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BACKGROUND: Convalescent plasma has been used to provide passive immunotherapy to patients with Covid-19 with a high level of safety. Very few efficacy studies were available, and due to COVID being a relatively new disease, its exact therapeutic role was unclear. This observational study on the impact of Covid convalescent plasma (CCP) on clinical outcomes attempts to evaluate the effectiveness of convalescent Covid 19 plasma therapy in the treatment of Covid 19 patients at the tertiary care center in the Uttarakhand state of India. METHODS: CCP was collected by plasmapheresis/ whole blood from willing Covid-recovered donors who underwent pre-donation testing including ABO and RhD grouping, mandatory blood screening tests for HIV, HBV, HCV, syphilis and Malaria, Haemoglobin estimation and Covid IgG assay. Hospitalized patients with severe Covid-19 pneumonia who received these CCP units were followed up and the outcome (Recovery/death) was observed. RESULTS: A total of 63 patients who received CCP were included in the study. Out of the total, 13 (20.7 %) were females and 50 (79.3 %) were males and their ages ranged from 24 to 80 years with a median age of 53 years. The period between the start of symptoms and hospitalization ranged from 1 to 14 days with an average duration of 4.7 days. Symptoms on presentation included Fever 53/63 (84.1 %), Tachypnoea 60/63 (95.2 %) and Cough 42/63 (66.7 %). Among these patients, 22/63 (34.9 %) were on non-invasive ventilation (NIV), 6/63 (9.5 %) on non-rebreather mask (NRBM) and 32/63 (50.8 %) were on Ventilator support. The infused convalescent plasma had a Mean IgG value of 57.3 AU with a range of (10-142 AU). A total of 37 (58.7 %) patients were lost to Covid-19 infection and 26 (41.3 %) were discharged from the hospital in a healthy state. CONCLUSION: The use of convalescent plasma in addition to standard treatment in our study on patients with severe pneumonia due to Covid-19 did not demonstrate reduced mortality of Covid 19 patients amidst numerous variables. The results showed that the use of convalescent plasma as a treatment option in the present conditions needs a serious re-evaluation. Studies on a strictly defined recipient group and transfusion of CCP units, with adequate antibody titer and/or neutralization activity, must be analyzed for future works.
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Foundation programs are conducted in medical schools for undergraduate students, since they are naïve and unaware of the medical profession in depth. The program helps them to become familiar with the undergraduate medical training. The present intake of first year medical undergraduates had joined the institute amidst the COVID-19 pandemic and hence the foundation program had to be conducted through an online platform. The present paper is a description of the online program conducted in the institute and is aimed to focus on the pros and cons of using an online platform for conducting the program and the experience gained from it. The online foundation program was conducted over a period of 16 days through the Zoom© platform. The program was tailored to cater for the orientation of 175 students who were admitted for first year MBBS batch 2020-2021. Feedback from students was obtained through Google Forms© at the end of the program. The online program was conducted smoothly due to the dedicated efforts of all the team members. Sessions requiring hands-on training and physical field visits had to be omitted in the present program. Network connectivity issues were reported sometimes. The conduction of the online foundation course program was indeed a learning experience. The team work was well reflected in the feedback from the students, which revealed appreciation for the overall program. Many sessions went very well in the online mode; however, sessions on humanities and extracurricular activities could have been organized in a better way with the physical presence of the students.
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Background and Objectives: There are limited published data on association of results from commercial serological anti-SARS-CoV-2 IgG antibody CLIA (chemiluminescent immunoassay) assays with neutralizing antibodies. This study was undertaken with an objective to correlate sample-to-cut-off (S/Co) ratio of CLIA antibody tests with inhibition activity, which may then serve as a valuable guide for labelling plasma as COVID convalescent plasma (CCP) for therapy and assessing vaccine efficacy. Materials and Methods: A total of 139 donor serum samples who were previously RT-PCR positive and had recovered completely from COVID-19 at least 28 days prior to collection of samples were recruited at three sites. The samples were analysed for S/Co ratio and per cent inhibition activity with VITROS SARS-CoV-2 IgG chemiluminescent assay and GenScript cPass SARS-CoV-2 Surrogate Virus Neutralization Test (sVNT) kit, respectively. Linear regression equation and receiver operating characteristic (ROC) curve were used to check the proposed model of comparing S/Co with per cent inhibition. Results: The results indicate very good correlation between the S/Co ratio of the chemiluminescent IgG assay and the neutralization activity depicted by per cent inhibition on sVNT assay. S/Co ratio of 4·04 (low-titre) and 8·19 (high-titre) correlated with 30% and 68% inhibition, respectively. Conclusion: Chemiluminescent SARS-CoV-2 IgG assay can be used as a semi-quantitative test, with a cut-off of >8·19S/Co ratio for selecting donors for convalescent plasma therapy and assessing efficacy of vaccination.
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Thrombotic thrombocytopenic purpura (TTP) which can cause significant mortality is a thrombotic microangiopathy due to deficiency of VWF cleaving protease ADAMTS13 and as per medical literature there are examples that TTP can be caused by COVID 19 infection. A 35 years old female after admission with right sided weakness and slurring of speech was found to be COVID positive and diagnosed as a case of TTP. Patient had absent ADAMTS13 level on day 1. Treatment was started with therapeutic plasma exchange (TPE) later injection Vincristine and Rituximab was given after 4th TPE as it was suspected as refractory case. Finally patient received 16 TPE procedures with cryo poor plasma as exchange fluid and gradually her platelet count started to maintain normal and she was discharged. Specific management and such association of this type of cases need to be studied more judiciously.