A public lab, which is expert in the elaboration of anti-ophidic serums in Costa Rica, is moving forward in the process of creating another serum for the treatment of Covid-19 with plasma from recovered patients.
Plasma treatment is already being tested in other countries such as Spain and the United States.
In Latin America, however, Costa Rica appears as a pioneer, because it is also working on purifying the plasma to transfuse only the specific antibodies against the disease. The Caja Costarricense de la Seguridad Social (CCSS), a public state-owned agency, promotes and controls this project, which is carried out by the Clodomiro Picado Institute of the public University of Costa Rica.
The CCSS is currently centralizing the care of patients with Covid-19, which in Costa Rica, at the moment, totals 660 according to official figures, which also report 112 recovered people.
The plasma of the cured people will be converted into an injectable serum. The Clodomiro Picado Institute already calls it “the Anti-Covid-19 drug.”
The recovered patients develop antibodies against the coronavirus, which will be extracted from their plasma to be converted into “sterile concentrated injectable immunoglobulins” that will be applied to people with Covid-19 disease still active.
According to Guillermo León, coordinator of the institute’s industrial division, the basic procedures for the manufacture of anti-ophidic serum – in which the Clodomiro Picado Institute has a tradition of 50 years – are being tested in order to adapt them to the manufacture of this anti-Covid-19 serum from human plasma.
Fifty milliliters of this treatment would be enough for one patient, Djenane Villanueva reported for CNN en Español, after consulting with León and Alberto Alape, the institute’s director, although that will be verified once the treatment is put into practice, Alape said as quoted in an early April piece by La Nación’s Irene Rodríguez.
The production of this therapeutic serum requires a safe protocol for donation and separation of the plasma, the liquid part of the blood. Recovered patients may voluntarily donate their blood for this process, once 15 to 25 days have passed since the infection was detected.
The donor must meet the following requirements: they must do it voluntarily, weigh more than 50 kilos, not be sick, not have any sexually transmitted diseases or alterations in their immune system, and not be pregnant.
As Alape pointed out to Irene Rodríguez, transfusing whole plasma from one person to another has risks and side effects, because in that component of the blood there are other proteins that may not be compatible with the recipient. Therefore, once separated, in order to manufacture the anti-Covid-19 serum the plasma must go through a purification process, so that the patient will receive the specific antibodies that in the recovered patients neutralized the coronavirus.
This plasma purification process is a distinctive feature of the work being done by the Clodomiro Picado Institute, through a “physicochemical process and formulation and sterilization” —La Voz de América reported— with gamma radiation. The School of Materials Engineering of the state-run Technological Institute of Costa Rica (TEC) is in charge of carrying it out
The result is a serum in a vial, a small 50-milliliter glass container. So for every 25 liters of plasma from cured patients, 50 vials can be made: for every 25 people recovered, 50 sick people can be helped, La Nación report calculates.
This treatment could begin to be applied by mid-year, says the CNN en Español piece, based on interviews with the experts of the lab.
“When the amount of plasma obtained from recovered patients exceeds the demand that intensive care physicians are having in their units and there is already plasma left, they will send it to us. When we have 25 liters of plasma we will be able to process the first batch,” Guillermo León told Djenane Villanueva.
Once this is underway, León explained, it would take three days for the serum to be manufactured in a pilot plant at the institute. Quality control takes 15 days. In about 20, the institute would have it ready to send to the CCSS for application to patients.
CNN en Español’s April 15 report estimated that another week would still be needed for the Health Ministry to grant permits for the treatment. In addition, the Caja Costarricense de la Seguridad Social was still in the process of approving the full plasma transfusion, the first stage.
“The hope that this drug will work is based on preliminary experimental evidence that includes few clinical cases, but suggests that the prognosis of patients receiving the treatment is substantially improved,” Guillermo León also told La Voz de America.
Román Macaya, president of the Costa Rican Social Security Fund, said to the same outlet that the treatment being tested by the Clodomiro Picado Institute is the one that gives the best “shorter-term” results.