Covid-19, with Fontana and Gallera, the point of plasma treatment.

05/11/2020 Health, Italy



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Back the appointment with the Lombardy Region Press Conference in which the progress of the coronavirus epidemic is made.

To comment the data Governor Attilio Fontana and Councilor for Welfare Giulio Gallera, who as announced on the Facebook page Lombardia Notizie Online will also report the results of the experimentation of the cure with plasma.

Today’s data: In Lombardy there are 364 new positive cases, of which 70 in Brescia. 68 new deaths at the regional level. 7,508 swabs made on the last day.

Attilio Fontana: Today I am very proud to be present at this press conference to give an account of the experimentation begun in San Matteo in Pavia, from the Mantua hospital and from the university.

I spoke to Minister Speranza and also this morning. the government shows interest in wanting to continue with this initiative which also involves the Brescia and Bergamo hospitals.

Carlo Nicora, General Manager of the San Matteo Polyclinic in Pavia: Let’s talk about this pilot study project, which started in mid-March and ended on May 8. These are cured patient plasma used in critically ill Covid patients.

The project starts from the numbers of the epidemic of early March. The researchers focus on healing plasma and infusion in sick patients. The possibility of having local donors in each health center in Lombardy is important because the viral strain was the same for patients and donors.

Prof. Fausto Baldanti, virologist: the study focuses on the neutralization of the antibodies that isolate the spike, that is, the pathway of the virus to the cells. By taking the serum from patients who passed the infection and adding it to the virus cultures, we saw that cell destruction was blocked. It was the demonstration that there were neutralizing antibodies in the serum of the patients. We had to find a unit of measurement, titleThat is, what dilution of serum could the virus block. To imagine using plasma as a cure, we had to assess serum.

First, we try to calculate the serum blocking potential of curative patients.

Dott. Cesare Perotti– Once it has been established which plasma should be collected, we take care of collecting it quickly and safely. We can do this thanks to cell separators, common machinery in Lombardy. Start from donor-safe collection, approximately 600 ml collected in approximately 35 minutes. Approximately 350 ml is needed for each patient, therefore, doses of each duration are obtained to treat two people.

Prof. Raffaele Bruno: it is a pilot study, it is done when you have to prove an idea. Patients older than 18 years with positive swab and major respiratory distress, a chest x-ray showing pneumonia were included. 46 patients were enrolled, the last on May 8, between Mantua and Pavia.

The results, illustrated by prof. Baldanti:

Objectives: reduction of mortality, improvement of respiratory parameters and parameters related to infection.

When we left, ICU patient mortality was around 15%. Mortality after plasma treatment decreased to 6%.

Respiratory parameters improved dramatically at the end of the first week; radiographic images improved significantly during the first week; The three parameters to measure the level of inflammation improved significantly in one week.

Giulio Gallera: for us this study is a great pride. We are the only region in Italy with a structured protocol that has yielded its results. What we have done is available for the country. The goal is to find the hyperimmune plasma, a cure for a disease that today has no cure.

So today we launch the Plasma bench, we are studying a protocol that once defined will start the blood collection. We will start with the healed: our Assistant will call the cured people, who once verified the level of immunity, will be able to donate the plama; We will then call positive people for serologic testing, starting with healthcare workers who are already subject to verification; Avis Donors: We will focus on the most affected areas, such as Brescia and Bergamo.

Not only will we collect, but we will develop a broad usage model.

questions:

– Can you donate hyperimmune plasma to everyone? Yes, there is only one very rare exception related to patients with congenital IgA deficiency.

– What characteristics did the patients in whom the tests were carried out have in common? All patients we tested for hyperimmune plasma had severe respiratory problems, not all were intubated

– How long will it take to go from the experimental phase to practice? There is no fixed time for scientific journals to publish the article, also because they must first evaluate the work. In the week, however, we will introduce it. The protocol behind this project has already been shared with other structures, such as Bergamo and Brescia. Starting tomorrow we will work to transfer our work to all Lombard healthcare facilities. The presence of antibodies in the amount necessary for the plasma to be considered hyperimmune does not last over time.

– Will it be used preventively? No, it is not possible with us.

– Adverse events? They are the same as for any transfusion.