key: cord-0764829-p7u8u8gt
authors: Mahapatra, Smita; Pati, Sanghamitra
title: Constraints And Challenges In Convalescent Plasma Collection Amidst The Covid 19 Pandemic- Strategies And Recommendations To Overcome These
date: 2021-03-04
journal: Transfus Clin Biol
DOI: 10.1016/j.tracli.2021.02.003
sha: 235c330511ae2dfe6c2c05eb0f9334c5244bd6e0
doc_id: 764829
cord_uid: p7u8u8gt

Background: COVID 19 is an acute respiratory disease caused by infection by the virus SARS-COV-2 and has been declared as a pandemic whose specific treatment is still not established. One of the options in the treatment is Convalescent plasma (CP) therapy when there is presence of required amount of neutralizing antibodies in the plasma of recovered COVID patients. Our objective was to analyze the challenges and the constraints encountered in motivation of COVID 19 recovered persons to come for the screening procedures and to convince the selected persons to come for Plasma donation voluntarily. Material & methods: The present retrospective observational study was conducted for a period of five and half months. Out of 1515 number of persons contacted telephonically for Plasma donation, 1291 persons came for screening of whom 1028 persons were eligible for donation, 263 cases were deferred and 966 persons finally donated. Results: Maximum number of acceptance cases were from males-(98.7%). Of the accepted cases, (41.73%) were from the 18-30 years’ age group. 33.94% were from blood group ‘O’ Rh D positive giving maximum contribution from any blood group. 38.3% of the accepted cases had resolution of all COVID symptoms within time period of 28-40 days. Maximum number of accepted individuals (39.75%) had suffered from multiple symptoms followed by 39.02% of asymptomatic persons. Highest number of Plasma donation was contributed by Odisha Government Police personnel (51.56%). Discussion: In this global ongoing pandemic, the “Fear Factor of contracting the disease” has acted as a major challenge in motivating and convincing a COVID recovered patient for plasma donation. The challenge before the medical professionals was to motivate, educate and convince the potential donors and the society about the likely benefits of convalescent plasma. This could be finally overcome with the help of positive orientation through social and conventional media as well as mass appeal from government side on the benefits of plasma therapy in saving lives in the present pandemic.

J o u r n a l P r e -p r o o f antibodies that can neutralize SARS-CoV-2 and thus improve disease course in patients with COVID-19 infection before the maturation of a patient's own humoral response 2,3 .

In the past, convalescent plasma transfusion was used to treat a variety of infectious diseases, including influenza, Argentine haemorrhagic fever and SARS 10. 4- 6 Still, the effectiveness of CP in treating other infectious diseases, such as Ebola, remains inconclusive 7 . Since COVID-19 convalescent plasma (CP) was approved by the USFDA as an experimental treatment for patients with COVID-19, facilities have been set up for collecting CP throughout the US. In India, permission to conduct a Clinical Trial of Convalescent Plasma for COVID-19 patients was given by the Drugs Controller General of India in early April 2020. Later, Government of India on 25.6.2020 and Director General of Health Services on 01.7.2020 laid down circulars to use CP as an off label drug 8, 9 . Basing on the above circulars, the Govt of Odisha decided to start Convalescent Plasma Therapy in the Sate as an off label drug.

The aim and objective of the present study is to analyze the challenges and the constraints encountered during the motivation of COVID 19 recovered persons through counselling to come for the screening procedures to donate CP and to convince the selected persons to come for Plasma donation voluntarily.  Donors with total serum protein > 6gm/dl were accepted. 

 Those who have uncontrolled diabetes or hypertension.

 Women, who have ever been pregnant.  A cancer survivor or any patient with Chronic kidney/ heart/lung/ liver disease.

 Neutralizing antibody titer for IgG of < 1:80

 CP was collected from individuals who gave written consent to donate. The consent was taken after informing the Donors in person regarding the procedural time taken, the amount to be collected (which will be divided into two aliquots) and the utility of the plasma collected for two COVID 19 patients. This was preceded by thorough counselling sessions, telephonic as well as one-on-one. All the connected papers related to Donor consent were kept on record.

 Convalescent Plasma was collected by Plasmapheresis procedure (Trima Acele machine) which ranged from 400 ml to maximum up to 500ml which was divided into two aliquots each with 200 to 250 ml of Plasma. It was independent of the donor size and weight. Similarly, the lowest acceptance and deferral cases were 30 &10 and they were from the 51-60 years' age group. (Table 1) Maximum acceptance of 239 was from group of persons whose screening was done in 

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