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Greenwich Hospital Participating in COVID-19 Plasma Therapy Trial

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By Richard Kaufman

Until a vaccine for the coronavirus is found, which could take anywhere between 12-18 months to develop according to top U.S. health officials, effective treatments, therapeutics and increased testing will be key.

On Monday, it was announced that 10 Greenwich Hospital patients who are critically ill with COVID-19 have received plasma therapy, an experimental treatment that involved blood plasma from people who have recovered from the disease.

Greenwich Hospital is participating in a nationwide clinical trial overseen by the Mayo Clinic, which was designated as the lead investigative institution by the federal government, to administer what is known as convalescent plasma to treat COVID-19. Plasma is the fluid part of the blood left once the red cells, white cells and platelets are separated.

Dr. James Sabetta, Chief of Staff and Director of Infectious Diseases at Greenwich Hospital, is the study’s principal investor in Greenwich. 

“In theory, the plasma contains protective antibodies that can transfer immunity to the coronavirus from a patient who had COVID-19 to someone who is suffering with the disease,” Sabetta said in a statement from Yale New Haven Health earlier this week. “The patients who have received the plasma are still in the hospital recovering.”

Dr. Tom Balcezak, Chief Clinical Officer for Yale New Haven Health System, said everyone is waiting for answers on plasma therapy. He noted that it has worked in treating other diseases, such as SARS and Ebola, but coronavirus is different.

“This disease has some interesting features to it, including the fact that the immune response in some individuals actually causes the disease to be worse. All hospitals within the Yale New Haven System and many other hospitals across the state of Connecticut and in the United States have entered into this trial,” Balcezak said.

Plasma is being collected locally in the New York and Rhode Island blood centers.

“We are all participating in this together as really a national trial to see if it will work, and if so, what are the parameters to give the plasma, and what are the parameters when not to give the plasma?” Balcezak added.

To qualify for the experimental treatment, “patients must have a severe or life threatening infection with COVID-19 or be judged to be at high risk of progression to life threatening disease,” said Sabetta.

Patients or their families must also give informed consent. 

Sabetta noted that the ability to offer the treatment is dependent on the limited supply of plasma. 

Plans are currently underway to screen recovered patients who were tested at Greenwich Hospital to determine if they can register as potential COVID convalescent plasma donors with the New York Blood Center.

While it will take some time to understand if convalescent plasma therapy is of benefit, preliminary data is encouraging, according to Balcezak.

“There’s a little bit of data that suggests that in very severely ill patients, that it might work,” Balcezak said. “It’s not the gold standard, but it’s encouraging and a little bit of encouraging news given the fact that there are no treatments yet for this disease. It’s very welcome.”

Greenwich First Selectman, Fred Camillo, pointed out that plasma therapy was used during the pandemic of 1918.

“Plasma therapy is one of several things that we hear is going to be tried [with coronavirus], and we pray it’s met with success. Let’s hope it’s widely successful,” Camillo said. “In the meantime, while people are working hard to find treatments and vaccinations, all we can do is keep our distance and keep following the protocols to make sure this thing slows down.”

Increased testing, specifically for antibodies to coronavirus, will also remain a key component in the battle of coronavirus, especially as states begin plans to reopen.

“Antibody testing will be important in determining the number of asymptomatic or minimally symptomatic infections. The key question will be, does a positive antibody test represent immunity or protection against future infection? This is not known,” said Dr. Gavin McLeod, from Greenwich Hospital’s Department of Infectious Disease.

“All new tests need time to become more precise and accurate. For example, antibody testing for HIV and Hepatitis C needed years to improve the sensitivity and specificity,” he added. “As an initial step, having antibody testing for this virus will help determine the scope of infections and provide a starting point for further research and improved knowledge of COVID-19.”

Balcezak said that Yale New Haven Health is just starting to bring antibody testing on-line.

“Our laboratory is working very hard to be able to do that. I anticipate we should be able to provide laboratory antibody testing here, I’d say probably within the week or so,” he said.

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