By Minnesota Spokesman-Recorder News Service
At Mayo Clinic in Rochester, Dr. Michael Joyner of the Mayo Clinic in Rochester is part of a group of experts that are pursuing a unique but time-tested treatment to help patients with COVID-19 fight off the virus. Convalescent plasma treatment has been used historically to treat infectious diseases before the discovery of vaccines.
Dr Michael Joyner (MJ) sat down with MSR for a brief interview
MSR: What is involved in convalescent plasma treatment?
MJ: It involves taking antibody-rich plasma from the blood of patients who have survived COVID-19, then infusing it into those who are ill to help their bodies fight off the disease. The approach is known as “convalescent plasma treatment.”
MSR: Why is it called convalescent plasma treatment?
MJ: It’s called convalescent because the word refers to when people are getting better.
MSR: You spent most of your career as a physiologist how did you get involved in this?
MJ: That’s true and I am also an anesthesiologist. What happened is my friend Dr. Arturo Casadevalle at John Hopkins wrote an editorial in the Wall Street Journal discussing the historical use of convalescent plasma. I reached out to Arturo and since we have a large network of collaborator we reached out to them. This was me repurposing my career for a few months in my lab to help attack this problem, to see if we could find some way to push back. I have thrown in with Arturo and want to help him move this forward. He is our visionary/spiritual leader.
MSR: Tell us who else is involved in this project?
MJ: We have people from about 40 universities and medical centers all over the country from about 20 states working on this and we are getting cooperation from the Food and Drug Administration. We are trying to get this online right away it’s already started in New York and Houston and we hope the pace is going to pick up throughout April.
MSR: The FDA has approved the process but with limitations. Explain the limits?
MJ: You have to get special permission. It’s one off at a time. We are currently working to get an expanded access protocol going so we can begin to collect more [plasma] all over the country and treat more people. It’s going to be a while until the supply is high. Infrastructure is being put in place to collect it at scale distribute it and get it to the people who can benefit from it. And then keep detailed records and make sure we do all the compliance and reporting, get people’s permission and study it while we are actually using it. We want to do it in a rigorous and ethical way.
MSR: When does this treatment date back to?
MJ: Before 1900 it was tried.
MSR: It appears some people have died from heart failure as a result of contracting the virus. How do you explain this?
MJ: One of things that can happen when you have an overwhelming infection is you have a condition called myocarditis meaning the heart becomes inflamed and the efficiency of the pumping action becomes worse. It’s unclear if COVID19 does anything unusual. It appears that when you are septic and when you have critical illness, when you have multi organ failure, typically your heart function goes down as well. It’s unclear if there is any kind of nasty stuff being excreted by this virus. It’s possible it targets the heart, but we don’t know that yet. My guess is it is more of the general phenomena. Time will tell we have to do the research.
MSR: How does COVID-19 attack the body?
MJ: Not clear exactly how covid attacks the body
I think we are 80 percent there. We have the general game plan but the details are still being worked out
MSR: How are you going to get started in Minnesota?
MJ: There are plans to collect it [plasma] and distribute it nationally. Most of the people we will begin to collect [plasma] from will be in the Rochester and southeastern Minnesota region.
MSR: What is plasma?
MJ: When you look at your blood it is red but red cells are about 40 percent the rest is protein containing fluid that if you separate it put it in a centerfuge and spin it around you will get this kind of yellowish material that’s plasma is the part of the blood of the blood that is not the red and white cells the non-cellular part of the blood.
MSR: What are its chances of success?
MJ: It’s too soon to tell. It depends on how sick the patient is. Our best shot is people who are sick but not terribly sick or in the ICU yet. And it may help people in the ICU.
MSR: Is it a panacea?
MJ: No what we are trying to do is bend some curves. We want to stop people deteriorating as they go form sick to the ICU and as they get in the ICU and do worse, we want them to stabilize and get better.