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Published on: Apr 13, 2020
3 minute read
By: Dr Rajan Choudhary

Plasma Treatment For COVID-19?

TREATING COVID WITH BLOOD

We have previously covered proposed treatments for COVID-19, in particular hydroxychloroquine, and explained why we shouldn’t look for a magic cure for this disease. Viruses are difficult to treat, and ultimately supportive treatment appears to be best we can achieve. But an editorial published in BioMedicine Central appears to show a novel treatment for the most ill patients, one that may have flown under most people’s radar.

“A novel treatment approach to the novel coronavirus: an argument for the use of therapeutic plasma exchange for fulminant COVID-19”

An interesting title. Lets dissect it.

SUMMARY

- Blood is made up of many different components

- The immune system recognises the virus and produces antibodies against it to neutralise it

- These antibodies float in the blood plasma, a watery solution

- The plasma can be extracted from donated blood, and given to patients suffering from COVID-19

- So far evidence suggests it can help treat the most seriously affected patients.

WHAT IS IN OUR BLOOD

To understand this we must first understand what our blood is made of. Most people know that blood functions to transport oxygen from our lungs. But this is an oversimplification. Blood has many different functions:

- Transport: along with oxygen it transports sugars, fats, protein subunits throughout the body. This is done with the watery PLASMA of the blood.

- Clot: cells and protein structures act to plug any holes that form from cuts and damage. This is done by the PLATELETS in the blood

- Immunity: Immune cells respond to bacteria, viruses, parasites in the blood and body. They target these pathogens, identify and tag them with antibodies, and ultimately destroy them. This is done by the WHITE BLOOD CELLS.

And many more functions that we won’t bore you with.

IMMUNITY

It is this last point that is of interest to us. Our immune system consists of white blood cells that can recognise invading organisms in the blood, around cells and even invaders hiding within our own cells. All cells have protein markers on their surface, no matter if its human cells, bacterial, viral, fungal etc. These markers can be highlighted and targeted by specialised white blood cells, who in turn produce antibodies against these markers. Think of antibodies as handcuffs with flares attached: once attached other white blood cells use this information to find and destroy the invaders.

What is amazing about antibodies is how complex they are. The proteins in our body are incredibly complex. They are long chains that fold into unique shapes depending on hundreds of different types of chemical interactions. These are so complex that supercomputers can take literal years to figure out the shape of a single protein and how it folds depending on the subunits in its chain. This means that our immune system has to recognise these markers and figure out a complementary tag out of hundreds of billions of potential sequences. Antibodies have to be specific to their tag. If an antibody is produced that can target more than one tag, it can cause problems. If it targets a bacterial tag, but accidentally highlights the person’s cells as well, the immune system will start targeting and destroying the person’s organs. These auto-immune disorders can be devastating.

But when they work, antibodies are miraculous. They persist in the blood after an infection, and if a second infection occurs, memory cells in the blood can rapidly produce these antibodies before the infection can even produce symptoms. This is known as immunity, and is why we usually don’t get the same illness twice. Antibody based treatment is see as the future of medical therapy, and is something we will cover in future blogs.

PLASMA EXCHANGE

From population testing we can see that the majority of patients with COVID-19 recover, experiencing either mild symptoms, moderate symptoms requiring some form of treatment and hospitalisation, or no symptoms whatsoever. In these patients their immune system will have successfully recognised the virus and produced antibodies against it to neutralise the virus. It is the patients with severe symptoms, those in which the virus is running rampant in the body, that the production of antibodies happens too late.

Plasma exchange involves obtaining blood from patients who have beaten the virus, spinning the blood to separate out the red cells, white cells, platelets and watery plasma. The plasma contains all the glucose, small proteins and importantly for us, the antibodies. This plasma can be transfused into patients with COVID-19 that cannot cope, in order to help their immune system. These transfused antibodies will neutralise some of the viruses in the patient, reducing the viral load, amount of replication and cell destruction that causes such devastating symptoms in COVID-19.

The published editorial showed that in the most critical pneumonia patients, requiring mechanical ventilators and drugs to support the heart, mortality in plasma exchange patients resulted in a 47.8% mortality instead of 81.3%. Of course it is a single study with a limited number of patients, but the results are encouraging. It is further helped by the fact plasma exchange is a well established therapy, with established protocols known to intensivists and haematologists.

THE FUTURE

We may see the use of Plasma exchange for critically ill patients increase as the pandemic continues. It is not a treatment option available for everyone, as it requires intravenous access and careful monitoring in a controlled setting. But it also needs donation from people who have recovered from COVID and have suitable antibodies. So whilst it might not be a magic pill that everyone expects to cure COVID, it might be the difference between life and death for those that need it most.

Dr Rajan Choudhary, UK, Chief Product Officer, Second Medic Inc

www.secondmedic.com

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how air pollution impacts respiratory health

Air pollution has become one of the most serious public health challenges worldwide. In India, rapid urbanisation, industrial activity, vehicular emissions and seasonal pollution spikes have led to dangerously poor air quality in many regions. Understanding how air pollution impacts respiratory health is essential because breathing polluted air directly affects the lungs every single day.

According to the World Health Organization (WHO), air pollution is responsible for millions of premature deaths annually, with respiratory diseases being one of the leading outcomes. The lungs act as the primary entry point for pollutants, making the respiratory system especially vulnerable.

What Is Air Pollution?

Air pollution consists of harmful substances suspended in the air, including:

particulate matter (PM2.5 and PM10)
nitrogen dioxide
sulphur dioxide
ozone
carbon monoxide
toxic chemicals and allergens

These pollutants are inhaled deep into the lungs with every breath.

How Pollutants Enter and Damage the Respiratory System

When polluted air is inhaled:

particles bypass natural nasal filters
toxins reach the bronchial tubes and lungs
inflammation begins in airway lining

Fine particles (PM2.5) penetrate deep into lung tissue and may even enter the bloodstream.

Immediate Effects on Respiratory Health

Airway Irritation

Pollutants irritate the lining of the respiratory tract, causing:

coughing
throat irritation
chest tightness
wheezing

These symptoms often worsen on high pollution days.

Reduced Lung Function

Short-term exposure reduces:

lung capacity
oxygen exchange efficiency

Even healthy individuals may feel breathless during pollution peaks.

Long-Term Respiratory Damage

Chronic Inflammation

Continuous exposure keeps airways inflamed, leading to:

persistent cough
mucus overproduction
airway narrowing

Chronic inflammation is a precursor to long-term lung disease.

Increased Risk of Asthma

Air pollution:

triggers asthma attacks
increases asthma severity
contributes to new asthma development

Children exposed to pollution are at higher risk of lifelong asthma.

Chronic Obstructive Pulmonary Disease (COPD)

Prolonged exposure damages lung tissue and airways, increasing the risk of COPD even in non-smokers.

Lung Infections

Pollution weakens natural lung defenses.

This leads to:

frequent respiratory infections
prolonged recovery
higher risk of pneumonia and bronchitis

ICMR studies link pollution exposure with increased infection rates.

Impact on Vulnerable Populations

Children

Children breathe faster and inhale more pollutants relative to body size.

Effects include:

impaired lung development
increased respiratory infections
long-term lung function reduction

Elderly Individuals

Age-related decline combined with pollution increases:

breathlessness
hospital admissions
mortality risk

People with Existing Lung Disease

Individuals with asthma, COPD or bronchitis experience:

more frequent flare-ups
worsening symptoms
reduced quality of life

Pollution and Immune Defense of the Lungs

Air pollution impairs immune cells in the lungs.

This results in:

reduced ability to clear pathogens
higher susceptibility to viral and bacterial infections

Polluted air essentially lowers respiratory immunity.

Seasonal Pollution Peaks and Respiratory Health

In India, pollution worsens during:

winter months
crop residue burning periods
high traffic seasons

These spikes correspond with increased respiratory illness cases.

Symptoms That Suggest Pollution-Related Lung Damage

persistent cough
frequent chest infections
breathlessness on mild exertion
wheezing
reduced exercise tolerance

Ignoring these signs can lead to chronic disease.

Preventive Measures to Protect Respiratory Health

Reduce Exposure

limit outdoor activity during high pollution
avoid heavy traffic areas
use air quality index (AQI) alerts

Improve Indoor Air Quality

ventilate rooms properly
avoid indoor smoke sources
use air purifiers if needed

Strengthen Lung Health

stay physically active indoors
practice breathing exercises
maintain good nutrition and hydration

Protective Measures

wear appropriate masks during severe pollution
protect children and elderly from exposure

Role of Preventive Healthcare

Preventive healthcare supports respiratory health by:

early detection of lung function decline
monitoring symptoms
managing asthma and COPD effectively

NITI Aayog highlights pollution-related respiratory disease prevention as a national priority.

When to Seek Medical Attention

Consult a doctor if:

breathing difficulty increases
cough persists beyond weeks
infections recur frequently
wheezing or chest tightness worsens

Early care prevents irreversible lung damage.

Long-Term Impact of Ignoring Pollution Exposure

Chronic exposure without protection may lead to:

permanent lung damage
reduced life expectancy
increased cardiovascular risk
poor quality of life

Respiratory health protection must be proactive, not reactive.

Conclusion

Understanding how air pollution impacts respiratory health reveals why polluted air is a silent but powerful threat to breathing. From airway irritation and asthma to chronic lung disease and infections, pollution affects every level of respiratory function. While individuals cannot control environmental pollution entirely, awareness, preventive measures and early medical care significantly reduce harm. Protecting respiratory health today ensures better breathing, resilience and quality of life in the future.

References

World Health Organization (WHO) – Air Pollution and Respiratory Health Guideline
Indian Council of Medical Research (ICMR) – Air Quality and Lung Disease Report
National Centre for Disease Control (NCDC) – Pollution-Related Respiratory Illness Data
Lancet – Global Burden of Air Pollution and Lung Disease Studies
NITI Aayog – Environmental Health and Preventive Care Strategy
Indian Journal of Chest Diseases – Air Pollution and Respiratory Outcome
Statista – Air Quality and Health Impact Trends India

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