Coronavirus: Without a positive COVID-19 test, many eager prospective donors face difficulties giving plasma
Medical centers across the U.S. are racing to determine whether plasma from recovered coronavirus patients can successfully lessen the severity — or shorten the length — of the disease. But as institutions like the Ohio State University Wexner Medical Center perform their first plasma transfusions as a treatment, others are left with limited knowledge or resources to participate in these trials, despite the number of willing prospective participants.
“The donors are individuals who are coming in and volunteering to donate blood,” Rama K. Mallampalli, MD, chair of the Department of Internal Medicine at the Ohio State University Wexner Medical Center, tells Yahoo Life.
Still, the process of donating plasma isn’t as simple as it sounds. “We’re developing a set of potential donors from those who go to our website, and they have to go through and fulfill certain criteria,” Mallampalli continues, referring to a positive COVID-19 test. “Then once we identify a potential donor, we go ahead and analyze their blood with the antibody test.”
For people who work at medical institutions where plasma treatments are taking place, getting tested for the necessary antibodies seems relatively easy. Margaret Zhang, MD, a resident at Mount Sinai in New York, tweeted on April 9 that she couldn’t get tested for COVID-19 during the two days she had a fever, but was able to get a test to confirm that she can donate plasma.
Had a fever for two days, two weeks ago followed by some cough; couldn't get tested at the time. Got my blood drawn for antibody testing at Mt Sinai on my first day off Monday, and GUESS WHO HAS ENOUGH COVID ANTIBODIES TO DONATE PLASMA??! YOUR GIRL!!!!!!!
— Margaret Zhang, MD (@MargaretZhangMD) April 9, 2020
But for others, it’s not so simple. In response to Zhang’s tweet announcing that she has enough COVID-19 antibodies to donate plasma, many said they don’t have access to the same testing.
Wow! Didn’t know this was available yet. Do you know if this is nationwide? Or how to find out if offered in your area?
— Lianne Kraemer (@lianne_kraemer) April 10, 2020
We need this everywhere so we can reopen the world!!!
— julia gulia (@Juliean512) April 10, 2020
This is fantastic! Do you know of any protocols in or around DC? I'm presumptively positive, still symptomatic and likely won't get tested unless my breathing gets bad. Hoping to provide plasma when I'm healthy, but most studies I'm aware of require a positive test while ill.
— Yael Fitzpatrick (@GazelleInDminor) April 10, 2020
Who do I contact about this, and how long post symptoms do they want you to wait before coming in, do you know?
— Adam J Calhoun (@neuroecology) April 9, 2020
Hi, I am a Mayo Clinic immunologist currently living in Mexico. Congrats on that test result, big time! Do you happen to know how antibody determination is being done? Platform & antigen? It'd be so useful for us to find out.
— Irma Aguilar-Delfin (@dyctiostelium) April 9, 2020
Zhang didn’t immediately respond to Yahoo Life’s request for comment. Through Twitter, however, she suggested that people reach out to the American Red Cross, which is now facilitating plasma donations from recovered COVID-19 patients. But again, this process comes with a number of criteria, including a positive COVID-19 test or an antibody test, to even be considered.
Lydia Wagner, a 59-year-old woman from New York, was met with this exact obstacle when she filled out a donor eligibility form with the Red Cross and received an email rejecting her donation.
“Thank you again for your interest in donating convalescent plasma for people hospitalized with COVID-19. Because you indicated that you did not have a test confirming your diagnosis of COVID-19, additional testing is required for you to be qualified as an eligible donor. This testing would determine if your plasma has adequate levels of antibodies to treat people seriously ill with COVID-19,” the Red Cross email provided by Wagner reads. “We have not yet established a process by which this testing can be performed. Once we have a mechanism by which we can get this testing done, and as needed, we will contact you to provide a sample for testing.”
Wagner explains that she and her husband were presumptive positive after experiencing a number of specific symptoms that align with COVID-19. “When I recovered much easier than he did I thought I would be a good candidate,” she tells Yahoo Life. “I was unable to get tested when I was sick because I was not checked into a hospital and now I cannot give antibodies because they don’t have a test for them.”
According to New Jersey primary care physician Alexander Salerno, MD, the vicious circle is a result of the lack of COVID-19 tests made available to the public in the first place.
“You’re not gonna be able to have as many potential people that can offer a plasma exchange and plasma extraction because in order to do that you had to have a positive test, you had to have gone through two weeks, you have to then be retested to demonstrate that you cleared the infection and there’s no infectivity. And only then can you go to the Red Cross,” Salerno explains to Yahoo Life. “So it’s hard enough to get one test, and now you’re gonna have to get two tests.”
Luckily, that is set to change as early as next week when antibody tests become more accessible. And unlike the promise of more accessible COVID-19 tests, Salerno feels confident that antibody tests will be easier to get ahold of. “Blood is easy to take,” Salerno says, explaining that the antibody tests are already going through final approvals by the Food and Drug Administration. “They hope that by next week they can then offer this as a commercial run to everyone.”
Like the many Americans eager to donate plasma, doctors involved in the earliest programs are looking forward to antibody testing becoming more widespread. Mallampalli points out that this is not just for the sake of donations but also to determine how the virus has spread.
“We want to expand testing not only to look at donors but also potentially health care workers, randomly testing the community to look at the penetrance of this infection, who’s been exposed,” Mallampalli explains. “We also want to expand at the same time the pool of donors because we want to be able to have enough plasma to give to these sick patients.”
Mallampalli believes that “we’re well on our way to do that over the next couple of weeks,” which would allow hospitals to act on the promises of antibody testing touted by Dr. Anthony Fauci, a leading public health expert and adviser to President Trump.
“People need hope. And we have some very sick people at all ages, not only here at Ohio State, but regionally and nationally,” Mallampalli says of antibody testing and plasma exchanges. “This has been used for over 100 years, it’s been used in other pandemics and epidemics, and there’s a lot of anecdotal evidence that suggests that it may work. ... We’re very optimistic.”
For the latest coronavirus news and updates, follow along at https://news.yahoo.com/coronavirus. According to experts, people over 60 and those who are immunocompromised continue to be the most at risk. If you have questions, please reference the CDC and WHO’s resource guides.
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