gave back to her,” Christen said. “It is all about taking care of each other on this planet. If there is anything we can do to help other people, we need to be doing it.”

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