Support of NHS staff will be crucial in testing convalescent plasma treatment for the sickest COVID-19 patients

Dr Gail Miflin, Medical and Research Director at NHS Blood and Transplant, explains the stories behind the headlines on the potential of convalescent plasma to help treat patients with COVID-19.

In the last few weeks, we’ve had news that really brought home what our COVID-19 convalescent plasma programme is all about.

The first patient received plasma through RECOVERY. They also happened to be the first child to get a convalescent plasma transfusion through NHS Blood and Transplant (NHSBT). We’ve been driving ourselves and our teams hard over the past two months but the news out of Manchester Children’s Hospital really brought it home.

Convalescent plasma is the antibody rich plasma of people who have recovered from an infection, which can be transfused into people who are struggling to develop their own immune response. The neutralising antibodies can bind to the outside of the virus and stop it invading cells.

Over the past two months we’ve built a nationwide plasma donation service so that we can supply hospitals at a large scale – if a trial is successful. There has never been a full randomised control trial of convalescent plasma before.

Our Clinical Trials Unit is leading on this work, with two platform trials.

As of this month we’re supplying the RECOVERY platform trial, which is testing a range of potential treatments for COVID-19. We are also continuing to work with the REMAP-CAP platform trial, in which adult patients in intensive care with COVID-19 derived pneumonia have received transfusions.

By the end we should know whether convalescent plasma transfusions could improve a COVID-19 patient’s speed of recovery and chances of survival.

We have already collected more than 7,500 units of plasma, a huge achievement. By way of comparison, a small study from China that attracted international media attention in April involved just 10 people.

The scale of the work is enormous. We have recruited more than 300 staff and started taking apheresis donations for the first time. All 23 of our donor centres are now taking plasma donations and we’re creating five new ‘pop-up’ donor centres which will be dedicated to plasma donation, the Harlequins rugby ground included.

To deliver this ambitious programme, we’ve worked collaboratively across the health sector. NHS England and NHS Improvement was particularly important, in using an exemption from the Secretary of State to securely share information which has enabled us to contact people who had tested positive for COVID-19.

We are grateful for the support of NHS colleagues across the country, many of whom have donated plasma. Their stories have been especially moving – the consultant from Birmingham who had lost a colleague to COVID-19 only a few days earlier springs to mind. NHS colleagues who offer to donate are being prioritised.

We’re getting indications that generally, the sicker someone was, the more antibodies they produced. Our antibody test results so far show men, the over 35s, and people were ill enough to need hospital care, had the highest antibody levels. Their plasma is most likely to save lives.

We will continue to collect plasma and treat patients as quickly as possible, although we expect our trial results will come later than originally expected due to the national decline in new infections – but continuing to collect means we can build up supplies for if infections increase in the coming months.

We would be grateful for the continued support of all clinical colleagues working with COVID-19 patients, for their help in onboarding with us for RECOVERY and REMAP-CAP and for randomising patients into the trials. The more patients we can treat now, the sooner we can potentially start supplying hospitals for use at a large scale.

This is a critical time for NHS Blood and Transplant and the wider healthcare sector, and everyone’s support and interest is very much appreciated. Knowing that seriously ill people are now getting a treatment which could save many lives is what is driving us all on.

For more information on the trial and how to donate, please visit the NHSBT website

Gail Miflin

Dr Gail Miflin is Medical and Research Director at NHS Blood and Transplant. She joined the organisation in 2010 and became a Director in 2016. Previously she was a Consultant Haematologist at hospitals and NHS Trusts, specialising in treating patients with red cell disorders.