A promising COVID-19 treatment gets fast-tracked

Arturo Casadevall and collaborators at Johns Hopkins and beyond have worked around the clock to develop a convalescent serum therapy to treat COVID-19 using blood plasma from recovered patients. If early promising studies on the therapy done in China are confirmed by U.S. trials, thousands of survivors might soon line up to donate their antibody-rich plasma. “I absolutely think this could be the best treatment we have for the next few months,” Hopkins pathologist Aaron Tobian says.

This could very well be a game changer.

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Much more likely than chloroquine, for sure.

The other extremely significant hypothesis being tossed around right now is that ventilators are doing more harm than good to in most COVID-19 cases. If that ends up being true, then we should see better outcomes and the ventilator shortage will go away too.

It doesn’t scale well, unfortunately.

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I’ve been watching that discussion and it seems to make sense, although I don’t know much about pulmonary physiology. It seems somewhat analogous to what happened with hantavirus in the 1990s, when it took a while out that administering fluids was helping to kill patients.

Perhaps @colewd and @Giltil should watch the video from someone on the front lines that precipitated the discussion, to learn how modesty is more likely to affect change when presenting anecdotal observations:

There’s also a Medscape article showing that people seem to be taking this seriously.

I’m also going to dig out my leftover Diamox from my trips to the Himalayas!

That’s an informal anecdotal report if a series of cases. There are actually papers out on this now, retrospective analysis in both NY and China.

Depends on the details. It is possible that we could stock up on plasma during the lulls to have it on hand the next time there is a spike.

I am aware of that, but this guy was the first to bring it to the forefront in the US, and he did so modestly and effectively.

Because I myself use a positive-pressure CPAP machine each night, I have wondered if COVID-19 patients might experience less lung damage with a negative pressure breathing assistance device—basically an iron lung. Yes, it would be bulky, but wouldn’t it more closely duplicate how the human body normally breathes by means of the diaphragm and rib cage?

Automakers are already well stocked and equipped to produce the metal shells of such a device. (I used to work as a consultant in a Ford truck plant back in the 1980’s so I can still visualize the assembly line machines which could rapidly manufacture the frames from the standard steel sheet metal rolls and a few robot welders.) And I would think that the electronics might be a bit simpler than the average ventilator, and perhaps require fewer sensors.

Even I have a hard time sealing in the high positive air pressure from my CPAP machine. It treats the lungs like resistant balloons, and getting the air humidification right (to prevent irritating drying of tissues) is nearly impossible. I must go to great lengths to prevent air leaks from my mouth by means of multiple tight tennis headbands, elastic straps, and velcro. So I have often imagined an alternative negative air pressure device.

This sounds similar to Gammagard which is an FDA approved treatment using pooled human serum/plasma for use in patients with compromised immune systems. I would suspect that the same adverse reactions would also apply, which can include blood clot formation and renal failure.