Issam Al-Fadheli did not know when he was returning from work that he would contract the coronavirus. The symptoms began to appear in him, at first a slight fever that went up the next day, aching bones, a headache, and then a sore throat and shortness of breath.
The symptoms lasted for two weeks, then began to fade, but his experience pushed him to help others. He heard about the convalescent plasma donation program and thought to himself, “that’s it!”
Issam reported to SQU Hospital to donate plasma. The necessary checks were done before he donated three times at the University’s Blood Bank. Reflecting on the experience, he said: “It is a wonderful feeling, just thinking the plasma may save a human life from the risk of the coronavirus.”
In this context, Dr. Arwa Zakaria Al Riyami - Senior Consultant Hematologist at SQU Hospital - explained the mechanism of donating convalescent plasma for use in treating patients with Covid-19.
Al-Riyami said: “An invitation to donate convalescent plasma at SQU Hospital is normally sent to all individuals who have recovered from Covid-19 after at least 14 days have passed since they recovered from the symptoms and the quarantine period has ended.”
She indicated that: “The blood donation process in general passes through various stages to ensure the safety of donors and whether it is possible for them to donate; these stages begin with an interview with the specialist doctor to review the donors’ health condition and get their approval for donating convalescent plasma; adequate tests are also made to see whether they are able to donate plasma and when, in addition to lab tests to ensure they are Corona-free and to determine the appropriate time for donation, including taking a swab and a blood test to measure the level of antibodies to the virus.”
The doctor added: “The donor file is transferred to the University Blood Bank where the test results are reviewed and the donor is contacted to set a date for donation. The donor should meet the conditions for donating and be able to come to the bank, after making sure they have recovered from the disease, shown no symptoms, and made no contact with any Covid-19 patients, in compliance with the special conditions for donating blood under the Covid-19 pandemic. The donor is also provided with general advice before coming to the Bank to donate.”
Al Riyami went on: “There are general donation steps, including filling out a blood donation form, checking hemoglobin level, weight and pressure, and taking test samples for hepatitis B and C, immunodeficiency disease, and others. The plasma donation is carried out using a special device that collects the plasma in a special bag in a safe and sterile manner. This procedure takes about 30-60 minutes, during which about half a liter of plasma is collected.”
“Then, the plasma is separated into 2-3 units and is treated with a special pathogen inactivation technique to eliminate any viruses and microbes that may be present in it. The quality of the plasma and level of antibodies are also confirmed through special tests. The plasma is stored in the freezing machine of the blood units of the University Blood Bank until it is requested for treatment, as each patient needs approximately 1-2 units of plasma according to condition of the disease.”
She stated: “When a patient is likely to benefit from the plasma, and after getting appropriate approvals, the plasma is requested from the Blood Bank; then the plasma unit is removed from the freezing machine and thawed to room temperature, and then given to the patient intravenously. The patient's condition is closely monitored, and their response determined. After donating, the donor is contacted to confirm their condition, and to set the next date for donation, as they can donate plasma weekly, provided that the total number of donations does not exceed 4 times.”
Al-Riyami conducted an analytical team study at the International Blood Transfusion Society to develop recommendations to blood transfusion staff and researchers on the use of convalescent plasma and identify knowledge gaps in the clinical application of its use.
In the study, the criteria for selecting donors and mechanism for plasma collection and preservation in blood banks in 22 countries on 6 continents were compared. The mechanisms and challenges in this process were compared in developed and middle- and low-income countries.
Key conclusions suggest that the use of convalescence plasma in Covid-19 patients should preferably be within a clinical study, with a recommendation to start clinical studies on its use in the early period of the pandemic after evaluating the potential to collect it, and the expected benefits and potential risks. It should be used in the early stages of the disease, based on the experience of using plasma in the treatment of other viral infections, and it is important to ensure its safety in adult patients and children with Covid-19. Its efficacy should also be evaluated in comparison to other treatment alternatives, wherever possible.
It is worth noting that the University Blood Bank is part of a clinical study aimed to examine this type of treatment for patients with Covid-19. The research is being conducted by a team from SQU Hospital led by Dr. Zaid Al-Hinai.