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A patient suffering from COVID-19, who was given plasma from convalescents in Lublin, felt well after a few hours. The first patient in Poland to be treated with an innovative therapy will soon leave the hospital. However, the pandemic is still a long way off, says Prof. Krzysztof Tomasiewicz, head of the Department and Clinic of Infectious Diseases at the Medical University of Lublin.
- The first Polish patient who was given blood plasma from convalescents felt better after a few hours – says prof. Krzysztof Tomasiewicz, head of the clinic where an innovative therapy was used
- Plasma offers hope in combating the COVID-19 epidemic, but most of all there is a need for a drug that will be widely available, effective and usable in the form of an oral preparation – adds the professor
- The administration of chloroquine as a drug supporting the treatment of COVID-19 is not an experiment, because this drug has this indication in Poland. In the case of other drugs – no one will conduct standard clinical trials in a pandemic – he explains
- When asked when the peak of the pandemic will be, he says that he doesn’t think there will be a single peak. «There will be ups and downs that look like a saw’s teeth on the chart. Both increases and decreases will be in similar numerical ranges »
Halina Pilonis: The patient who was treated with the blood plasma of convalescents is to leave the hospital. Does that mean we beat the virus?
Prof. Krzysztof Tomasiewicz: This is only one patient, so no such conclusions can be drawn. But the sick man is feeling very well and will leave the hospital. However, I must emphasize that this therapy will not eliminate the pandemic in the world.
Plasma is difficult to obtain because it must be collected from those who have recovered and match the patient’s blood type. What is needed is a drug that is widely available, effective, and usable as an oral formulation. But at the moment we don’t have a cure against this virus.
Who is the patient who benefited from this therapy?
He’s a middle-aged man, a doctor. He had a high fever and breathing problems. His blood oxygenation was getting weaker. Inflammatory parameters were rising, which threatened with a cytokine storm, and it is she who is responsible for the severe course of the disease.
The body secretes cytokines that are normally expected to cause reactions to destroy the virus. However, their excess sometimes causes excessive inflammation to harm the patient’s body.
- Read: Who can be treated with plasma from convalescents?
Was he at risk of any side effects from the treatment he was using?
Apart from a possible allergic reaction to plasma components, no.
How did the plasma injection work?
After a few hours the patient felt much better. Blood oxygen saturation improved and inflammatory factors decreased. The number of immune cells has also increased. After six days, the patient no longer had any symptoms and is now in great shape. In fact, he could be released from the hospital. We still have to test that he is healthy.
How did you get the plasma?
We started educating the patients we treated and recovered to donate blood to prepare treatments for other patients. We knew that antibody production peaked approximately two weeks after recovery. The Regional Center for Blood Donation and Blood Treatment, which prepared the plasma, was very actively involved in these activities. In total, plasma was collected from four convalescents. They were qualified like blood donors. They had to be healthy.
- Read: Experimental therapy in Warsaw. 100 patients will get blood plasma from the recovered
Should all patients be treated this way?
Not. We administer chloroquine, lopinavir / ritonavir to all patients in our clinic. In case these drugs do not work, we try other methods.
Is the use of all drugs for COVID-19 a medical experiment?
The administration of chloroquine as a drug supporting the treatment of COVID-19 is not an experiment, because this drug has a registered indication in Poland. We receive the drug from the manufacturer for free and use it to treat patients in the hospital. In the case of other drugs – no one will conduct standard clinical trials in a pandemic. In such studies, it would be necessary to administer drugs only to some patients and compare the course of the disease in them and in those who do not get them. In the case of COVID-19, it’s ethically questionable and too long-lasting. It would be a sin not to give the medicine to the sick person, knowing that they can benefit from it. In the recommendations recently published by AOTMiT, in addition to the Agency’s information that the administration of drugs takes place as part of a medical experiment, there are also recommendations of experts who inform how these drugs can be used because they do it and see the effects of treatment.
- Read: Scientists are still looking for an effective COVID-19 treatment. We review promising therapies
Are we already at the peak of the pandemic?
No one knows this.
In my opinion, there will be no peak pandemic. There will be ups and downs which will resemble a sawtooth on the chart. Both increases and decreases will be in similar numerical ranges. We do not know why the Polish scenario looks like this. It is certainly an effect of the early implementation of restrictions.
And although there are often accusations that the lack of a significant number of cases is the result of too few tests, we would notice a sharp increase in the number of patients in hospital wards. It is not so. There are slow respirators, and there are no major problems with the spots. So everything indicates that the Italian scenario is not threatening us. Although no one is able to predict what will happen when, as a result of loosening the restrictions, interpersonal contacts become much more intense.
- Read: The epidemic will end in July, but that’s the most optimistic scenario. Interesting conclusions of the Krakow scientist
Does this mean that the restrictions should not be lifted yet?
For the sake of the economy, we have to start doing this. And every country does that. Unfortunately, isolation also exacerbates social problems. We have more and more information about domestic violence and the rise in alcohol consumption. More and more patients go to hospitals after home quarrels and alcohol addictions.
The Swedes adopted a model of protecting the elderly and less stringent isolation of the rest. They assumed that such laws would make society group resilient. But today we don’t know if that is the case. Is it possible to acquire such immunity, and if so, for how long?
Why do we still know so little and change our minds often?
From the beginning of the epidemic, all efforts were made to save lives and contain the spread of the pandemic. At this stage, there was not enough money invested in research.
We underestimated this virus. We were hoping that, like the AH1N1 flu, it would turn into a seasonal disease. At the beginning, we doctors also said that flu kills many people and we do not close cities because of it. However, when we saw how electrifying the COVID-19 course is, we changed our mind.
We still do not know if the disease gives immunity for how long. We do not know why one of the household members gets sick and the other does not. Without answers to these questions, we cannot predict the future role of the coronavirus.
Hopefully the research that is now starting in the US will improve the situation.
- Read: One year in quarantine. Is this what awaits us?
Politicians also changed their minds many times. At the beginning, the masks were ineffective, and then they were obligatory …
For many weeks I have been saying that wearing masks permanently will not do the job. However, if the virus can stay with us for a long time, the mask is a barrier. All medicine has a political subtext in a sense, because money is behind specific decisions and its spending must be preceded by a certain calculation.
At the beginning of the pandemic, it was reported that COVID-19 was more severe in smokers. Now a study has been published in France which shows that nicotine protects against infection …
The lung pathology caused by cigarette smoking is self-evident. We can be sure that smoking worsens the prognosis of patients. We cannot jump to conclusions when analyzing the data. On this basis, it could check if there were more coffee drinkers among those suffering from COVID-19, and if so, it could be concluded that coffee increases the risk of developing the disease.
Have a question about the coronavirus? Send them to the following address: [email protected]. You will find a daily updated list of answers HERE: Coronavirus – frequently asked questions and answers.
Also read:
- Hydroxychloroquine and chloroquine. What about the side effects of drugs tested to treat COVID-19?
- Countries that deal with the coronavirus. Where is the epidemic under control?
- The World Health Organization warned of a pandemic two years ago. What did we do to prepare?
- Who is Anders Tegnell, author of Swedish tactics to fight the coronavirus?