ICMR Removes Plasma Therapy From India's COVID-19 Treatment Protocol

The Indian Council of Medical Research has removed plasma therapy as an effective method of COVID-19 treatment after the National Task Force - formed on the recommendations of the Supreme Court - proposed the removal of this therapy.

The decision comes after social media was flooded with desperate requests for plasma as hospitals kept prescribing the treatment even as many doctors said that it did not help in treating COVID-19 in a large number of cases.

Even though the ICMR had earlier through its PLACID Trial stated that plasma therapy is not really effective in reducing the severity of COVID-19, the therapy was still a part of the trial protocol as an off-label emergency use authorization therapy without enough supporting evidence. This PLACID trial which showcased that plasma therapy is not helping in treating COVID-19 was published in October 2020.

What Is Plasma Therapy?

Convalescent Plasma Therapy is when immunoglobins and antibodies are separated from the blood of a recovered patient and are donated to another patient with severe infection. This transfusion is able to neutralise the pathogen and eventually leads to its eradication from the blood circulation.

The infected develop antibodies to fight off the pathogen and these are transferred to people with severe infections who are not actively developing an immune response against the acting pathogen.

What Did The PLACID Trials Say?

The ICMR conducted the PLACID trial at 39 hospitals with 464 participants of which 235 received plasma therapy. The final outcome and results showed no significant difference among people who received plasma or who were in the control arm. The plasma therapy arm witnessed 34 deaths while the control arm that did not receive plasma therapy witnessed 31 deaths in a 28 post-treatment period.

This study that was published in October 2020 prompted the ICMR to announce that plasma therapy was ineffective, but it continued to remain as a part of the COVID-19 treatment protocol. Dr. Balrama Bhargava, director general of ICMR as well as Dr. V.K. Paul, member, NITI Aayog have in every press conference repeatedly suggested that this emergency use treatment protocol be used rationally and judiciously.

What Steps Has The Government Taken Now?

The Supreme Court constituted a 12-member National Task Force to gauge the COVID-19 situation in the country which would also overlook the existing treatment strategy. This Task Force reviewed the current protocol and recommended the removal of plasma therapy as it did not show any direct benefits in improving the health of COVID-19 patients.

After the Task Force's recommendation, the ICMR issued a fresh revised protocol for managing COVID-19 wherein plasma therapy was taken out of the original protocol. The ICMR always kept plasma as a part of emergency use therapy which was off label and lacked substantial evidence. This list still includes Remdesivir and Tocilizumab.