Potential COVID-19 therapies-vaccines and convalescent serum

Dr. Dave On Call

In Episode 3 of Dr. Dave On Call, we discuss potential COVID-19 therapies-vaccines and convalescent serum.

The race to make a successful COVID-19 vaccine is well underway using a collaborative approach of both governmental and private entities. The likely timetable for the deployment of a COVID-19 vaccine is 14-18 months or longer. Why so long? We have to make sure that the COVID-19 vaccine is safe, effective and can be scaled at an immense level to give to large populations. This takes time-making a vaccine, conducting the necessary clinical trials and then manufacturing enough vaccines for the general population.

The effectiveness of a vaccine is dependent on our immune system making an adequate amount of antibodies to fight COVID-19. Antibodies are proteins created by our immune system that recognize viruses and kill them. For example, when a person receives an influenza (flu) vaccine, our immune system creates antibodies to those particular strains of flu in the vaccine. This is called "active immunity", when our bodies create our own antibodies. If you receive a flu vaccine and are then infected with the flu, your antibodies will kill that strain of flu in your body.

A potential COVID-19 treatment (and also prevention) that may greatly help as we await a vaccine is convalescent serum. "Convalescent" means, "recovered". This specific treatment utilizes "passive immunity", using the virus neutralizing antibodies of an individual who has already recovered from COVID-19. Convalescent serum has been successfully used for 100s of years, during the H1N1 Spanish flu pandemic, polio pandemic, 2009 H1N1 pandemic, Ebola 2013 epidemic. It has also been used to treat other Coronavirus epidemics (SARS 2003, MERS 2012). Most recently, convalescent serum has been used to treat critically ill COVID-19 patients in China with promising results.

We need donors who have recovered AND have enough COVID-19 neutralizing antibodies to donate their serum at local blood banks. We also need availability of assays and labs to measure the COVID-19 neutralizing antibodies. This ensures that when people donate their serum, they have enough neutralizing antibodies to kill COVID-19 in those affected patients. We will have to have established protocols to determine how much convalescent serum to give to COVID-19 patients as well as those at-risk people (ie healthcare workers, family members of COVID-19 patients, elderly, etc).

Convalescent serum may be the most successful therapy we have presently available to treat critically ill COVID-19 patients. It may also be an option to prevent COVID-19 infections in at-risk individuals like healthcare workers, family members of COVID-19 patients, elderly, etc. This relies upon individuals who have recovered from COVID-19 to take the initiative and donate their blood, which may save the lives of many ill COVID-19 patients and prevent COVID-19 in at-risk individuals.

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Citations:

JCI article: https://jci.me/138003/pdf

JAMA article: doi:10.1001/jama.2020.4783