While waiting for the approval of a vaccine against Covid-19, the antiviral Remdesivir and convalescent plasma continue to be the resources to treat patients with coronavirus.
Dr. Humberto Guiot, specialist in infectious diseases and professor at the Medical Sciences Campus of the University of Puerto Rico, explained the difference between the two treatments.
He noted that the adverse effects of these treatments are very low. Therefore, within the security framework, it has been seen that they do not cause great damage to the people in which they are used.
He indicated that Remdesivir is a drug that has been in development for years and has been used to treat other viruses such as Ebola. Now, with the Covid-19 pandemic, it reflected that it had some activity against the virus, since it interferes with its replication and with the chains of its genetic material.
“From the studies that have already been done in patients with Covid-19, a modest decrease in the number of days that patients have symptoms when using the drug has been found and we know that it was granted by the Food and Drug Administration (FDA, for its acronym in English) a request for emergency use for hospital patients who meet certain requirements, who have low blood oxygen, which implies that they have a lung infection by the virus, moderate and severe, “said the doctor.
How convalescent plasma works
Regarding treatment with convalescent plasma, it is not a component developed in the laboratory.
“The convalescent plasma is when a person suffers an infection, the body develops defenses and those defenses are called antibodies. There are some early antibodies that are a bit more immature, that are not neutralizing antibodies and that are known as IgM, which are the first ones produced by the body, ”Guiot explained.
He explained that after days of infection the body develops antibodies that are more mature, more specific and more neutralizing than IgG. “So, what is done with the convalescent plasma is that the people who had the infection and recovered adequately are given laboratory samples and if they have these mature IgG-type antibodies – and they are already fully recovered – those people are extracted those antibodies, ”added the member of the La Fortaleza Medical Task Force.
He mentioned that an infusion is made with high concentrations of these antibodies that are mature and neutralizing, and they are infused into the person who is acutely ill at an earlier stage of the condition, because that patient’s body has not had a chance yet. to self-produce those defenses.
“So that’s called a type of passive immunity, because you take out the mature defenses that another human who was exposed to the condition produced and provide them to a person who is acutely ill, and what it does is that those antibodies go into the body. bloodstream, and neutralize the virus that is active in that acutely ill person. If the person has not yet been able to produce the antibodies that protect them from the disease, so I am going to infuse them, created by another person, “he said.
He stressed that this involves a protocol because fluids and substances produced by one human are extracted and injected into another.
The protocol establishes that other tests be done to be sure that the donor does not have other communicable diseases.
He stated that the observed adverse effects have been minimal and, furthermore, indicated that the effectiveness is still under study.
“There was a study that was recently completed by Mayo Clinic University in which patients were infused with this convalescent plasma and also showed some benefit in mortality when the treatment was infused within the first three days of diagnosis. But, it is also a benefit that was a model, it is not like everyone who was infused with the plasma survived. It is not a drug that has shown extremely high effectiveness, but so far it is one of the only weapons we have and it is being used, “he said.
Guiot did express concern about the price of both treatments, which has raised concerns among components of the health sector. Next week there will be a discussion about it, following a call from the Department of Health.
He commented that the federal government was providing the treatments for free to patients in hospitals, but that has changed.
“Now the hospitals have to pay it out or see if they can bill the medical plan directly. We are working on that ”, he highlighted.