Injecting Blood From Recovered Coronavirus Patients Into Newly Infected Could Slow Spread of Disease

The blood of recovered coronavirus patients could be used to slow the spread of the virus, scientists at Johns Hopkins have said. The concept, known as "convalescent plasma," is based on the idea that antibodies in their blood could be used to boost the immunity of people newly infected, or those at higher risk of contracting it.

In an article published in The Journal of Clinical Investigation, Johns Hopkins' Arturo Casadevall and Liise-anne Pirofski, from the Albert Einstein College of Medicine, New York, state that COVID-19 has the potential to affect billions of people and as of yet, there are no vaccines or drugs available for the SARS-CoV-2 virus that causes the disease. Casdevall and Pirofski say that "human convalescent serum is an option for prevention and treatment of COVID-19 disease." They say it could be available in a short timescale as long as enough people who had recovered from it could donate their blood.

Convalescent plasma taken from a recovered coronavirus patient would be rich in the antibodies needed to fight off the infection. If these people donated their blood, the serum could be used to pass these antibodies on to other people who have not been infected. "As more individuals contract COVID-19 and recover, the number of potential donors will continue to increase," they wrote. The donated blood would be processed and the serum isolated, which could then be injected into newly infected patients, or those at higher risk of contracting COVID-19.

This technique has been used to stem outbreaks of several diseases in the early 20th century, including measles, mumps and influenza. Retrospective research, they explain, showed people who had been given the serum had a lower mortality than those who did not receive it. A decade ago, it was also used during the H1N1 influenza pandemic, where the serum was used to treat individuals in intensive care. It was also used during the Ebola outbreak in West Africa in 2013, with two patients transferred to the U.S. surviving the disease after treatment.

"Although every viral disease and epidemic is different, these experiences provide important historical precedents that are both reassuring and useful as humanity now confronts the COVID-19 epidemic," they wrote.

Casadevall said the treatment could be set up at Baltimore's Johns Hopkins University in just a few weeks. "Deployment of this option requires no research or development," he told Johns Hopkins' news portal The Hub. "It could be deployed within a couple of weeks since it relies on standard blood-banking practices."

Initial funding has been provided for Casadevall's project and he and his team are now working to secure more resources. According to The Hub, the biggest problem implementing this system is timing. A person would need to be treated with early symptoms to make it most effective. Casadevall and Pirofski say that while there are a number of unknowns, such as what dose would be effective, "anecdotal data on use of convalescent serum suggest it is safe in coronavirus infection."

They conclude: "Today, nurses, physicians, and first responders exposed to known cases of COVID-19, some of whom have developed disease, are being quarantined, which threatens to collapse the health care system. It is anticipated that convalescent serum will prevent SARS-CoV-2 infection in those to whom it is administered. If this is established, individuals who receive convalescent sera may be able to avoid a period of quarantine. This could allow them to continue their critical function as health care providers."

This approach is not supposed to be a treatment, they argue. Instead, it would be a "stopgap measure" that could be used to slow the current epidemic. They also say implementing it would require a huge amount of coordination between different specialists and hospital administrators. "As we are in the midst of a worldwide pandemic, we recommend that institutions consider the emergency use of convalescent sera and begin preparations as soon as possible. Time is of the essence."

Cedric Ghevaert, Senior Lecturer in Transfusion Medicine at the U.K.'s University of Cambridge and Consultant Haematologist at NHS Blood and Transplant, told Newsweek that Casadevall's proposal could work "in principle," but added that "several things are not discussed."

"Given the speed of spreading of the epidemics, arranging collection, distribution, quality control, dosage etc. may simply be a case of shutting the door after the horse has bolted," he said, adding that another issue could related to the hyperimmune reaction that causes acute lung injury. "This approach may not remove this, it may even encourage it," Ghevaert said.

He also said this technique "works well for blood borne agents," but it is not clear whether the SARS-CoV-2 virus does this.

The convalescent plasma approach has already been implemented in China, where the disease is believed to have originated, with researchers reporting encouraging anecdotal results. At the end of February, state-run Xinhua news agency said of the 245 people treated with the plasma, 91 had shown improvements. The number of new COVID-19 cases in China has started to drop, with fewer fatalities also being reported. Global infections and deaths outside China have now overtaken the number in the nation's mainland.

According to the Johns Hopkins dashboard tracker, there are now over 3,700 cases in the U.S., including 69 deaths.

This article has been updated to include comments from Cedric Ghevaert.

This article has been updated to include more information on the author affiliations.