Previously infected with COVID-19, doctors donate plasma to patients

Dr. Luis Reyes never thought he would fall ill to COVID-19, that is until he received the news in March that he had tested positive, and his mild symptoms began to escalate.

Following a week-and-a-half of isolation, Reyes is trying to help people who are still struggling with the disease by donating his plasma in hopes that his antibodies will treat patients in critical condition.

“One of the most frustrating parts of this disease is that there’s no treatment,” Reyes said. “There’s no vaccine, there’s no medications and you just have to basically stay there waiting either to get better or to get worse.”

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But convalescent plasma transfusions are being studied and advocated as a possible treatment.

“People that have already recovered from the disease, we build antibodies which are proteins that protect the body against the viruses,” Reyes said. “And because they’re specific to that virus, then there’s transfusion of this plasma, of this antibodies, to patients that are having these problems and are not building enough antibodies to fight it.”

Reyes, a general surgeon, is one of a handful of doctors within South Texas Health Systems who previously tested positive for COVID-19 and are now donating their convalescent plasma to help patients who still have the disease.

Dr. Rudy Alvarez, a pathologist with South Texas Health Systems McAllen, said turning to doctors within their hospital system was the easiest to find viable donors.

“They’re usually the most willing donors, not that the public is not willing, but you have to reach out to those individuals,” Alvarez said. “What we’ve seen is we’ve already had a lot of providers that are positive and most of those are individuals that are willing to donate, so it’s much easier to go through our people.”

There are ongoing national trials and evaluations on such plasma infusions, Alvarez said, to see if plasma would be a good treatment option because the white blood cells of people who were infected with the virus have interacted with the virus. That, in turn, causes antibodies to be formed.

“That’s what overcomes the infection, your antibodies,” Alvarez said. “You mount a defense and you overwhelm the virus and you feel better.”

Usually, these types of transfusions are difficult to do, Alvarez said, because the convalescent plasma is essentially an investigational drug. However, when this began, the U.S. Food and Drug Administration loosened the criteria, allowing it to be used through “compassionate use,” a process through which the FDA allows access to not-yet-approved drugs.

So far, about three people have donated and there are eight people on the registry, meaning they are willing to donate but still need to be screened to see if they’re eligible.

Before a person can donate, they must test negative for COVID-19 to ensure they’re no longer sick.

The person also has to meet the usual criteria mandated if they were to donate plasma under normal circumstances.

“The donor has to be eligible, meaning there’s about 200 donor questions that you have to ask because many things we just do not test for in blood,” Alvarez said. “So they have to meet all the donor eligibility that any donor would otherwise meet.”

The recipients of the infusions must also meet certain criteria.

They must have tested positive for COVID-19 and be in critical condition.

“A donor can donate up to three to four units or doses for a recipient, and what we’ve seen is that patients may be get better two to three days after having received the plasma,” Alvarez said. “Again, these are critical condition patients (but) they’re looking to see if this can be done even earlier, before they go into critical condition.”

The danger of the disease, Alvarez said, is that it causes an over-response of the immune system and it overwhelms the body to the point that it shuts down the organs.

“If we wait too long, no drug, no plasma, no therapy is going to get you out of a terrible situation,” he said. “You’ve damaged the organs, sometimes beyond repair, so it’s a careful balance.”

For Reyes, the disease fortunately never progressed to the point that he needed hospitalization. Nonetheless, he said it was the worst illness he’s ever experienced.

“When people say this is just like the flu … I have had flu, I don’t know, 20 times in my life,” Reyes said. “I even had the H1N1 flu, but this is absolutely the worst that I’ve ever had. This is definitely not the flu.”

One of the most difficult aspects of dealing with it was that his symptoms would at times be mild but then quickly advance.

“There was kind of like no in between, either I would feel just with mild symptoms or I would feel really sick,” Reyes said.

“It is awful because I was thinking that I was getting better and it would just come back again,” he added. “There comes a time that you don’t want to believe that you’re getting better anymore because it’s just on and off.”

Even after he recovered, he continued to be affected psychologically — dealing with anxieties or not wanting to infect anyone else.

“It gives you a scare where you don’t want to, for sure, be sick again, and you don’t want anybody else to be sick,” he said.

He added that he continues to take precautions by thoroughly washing his hands and keeping everything clean.

Now, he’s back to work and says his sense of taste and smell returned, though his strength is still at about 80%.

“At the beginning, just picking up my clothes would make me short of breath,” he said. “Now I’m fine.”

Throughout the ordeal, he lost 10 pounds and experienced shakes and sweats through some nights as well as nightmares and hallucinations.

“It comes in different degrees,” he said. “I was one of the lucky ones that didn’t need ICU but some people are not that lucky.”

As the world continues to scramble for effective treatment and possibly a vaccine, Reyes continues to try to help those unlucky people. Friday, he said, would be his second time donating his plasma in as many weeks.

“I hope nobody else gets it and if I can help anybody get out of this one, I definitely will because it is awful when you’re sick,” he said.

Editor’s note: This story was updated to clarify Dr. Luis Reyes’ field of practice.