Corona virus Disease 2019 (COVID-19) can be a severe respiratory illness caused by Severe Acute Respiratory Syndrome (SARS-CoV2) for which there is no standard treatment in affected persons nor a vaccine to prevent the infection. The investigators propose to test whether the use of Convalescent plasma given to patients with severe COVID-19 disease will decrease risk of death, decrease use of ventilatory support decrease biomarkers of inflammation and improve measures of viral replication compared with controls subjects who were not transfused.Convalescent plasma, will be collected from persons who are more than 21 days post negative viral testing or 28 days post resolution of symptoms.
Coronavirus Disease 2019 (COVID-19) can be a severe respiratory illness caused by SARS-CoV2
for which there is no standard treatment in affected persons nor a vaccine to prevent the
infection. This condition has and continues to cause significant burden on Health care
systems with affected persons needing prolonged stay on ventilators in Intensive Care Units.
Convalescent plasma has been used in the treatment of other life-threatening conditions such
as Novel Influenza A (H1N1) pandemic, SARS-COV-1 epidemic and Middle East respiratory
syndrome -related Coronavirus (MERS-CoV) epidemic. Since convalescent plasma has been found
to be beneficial in some diseases but is not always successful in all conditions in which it
has been tried, there is no guarantee of success in this disease, and so it is necessary to
conduct this study.
A sample of 30 patients with severe and life threatening COVID-19 disease will participate in
phase 2 clinical trials. Convalescent Plasma will be administered to participants fulfilling
the criteria due to its proven effect on H1N1 pandemic, SARS-COV-1 and MERS-COV epidemic.
Although it has proven beneficial in some diseases, there is no guarantee that it will bring
the desired outcome , hence the importance of the clinical trials. The observation will
consist of three groups, namely, donor, participants and a control group. These patients must
recover from all COVID-19 symptoms.
The participants who fulfill the inclusion criteria will receive convalescent plasma,
collected from persons who are more than 21 days post negative viral testing or 28 days post
resolution of symptoms. Potential participants will be approached by a research assistant
within 24 hours of diagnosis and be told about the study and informed consent obtained only
after the participants are identified as meeting the inclusion criteria for either
participation as donor or recipient of plasma. If in the case of recipients, the recipients
are intubated or otherwise unable to give consent, the recipients proxy will be required to
do the same before participation is allowed. Plasma donations will also be solicited on the
University of the West Indies (UWI) and University Hospital of the West Indies (UHWI)
websites and Mona Messaging platform of UWI as well as social media platforms that will be
managed by the UHWI public relations department. In addition, the investigators will also use
electronic news media publications to inform interested persons about the study.
A sample of the recipients plasma will be kept for future studies as yet unknown. If any of
these are genetic studies, attempts will be made to re-contact the donors to consent to these
studies. The duration for this first study will be for one year.
The recipients for this plasma infusion must fulfill criteria for severe or immediately
life-threatening infection. The control group will also fulfill the criteria for severe or
life-threatening disease but have a contraindication to receiving plasma. The plasma donors
must fulfill the criteria for selection of blood donors but in addition would have been
recovered from COVID-19.
The data analysis will include changes in means of the objectives using Student's t-test.
Each participant will be assigned a study identification (ID) number and data linked to the
study ID will only be accessible to researchers using a password protected computer.
The participants name and study ID number will be kept in a locked filing cabinet with access
only to the research team.
This is a moderate risk study and participants will be informed that no personal benefit will
be derive from participating in this study.
Limitations include not getting enough persons for plasma donation if the infection rate in
Jamaica remains low, or the age of the affected persons is outside of the accepted range of
our blood donor requirements. As this is a pilot however, the investigators may be able to
achieve the sample size which should allow the investigators to identify any challenges in
conducting a larger trial.
Participants will have every effort made to maintain confidentiality by using only study ID
numbers on data collection sheets and laboratory studies.
Biological: Convalescent Plasma Infusion
250 mls of convalescent plasma on day 1 & 2.
Inclusion Criteria
- 18 years of age or older:
- Laboratory confirmed COVID-19:
- Severe or immediately life-threatening COVID-19:
- Severe disease is defined as one or more of the following:
Exclusion Criteria:
- Patients with mild or moderate COVID-19 infection that do not need in-patient care:
- Patients with a history of severe allergic reaction to plasma infusion:
- Patients who do not give consent or withdraw consent from study:
University of the West Indies
Kingston, Jamaica
Investigator: Tomlin Paul
Contact: 8769272556
tomlin.paul@uwimona.edu.jm
Investigator: Giliian G Wharfe, MB, BS, DM
Gilian G Wharfe, Principal Investigator
University of the West Indies