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Plasma treatment: institutions await authorization

Following the experiences of Buenos Aires, Córdoba and Santa Fe, two institutions with extensive experience in the field of health in Entre Ríos presented a protocol to the Ministry of Health with the aim of joining a national research project to treat patients with acute diagnosis of coronavirus with plasma of recovered patients. The joint proposal presented by authorities of the San Martín de Paraná hospital and the La Entrerriana sanatorium is being analyzed by the Ethics Committee that depends on the provincial health portfolio and the Minister Sonia Velázquez was internalized on it.

This is a program designed by the Center for Medical Education and Clinical Research (Cemic) in Buenos Aires, and once the provincial approval has been achieved, its experimental phase could begin. There are many questions about how effective this procedure can be, while the scientific world still faces the challenge of fighting a practically unknown disease. The first successful experience with convalescent plasma in the country was carried out in the 50s and 60s when the hemorrhagic fever epidemic claimed an innumerable number of lives; until the revolutionary finding of Dr. Julio Maiztegui, along with another group of professionals, managed to significantly reduce fatality.

Although the possibility of proceeding with this procedure depends on the evaluation and approval of the health authority, in Entre Ríos, patients have not yet been treated with this method, both in the public and private systems. “The coronavirus has an initial supportive treatment and the first thing that is attempted is to isolate the patient from the community to which they can infect. These are divided into patients with or without risk factors, by age and other conditions related to comorbidity, that is, some underlying diseases that predispose them to a greater chance of complication. They are those who are admitted to the San Martín hospital, in a room with exclusive staff to treat them, in a flat with 24 rooms and 48 beds for their exclusive treatment. They are admitted, observed, vital signs are taken, such as temperature, oxygen saturation and respiratory rate. These signs may or may not be altered, along an evolution that may take between seven and 10 days: at that time, some make these alterations and they begin to look more closely, so the need to provide them begins to be valued oxygen by another route. Or to do some techniques so that the patient has the ability to oxygenate himself better. They lose oxygenation capacity due to the involvement of the lung by the virus. The course will depend on the patient, because there are no therapies that have been shown yet, at least in controlled and conclusive studies and then ratified by other investigations, which are the ones that should be used, ”illustrated the director of the San Martín hospital, Carlos Bantar. , about the clinical approach to the positive cases attended in that establishment.

The doctor and specialist in Microbiology explained that convalescent plasma is a compassionate therapy that has already been tried in Wuhan, the Chinese city where the pandemic originated. “Plasma is the liquid that contains the elements of blood: white and red blood cells, platelets, that is, blood cells. That plasma has the antibodies or defenses that generate most infections. Under the hypothesis that these formed antibodies could block the virus in a certain instance and prevent invasion of the cells, medical trials began, “he said.

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The San Martín hospital plans to treat plasma patients with coronavirus.

Juan Ignacio Pereira

Pending an official response, the official explained what the protocol and its regulatory structure will consist of: “It must be clear that this therapy must be under the guidelines of a protocol designed, evaluated and approved by ethical bodies, for the Teaching and Research Committee of the San Martín Hospital. It is not for any patient, since patients must have an inclusion and exclusion criteria to access and this must be strictly followed. This is not taking a medicine from the fridge and hanging it on the patient. It is undergoing experimentation in the country and throughout the world. ”

Under the same regulation, a group of patients will be selected who present a prolongation of symptoms, such as fever, and other factors that lead to complications. In Entre Ríos most of the patients with Covid-19 register mild symptoms and a good general condition, except for one patient who required hospitalization in intensive care. Bantar considered that other factors should be taken into account: “If they have an increased respiratory rate or what we call dyspnea, which is the sensation of shortness of breath, these patients begin to walk a path towards the complication: the administration of convalescent plasma It could decrease the number of cases that eventually end up complicating, reaching intensive care and requiring mechanical ventilatory assistance. That is the hypothesis, that the one who is getting complicated could intervene with this technique ”.

While science continues to study the different clinical options and drugs that can guarantee an adequate recovery, in our province the treatments comply with the protocols developed by the Ministry of Health of the Nation. The director of the reference hospital in the province was expectant regarding the approval of the regulation. “Then there will be an awareness and solidarity campaign so that people who have become ill can donate plasma. In the protocol presented by San Martín and La Entrerriana, the plasma will be provided by the province of Buenos Aires through the Cemic ”, Bantar closed.

Another parallel project taking place in Paraná

Pedro Negri Aranguren, specialist in Hematology and Hemotherapy, directs the research project to initiate convalescent plasma treatment at the Modelo de Paraná clinic. “In order to know the results of this technique, a clinical trial must be carried out together with a research project, which tells which patients are going to receive the plasma and who are not going to receive it; take the previous symptoms and then infuse the plasma. Later the results will be seen. All this is not because we are facing an unknown infection ”, affirmed the specialist in dialogue with UNO. The scientific initiative has the approval of the Ethics Committee of the clinic in question, but the approval of the Ministry of Health still remains. Negri recalled the good results achieved when the mortality from hemorrhagic fever was reduced. He mentioned the effectiveness achieved against Ebola, in SARS1, although he estimated that “there have been no clinical trials that can scientifically demonstrate its usefulness.”

The doctor recalled that Cemic has 100 transfused patients with good results, which favored adherence to its protocol by the Model. “In the clinic we have different clinical trials, then we will have to add them all up and evaluate the results. The central point will be to have plasma ”.

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