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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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Tuberculosis Symptoms and Treatment: Early Signs, Diagnosis, and Recovery

Tuberculosis (TB) is one of the oldest known infectious diseases and continues to be a major public health concern, especially in developing countries. India accounts for a significant proportion of global TB cases, despite advances in diagnosis and treatment. The good news is that tuberculosis is preventable, treatable and curable when detected early and managed properly.

Understanding tuberculosis symptoms and treatment is critical for reducing disease spread, preventing complications and achieving complete recovery.

What Is Tuberculosis?

Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis. It primarily affects the lungs (pulmonary TB) but can also involve other parts of the body such as:

lymph nodes
bones and joints
kidneys
brain

TB spreads through the air when an infected person coughs, sneezes or speaks.

Why Tuberculosis Remains a Major Health Issue

According to the World Health Organization and ICMR data:

millions of new TB cases are reported annually
delayed diagnosis increases transmission
incomplete treatment leads to drug resistance

Early detection and treatment are key to TB control.

Common Tuberculosis Symptoms

TB symptoms often develop gradually and may be mild in the early stages, leading to delayed diagnosis.

Persistent Cough

A cough lasting more than two to three weeks is a hallmark symptom of pulmonary TB.

The cough may:

be dry or productive
worsen over time
sometimes produce blood

Fever and Night Sweats

Low-grade fever, especially in the evenings, is common.

Night sweats that soak clothing or bedding are a classic TB sign.

Unexplained Weight Loss

TB increases metabolic demand and reduces appetite, leading to significant weight loss.

Fatigue and Weakness

Persistent tiredness and reduced stamina occur due to chronic infection.

Chest Pain

Chest discomfort or pain may occur during coughing or breathing.

Symptoms of Extra-Pulmonary TB

When TB affects organs outside the lungs, symptoms depend on the site involved and may include:

swollen lymph nodes
bone or joint pain
headaches or neurological symptoms
urinary issues

Why TB Symptoms Are Often Ignored

Many TB symptoms resemble common infections or general weakness.

This leads to:

delayed medical consultation
prolonged transmission
disease progression

Awareness improves early detection.

How Tuberculosis Is Diagnosed

Diagnosis involves a combination of:

sputum tests
chest X-ray
molecular tests such as CBNAAT
blood tests and imaging for extra-pulmonary TB

Early and accurate diagnosis is essential for effective treatment.

Tuberculosis Treatment Explained

TB treatment involves a combination of antibiotics taken over a fixed duration.

Standard TB Treatment

For drug-sensitive TB, treatment typically lasts:

6 months

The regimen includes multiple antibiotics taken in phases to ensure complete bacterial clearance.

Importance of Treatment Adherence

TB bacteria are slow-growing and resilient.

Stopping treatment early can result in:

incomplete cure
relapse
drug-resistant TB

Completing the full course is essential.

Drug-Resistant TB

If TB bacteria become resistant to standard drugs, treatment becomes longer and more complex.

Drug-resistant TB requires:

specialised medications
longer treatment duration
close medical supervision

Prevention of resistance depends on correct treatment from the start.

Side Effects of TB Treatment

Some individuals may experience side effects such as:

nausea
loss of appetite
mild liver enzyme changes

Most side effects are manageable with medical guidance and do not require stopping treatment.

TB and Public Health

TB is not just an individual health issue but a community concern.

Effective TB control requires:

early diagnosis
treatment adherence
contact tracing
public awareness

India’s national TB elimination programmes focus on these strategies.

Preventing Tuberculosis

Preventive measures include:

early detection and treatment of active TB
improving nutrition and immunity
adequate ventilation in living spaces
screening close contacts

BCG vaccination offers partial protection, especially in children.

Living With and Recovering From TB

With proper treatment:

symptoms gradually improve
infection becomes non-contagious
normal life can be resumed

Regular follow-up ensures complete recovery.

When to Seek Medical Help

Consult a healthcare provider if experiencing:

cough lasting more than two weeks
unexplained weight loss
persistent fever or night sweats
blood in sputum

Early action saves lives and prevents spread.

Long-Term Outlook After TB Treatment

Most individuals who complete treatment:

recover fully
regain normal lung function
return to daily activities

Long-term complications are rare with timely care.

Conclusion

Tuberculosis symptoms and treatment must be understood clearly to combat this preventable and curable disease. Persistent cough, fever, night sweats and weight loss should never be ignored. Early diagnosis, complete treatment adherence and regular follow-up are essential for curing TB and preventing transmission. With proper medical care and public awareness, tuberculosis can be effectively controlled and eliminated as a public health threat.

References

Indian Council of Medical Research (ICMR) – Tuberculosis Epidemiology and Treatment Guidelines
World Health Organization (WHO) – Global Tuberculosis Report
National Tuberculosis Elimination Programme (NTEP) – Government of India
Lancet Infectious Diseases – TB Diagnosis and Treatment Outcomes
National Family Health Survey (NFHS-5) – Infectious Disease Indicators
Statista – Global Tuberculosis Burden and Trends

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