China had already given the first passive immunizations to intensive care patients in Wuhan in the first two months. The first unpublished reports raised hope among doctors. But anecdotes remained for the time being. Beijing also launched an appeal to donate blood, but the results have remained in the dark. Not least because the pandemic outside of China has suddenly caught everyone’s attention.
Meanwhile, in Europe as in the United States, the focus has been on blood plasma donation for passive vaccination. Transfusion physicians such as those at the Frankfurt University Clinic are preparing, companies in many countries are starting to purify the most active, promising antibodies from the blood for even more targeted immunotherapy. At the same time, it is important not to raise expectations too high.
Weak point: Without control groups
The reason since this weekend can be read in “Jama”, the specialist journal of the large American medical association. The data were published for the first time by a Chinese publication reviewed by international experts with an accompanying commentary by two transfusion specialists. The doctors from the Third People’s Hospital in Shenzhen describe in detail how they could save the lives of their critically ill intensive care patients treated with donor blood from the end of January. The American experts leave no doubt that they want this success to be understood as a wake-up call: “It is important that efforts now urgently need to be accelerated,” they write in the accompanying comment.
But the study has several catches: first, there are only five documented patients who have been treated and cured, and second, there was no control group. With such clinical healing attempts, it is impossible to know whether the patient’s condition has actually improved due to the treatment method used. This is even more serious when all the therapy with antiviral medication used up to that point in all five patients was not discontinued at the start of passive immunization. The seriously ill patients between the ages of 36 and 73 were treated with almost everything that was available to the clinic. Experienced clinicians would wave at the point: unusable.
In fact, the paper could only have survived the critical review because the medication has proven practically ineffective in the patients to the end-stage. Because it was only when the blood was enriched with the antibodies of the recovered blood donors after almost three weeks in the intensive care unit and an extremely high viral load in the lungs that things started to get going for the patients. A good sign.