It took less than eight hours for Dr. Kyle Annen to get the plasma — not just any blood donation, but one from a patient who had recovered from the new coronavirus and had the antibodies that might save someone else.
The clock started ticking when a physician at UCHealth University of Colorado Hospital called for help last week. A patient was severely ill and on a ventilator. The plea for “convalescent plasma” from someone who had already survived COVID-19, the disease caused by the coronavirus, was a desperate attempt to prevent another death in the coronavirus pandemic.
Annen, who is the medical director of the blood collection center at Children’s Hospital Colorado, immediately reached out to a few people who had previously called to say they had recovered from COVID-19 and would donate blood. And she soon found one.
A donor who had previously tested positive for the disease came to Children’s on short notice last Tuesday to take another test — and sat there, wearing a mask, waiting to find out whether that test would come back negative, as required.
Meanwhile, the hospitalized patient’s doctor was requesting permission for the transfusion from the U.S. Food and Drug Administration. The federal agency is allowing patients with “serious or immediate life-threatening” COVID-19 infections to get the transfusions, but their doctors must request an emergency “investigational new drug application,” called an eIND, for every single patient.
Annen could not provide the plasma without receiving the eIND.
“It was all systems go, all hands on deck,” said Annen, who is an osteopathic doctor certified in pathology in addition to director of Transfusion Services and Patient Blood Management at Children’s.
It all fell into place within seven or eight hours, she said. Children’s was only the third site in the nation to provide a transfusion of convalescent plasma — the liquid part of blood collected from patients who have recovered from an infection — trying to combat COVID-19, Annen said.
Convalescent plasma worked well in outbreaks of other respiratory infections, including the H1N1 flu in 2009-10. The FDA is asking researchers to start clinical trials to find out whether such blood transfusions will help during this coronavirus pandemic, and has authorized single-patient requests “given the public health emergency,” the agency said in a public notice last week.
Among the questions that researchers could answer: When is the best time for a person who has recovered from COVID-19 to give their blood so that it has the optimal number of antibodies?
Under current guidelines, people who had COVID-19 are required to wait for 14 symptom-free days before giving plasma. And they must submit proof that they once tested positive, then get tested again to show they are now negative and no longer shedding the virus.
That protocol is expected to change as soon as an antibody test is available. Antibody tests, which can determine whether a person previously had the disease, have not been available nationwide. Children’s Hospital does not expect to have them for a few more weeks, Annen said.
“The No. 1 question: ‘I’m sure I had it. I was sick but I didn’t get tested. Can I still donate?’” Annen said. “The answer right now is no.”
Children’s Hospital would not say, because of privacy laws, whether the first patient to receive the convalescent plasma has improved.
Annen’s lab was able to react fast to the request in part because the prospect of helping COVID-19 patients with convalescent plasma was already on her radar. But it also helped that her blood bank is small and in-house, from collection to processing. About 97% of blood donated at Children’s is used in the hospital.
“We are just little and nimble and move a little more quickly than everyone else,” she said.
About 10 people who have recovered from COVID-19 have given blood to the bank at Children’s since the first person one week ago.
That might have been a result of the pleas from family members shared across social media platforms.
An Evergreen family begged for plasma donations to save their husband and father. Michael Leonard was in an intensive-care unit, intubated and “fighting for his life,” his daughter Molly wrote in a post that was shared on Facebook and Twitter.
“His medical team thinks that he may benefit from convalescent plasma,” she wrote. “Sharing this post far and wide would also be a tremendous help.”
Molly wrote in an email to The Colorado Sun that her dad had received convalescent plasma last Thursday. The family received thousands of emails and messages offering help from across the country, she said.
She did not say whether her father is recovering.
In another post that circulated on Word of Mouth Littleton, a woman asked for convalescent plasma for her husband. “He was admitted 10 days ago and has been on a ventilator,” Denise Kaplan said. “He is 43!”
Dr. Annen said she expected such pleas coming directly from family members would decrease as more blood donation centers begin collecting convalescent plasma for COVID-19, which is expected this week.
Those include banks at St. Mary’s Hospital in Grand Junction and Vitalant (formerly Bonfils), which is starting with its Lowry collection site and then expanding to others across Colorado.
Vitalant is accepting its first donations this week in Colorado. Physicians at Colorado hospitals will order the convalescent plasma collection, and get the required patient identification number from the FDA. The blood bank will then provide the plasma to the hospital as soon as it’s available, said Larry Dumont, senior investigator at Vitalant Research Institute in Denver.
Children’s Hospital has fulfilled five requests for convalescent plasma so far, Dumont said. “Clinical reports are encouraging,” he said.
Standard requirements to give blood still apply.
Besides Children’s, the first hospitals to administer convalescent plasma for COVID-19 were in New York and Houston. Other initiatives are ongoing in Seattle, Los Angeles and Miami, as well as in Canada, Singapore, Saudi Arabia and a few European countries, Dumont said.
“Nationally, it is still in its infancy, but blood centers across the nation are working at record pace to get this intervention moving,” he said. Vitalant is talking to colleagues across the world to “learn from and help each other,” he said.
To donate convalescent plasma to Children’s Hospital during the pandemic, call 720-777-3557 or send an email to firstname.lastname@example.org.