China News Service, March 4th. According to the website of the National Health and Medical Commission, the General Office of the National Health and Medical Commission and the Health Bureau of the Logistics and Support Department of the Central Military Commission have jointly issued the "Clinical Treatment Program for the Recovery of New Coronary Pneumonia Patients During Recovery Period (Trial Implementation) "(Hereinafter referred to as the" program "). The "Plan" mentioned that the plasma of the recovered patients is mainly used in patients with rapid disease progression, severe and critically ill patients with new coronary pneumonia.
The picture shows the patients who have recovered from new coronary pneumonia confirm their signatures before donating plasma. Photo by Zhang Lang of China News Agency
The "Protocol" clearly stated that according to the time when the plasma of the recovered patients produced neutralizing antibodies, the content of "the time from the first symptoms to not less than 3 weeks" was added. Rehabilitation patients who donate plasma should also meet the following conditions: no less than 3 weeks from the first symptom; meet the standard of isolation and discharge in the latest version of the new coronary pneumonia diagnosis and treatment program; the age should be 18 years old, in principle, not more than 55 years old; male weight No less than 50 kg, no less than 45 kg for women; no history of menstrual blood transmissible diseases; those who can donate plasma after evaluation of related conditions such as comprehensive treatment by clinicians.
The "Proposal" mentioned that in the special testing section, it was clear that antibody testing should be carried out, and a virus neutralization test was carried out conditionally to determine the antibody titer. Requirement: Qualitative detection of New Coronavirus serum / plasma IgG antibody is reactive and 160-fold dilution is still positive according to the reagent instructions; or Qualitative detection of New Coronavirus serum / plasma total antibody is reactive and 320-fold dilution according to reagent instructions The test is still required to be positive. Conditional laboratories can perform virus neutralization tests to determine antibody titers. Plasma donors with a history of pregnancy or blood transfusion are advised to screen for HNA and HLA antibodies.
In addition, IgM antibodies produced after human infection with the virus gradually decline after reaching the peak in the acute infection period, and usually persist for 8-12 weeks or more. IgG antibodies have therapeutic value in the plasma of rehabilitated patients, and the presence of IgM antibodies does not affect the therapeutic effect, so IgM antibody testing is no longer required in special tests.
In addition, the "Protocol" revolves around the purpose of treating plasma-neutralizing viruses in rehabilitated patients, and details the indications, contraindications, and inappropriate conditions for clinical use. The plasma of recovered patients is mainly used in patients with rapid disease progression, severe and critically ill patients with new coronary pneumonia. In principle, the course of the disease should not exceed 3 weeks; if the virus is positive or the clinical expert determines that the patient has viremia, it should be used as soon as possible during the acute progression of the disease.
Unsuitable situations include: critically ill, multiple organ failure that cannot be reversed; treatment for non-neutralizing new coronavirus purposes; and comprehensive assessment by the clinician that other infusion situations are inappropriate.
Clinical treatment plan of convalescent patients with new coronary pneumonia during recovery period (trial version 2)