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Coronavirus plasma treatment: how implemented in Turkey, who can donate?

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İsmail Kayar made a series of decisions to live as soon as he left the hospital if he recovered due to Covid-19 in the hospital room. One of them was to donate for immune plasma therapy.

“I read this treatment over the internet in bed. I said,” What would I lose, I would have given some blood when I was weak? ”

In koronavirüsl struggle in Turkey “immune plasma therapy” began to be applied earlier this month.

Professor of Science, Ministry of Health and Ankara University Faculty Member. Dr. Alpay Azap underlines that the effect of plasma against Covid-19 is still being investigated, but he explains that it has been implemented since there is no other definitive treatment method and with the idea that patients may benefit.

 

What is “immune plasma therapy”?
The immune system of a person with Covid-19 develops antibodies that will attack the coronavirus.

 

Antibodies, which are molecules in the glycoprotein structure, are formed in the fluid of the blood called “plasma”.

For this reason, the fluid called “plasma” is taken from the blood of people who are diagnosed with Covid-19 in the immune plasma treatment and who recover after the treatment process, and are transferred to the patient.

It is hoped that these antibodies will help heal high-risk patients in intensive care.

Speaking to BBC Turkish. Dr. “Our expectation is that when we give this (plasma) to the patient, antibodies neutralize the virus,” says Alpay Azap.

Plasma treatment is applied to which patients?
İsmail Kayar, who was hospitalized for nine days, told the BBC Turkish that he was not treated in the intensive care unit, but still suffered from the disease:

“When I went to the hospital, my joints were hurting as if my flesh was going to be poured. Whatever side you are on, it hurts. For 5 days, I could not eat anything, nor drink water.

Immune plasma therapy was not applied to Kayar because certain criteria are sought in selecting patients to be applied.

Professor Dr. Azap says that the criteria of the heavy patient in the intensive care unit, such as low or high values ​​in the blood, and the patient’s need for oxygen support, are examined.

“It is necessary to use the plasma between the 7th and 14th day of the disease, because after 14 days it doesn’t work very much,” he says.

In the Ministry of Health, experts from infection, internal, hematology, intensive care and transfusion medicine came together and prepared a guide on how to supply immune plasma and how to apply the treatment.

According to this guide, it is said to be “very safe in general”, but side effects of plasma therapy can also be found. The guide notes that “1 percent fever, itching, redness and other allergic reactions, and viral hepatitis and HIV can be seen in between 1 and 5 thousand out of ten thousand”.

 

The team treating the patient decides on the application of plasma immune therapy. If the treatment team decides that the patient needs plasma, he calls the Red Crescent Blood Center. Turkey spanning the entire Red Crescent has supplied the appropriate plasma to the patient’s immune plasma from blood bank and hospital delivers.

Professor Dr. Azap says that the aim of the Red Crescent to manage the process is “not to force the relatives of the patients to find plasma” and adds:

“This business is also open to abuse. Some of the patients’ relatives are rightly coming to the point of” Let’s do whatever it takes. How much money you want to give “. To prevent such situations, it was said,” Let me donate blood and organize the Red Crescent “.”

However, relatives of the patients, who hope that their loved ones will recover quickly, are seeking donors through social media ads.

 

How does the donation process work?
Covid-19 patients have been proven by clinical tests and 14 days after the treatment process can apply for donations.

Crescent also throughout Turkey Covidien-19 examination that required public health information is entered in the patient management system is accessing the database. Patients who are recovered from these lists are called to ask if they want to become a plasma donor.

Before the donation is made, the person is tested again.

The negative test results go to blood donation points determined by Kızılay for plasma.

Then, the donor’s approval is obtained and examined to determine whether there is any harm in giving blood, and laboratory tests are applied to his blood.

Plasma in the blood of the donor, whose test results are appropriate, is taken by separating in the apheresis device and other components in the blood are returned to the donor.

The process takes 45-60 minutes.

Professor Dr. “There is no difficulty in being a donor. It’s the same as being a blood donor. The process is exactly the same,” says Azap.

 

İsmail Kayar explains that after the 14-day quarantine period, he was called to the hospital the day before he donated plasma:

“Detailed blood tests and coronavirus test were done again. The test result was negative again. It was detected that antibodies were produced in the blood. I was told that I could give blood.”

Kayar explaining that he gave blood after filling a form with questions such as illness, surgery history and smoking, summarizes the process as follows:

“There is a machine. They open a vascular access from the arm. You connect with the needle to the machine. There is no pain or pain during the procedure. Sometimes they say” hold your hand, let go “. The machine takes blood, separates it, then returns it.”

Immune plasma donation can be made up to 3 times a month at 7-10 days intervals from the date of the first donation.

Kayar’s plasmas were used in 3 people. “They said,” We freeze normally, we give it in case of need, but there are many waiting. ”

Kayar was planning to donate again the day after the interview. He said that he would donate a third time a week after him.

 

Who can donate for Covid-19 patients?
The person who wants to donate needs to be diagnosed with Covid-19 with a laboratory test and that this person has recovered clinically with 2 tests.

Apart from these, the following criteria are sought in donors:

Being between the ages of 18-60 (took the age of 19, not the age of 61)
If the woman has never been pregnant
No blood transfusion has been done to her in any period of her life

Does plasma donation have a risk for the donor?

The Ministry of Health notes that this donation does not pose any health risks.

It is underlined that the sets used for blood separation during the apheresis process are disposable and sterile.

It is stated that the treatment is free and the expenses are covered by the Ministry of Health.

Professor Dr. The punishment says donating antibodies in his blood will not weaken the donor against the coronavirus:

“Antibodies are constantly being synthesized by our immune cells, which we call B-lymphocytes, so the antibodies we receive from you will not weaken you.”

How effective is plasma treatment?
Professor Dr. The doom says how effective immune plasma therapy is scientifically controversial:

“Viral diseases are mostly controlled by immune cells. Antibodies contribute to the control of viruses, but are limited. Viruses enter and multiply into the cell, so they are microorganisms that can escape the action of antibodies.”

Professor Dr. He explains that some people who have had the disease do not have antibodies, or that some people may still have a virus in their respiratory secretions while the antibody is still in the blood, or that the negative virus can become positive again, “These cause serious question marks in the scientific setting about the effect of all antibody-based treatments.”

However, since there is no definite treatment method or vaccine against Covid-19 in the world, it is applied in some other countries.

The immune plasma method was first applied in Covid-19 treatment in experimental studies on a small number of people in China.

BBC science reporter Rebecca Morelle reports that approximately 600 patients have received plasma treatment in the U.S. so far.

Britain also announced that it will try this method nationally this week. If the trials are successful, it will be examined if the plasma from the healed person will improve Covid-19’s healing rate and chances of survival.

 

Professor Dr. Hurt, Covidien-19 support and a lot of medication to patients in Turkey because it is administered at the same time the effect of immune plasma treatment says it is currently difficult to measure.

“Everything is being tried because these patients are heavy. We want to do everything we can. Therefore, when you get a response from these patients, it is difficult to say whether plasma treatment has improved, it did not work when you did not, and it is difficult to say that.”

Stating that “comparative controlled studies” are needed to measure the effect of plasma on Covid-19 patients, Azap says, “These studies are now launched both in the world and in our country.

Has it been used in previous outbreaks?

Using the blood of healed patients in treatment is not a new idea in medicine. It has a history that goes back 100 years.

Recently, it was also applied in Ebola and swine flu outbreaks as well as Sars and Mers from coronavirus.

 

The torment says that this method was “partially” successful during its use in previous outbreaks, “it would have been a standard treatment method if they already had a definite success,” he adds.

“But because we think that this disease and patients can benefit, because there is no other treatment, we think it should be applied to suitable patients.”

“If people see the state of those in intensive care, people will pay,” says Ismail Kayar, saying that donating plasma is a “duty”:

“You have to go and give this (antibody) instead of carrying it in vain. You save lives. There is no great favor that man can do. Our body produces this precious thing without us. Maybe they will come back with 200 cc of blood we give. We should not spare this. “

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