The Central Pharmacotherapy Committee of the Costa Rican Social Security Fund (CCSS) endorsed the protocol for the institutional use of convalescent plasma in patients of any age with severe or critical presentation of covid-19, where its possible use of therapy in national, regional hospitals and the covid-19 patient care center.
With the publication made on June 25, the CCSS confirms that the therapy is available for patients with a diagnosis of covid-19 who meet the inclusion criteria for the therapeutic application of convalescent plasma covid-19 and who do not have exclusion conditions.
According to the protocol, the use of therapy occurs in the context of patients with clinical categorization of severe or critical. The clinical condition of the severe patient is characterized by an adequate and healthy percentage of blood oxygen, without respiratory failure and a lung capacity greater than 50%. The critically ill patient has at least one of the following points: respiratory failure, septic shock, or acute multiple organ failure.
Among the exclusion criteria for the use of therapy is that the patient has hypersensitivity to human proteins, that he has more than 14 days from the onset of symptoms, a reserved prognosis that includes cancer patients and patients with end-stage neurodegenerative diseases, patients with lung diseases evolved, oxygen dependent or COPD.
According to the treatment scheme, the serum will be applied once and will be done after signing the patient’s informed consent.
It is important to highlight that the therapy is guaranteed to be prescribed by specialists in internal medicine, infectious diseases, immunology and intensive care for as long as there is a stock of the treatment in the Blood Bank.
Dr. Marjorie Obando points out an important aspect for access to therapy: “The key point for this therapy, and the others that are trying to be developed together with the Clodomiro Picado Institute of the University of Costa Rica, is the solidarity of the recovered people because we need the blood donation to make the serum ”.
Donors are supportive individuals who were mild or moderate covid-19 patients, recovered and healthy from other infectious-contagious diseases. To verify this, prior to donation, they undergo clinical examinations and laboratory hematology tests to rule out detectable infectious agents.
In particular, tests are carried out for the detection of hepatitis B virus, human immunodeficiency virus and antibodies to Chagas disease and syphilis.
Convalescent serum consists of taking the plasma from the blood of the cured person, where the antibodies that have overcome the virus are, and passing them to a sick person in a severe and critical state to help them fight virosis. Antibodies are molecules created in the body’s immune system to attack the invading virus.
Plasma collection and distribution
The collection and distribution of plasma will be coordinated by the National Blood Bank in Zapote. For its part, the Blood Bank has said that not every cured person can be a plasma donor.
The requirements and criteria for donating are also maintained for the recovered, the campaigns look for people who had covid-19 and generated good defenses for them to share with a person in need.
As reported in the literature, the use of plasma can produce some adverse events, such as fever, chills, headache, myalgia, nausea, vomiting, itching or rash, dizziness, laryngeal stridor, both during and after the infusion, back pain , itching even up to 1-2 days later.
Some less frequent ones are the appearance of tachycardia, hypotension, thromboembolic phenomena, kidney failure or even presenting a serious condition such as anaphylactic shock.
Convalescent plasma therapy is one of the many options that doctors have to face covid-19 in seriously ill patients: it is not the only one and it is not the cure for the disease, it represents one more opportunity to approach the disease while not there are medications directly designed for treatment.