NEWARK, NJ — Inside the walls of University Hospital, the bulk of the city’s COVID-19 patients dominate the emergency room, the ICU, more than 40 isolation rooms and a triage tent outside.
But amid the chaos that can be felt in Newark and hospitals around the world as the coronavirus ravages global health care systems, there’s a program being led by University and its counterpart, Rutgers New Jersey Medical School, that’s offering hope for the sickest COVID-19 sufferers.
Dr. Marc Klapholz, chair of the Department of Medicine at Rutgers NJMS and chief of Medical Service at University, is the principal investigator for the institutions’ joint FDA-approved convalescent plasma program, which collects donations from those who have survived infection and infuses it into patients still struggling to fight off the virus.
Recovered COVID-19 patients have presumed antibodies in their plasma, which medical experts believe can give the seriously ill a better shot at survival. The liquid, thinner than blood but thicker than water, is a lucid gold.
University and Rutgers NJMS performed their first infusion on April 10 and have added 15 more as of Thursday.
“This is a real team-based approach and requires a strong clinical assessment,” Klapholz said. It involves our team for infection diseases, critical care, our research staff, our internal review board — it’s done under our IRB’s approval at Rutgers NJMS — and of course partnering with our blood bank and our nurses and clinicians taking care of these patients.”
The process is a marathon, not a sprint. Since the therapy is still in the emergent phases as researchers collect data on outcomes, each unit of plasma must receive approval from the FDA before doctors can administer its potentially life-saving benefits to patients. While there are no approved therapies for COVID-19, Klapholz said plasma as a treatment is one professionals' hope has real utility.
Plasma as a treatment for infection is nothing new to the medical field — infusion therapies helped treat Ebola, SARS-CoV and MERS during those outbreaks.
“Whether it will be effective here is too early to say, but we certainly feel that it is a promising approach to take in the treatment of these patients,” Klapholz said.
FDA guidance for the convalescent plasma program in Newark was issued on April 3, proceeding on the availability of plasma, an added hurdle to an already complicated-to-administer therapy. In order to be considered as a candidate, individuals must be able to prove they tested positive for the virus and then test negative and have no symptoms for at least 15 days.
University and Rutgers NJMS set up a hotline and email for prospective donors, which then refers them to a New York Blood Bank location or the American Red Cross if they qualify.
Matt Platkin, Gov. Phil Murphy’s chief counsel who contracted and recovered from the virus, publicly pledged to give blood after University President and CEO Shereef Elnahal tweeted a call to action that the hospital has been circulating to recruit more donors.
UPDATE: @UnivHospNewark and @Rutgers_NJMS, in partnership with @US_FDA, started infusing plasma from recovered #COVIDー19 patients into sick patients.— Shereef Elnahal, MD (@ShereefElnahal) April 11, 2020
If you are recovering from COVID and can donate blood to potentially save a life, contact firstname.lastname@example.org or 973-972-5474! pic.twitter.com/VDqLcnS8a1
“We are very excited to be trialing this potentially life-saving therapy at University Hospital,” Elnahal said. “The development of these treatment protocols, and their investigational approvals by the FDA, is a testament to our clinical care teams and to the strength of our partnership with Rutgers New Jersey Medical School. Even under all the stresses of this public health emergency, our teams are finding ways to innovate, improve care, and save lives.”
While the antibodies are believed to be what gives the plasma life-saving properties, hospitals have limited capacity to measure titers, or the level of antibodies in a donor’s blood. Blood will be held at the centers to test down the road while the experimental therapies are carried out on the very ill in the meantime, Klapholz said.
“What we’re seeing, it really is a scourge, and unfortunately we are losing way too many patients. We give them whatever therapies we have available, that includes the use of the hydroxychloroquine, although there’s no data at the moment that suggests it really helps. Now we’re able to offer more and more of these convalescent plasma to these patients that are severely ill,” he said. “ I think as physicians we are all trying to save as many patients as we can, and anything that we can have in our armamentarium that might help is really something that gives us not only hope but patients and families and everybody else out there.”