Very soon, St. Louis doctors will have a way to treat critically-ill COVID-19 patients and potentially save lives — all because of a Washington University professor and his two colleagues in Maryland and Minnesota.
The idea they’ve set in motion is actually to revive an old treatment that was used during the Spanish flu of 1918 and other pandemics since — transfusing antibodies from the blood of recovered patients into people who are seriously ill.
It came out of a collaboration between Jeffrey P. Henderson, MD, PhD, an associate professor of medicine and of molecular microbiology at Washington University School of Medicine in St. Louis, and colleagues from Johns Hospkins and the Mayo Clinic. It’s quickly taken root in every medical institution in the country.
And just on Friday, April 3, the U.S. Food and Drug Administration (FDA) announced that they will provide a framework that accelerates support for this work throughout the country — in partnership with the Mayo Clinic and the American Red Cross.
“Giving serum from newly recovered patients is a stone-age approach, but historically it has worked,” Henderson said. “This is how we used to prevent and treat viral infections like measles, mumps, polio and influenza, but once vaccines were developed, the technique understandably fell out of favor and many people forgot about it. Until we have specific drugs and vaccines for COVID-19, this approach could save lives.”
On March 24, FDA fast-tracked approval of the using the convalescent plasma treatment in emergency situations only. Henderson is awaiting FDA approval on an application that would allow doctors to use the treatment to keep moderately-ill patients from having to go on ventilators — and eventually for frontline health workers and general prevention. FDA’s announcement on April 3 gives Henderson hope that the agency will fast-track approval for these purposes as well, but he does not know how long approval will take.
The treatment relies entirely on being able to get people who have recovered from COVID-19 to donate their blood. And next week, Henderson will be focusing on evaluating blood plasma donors.
The country’s first blood plasma transfusion to treat COVID-19 took place at Houston Methodist Hospital on Saturday, March 28.
New York Blood Center was the first blood center to collect blood plasma donations from people who have recovered from COVID-19 to treat other patients with advanced illness.
“People are already receiving it in New York,” Henderson said. “It’s coming. We have these big blood banks moving fast now.”
St. Louis is working on setting up protocols for collecting and analyzing blood plasma donations locally, Henderson said. People can find more information about donating blood here.
St. Louis coronavirus cases are accelerating, Henderson said, and area hospitals are expected to be hard hit in April and May. However, he hopes these treatments will come “online” right in time for the peak of Missouri’s outbreak, as well as help alleviate other areas that are already struggling like New York.
“We are preparing in every way we know how,” Henderson said. “We have the advantage of not being the first big city. It has given us more time to prepare.”
About a month ago, Henderson was talking with his colleague, Arturo Casadevall, MD, PhD, the chair of molecular microbiology and immunology at Johns Hopkins Bloomberg School of Public Health in Baltimore. Casadevall began championing the idea of using plasma from convalescing patients to treat COVID-19 in early March. Plasma and serum are both the clear fluid portion of blood, and both contain antibodies, but plasma also contains some other proteins lacking in serum.
Plasma transfusion was used experimentally to treat small numbers of people during the SARS outbreak of 2002 and 2003. SARS, which stands for severe acute respiratory syndrome, is caused by a coronavirus closely related to the one that causes COVID-19. In one study, SARS patients who received plasma transfusions recovered faster than those who did not.
Henderson, Casadevall and Michael Joyner, MD, a physiologist at the Mayo Clinic in Rochester, Minn., quickly joined forces and leveraged the resources at their three institutions to test the approach. Their efforts resulted in an investigational new drug application to the Food and Drug Administration that was filed March 18.
This effort will also help further other research at Washington University regarding antibodies and vaccines.
“It’s a sharing environment,” he said. “Everyone is finding ways they can help.”