More than a month after her battle with COVID-19, Kony Chacon enjoys spending time with newborn daughter and shows no ill effects from the virus that jeopardized her life and that of her unborn child. She credits a century-old treatment now being used to help coronavirus patients fight off the infection – convalescent blood plasma transfusions – with helping her recover and, ultimately, reunite with her family.
Chacon was the first patient to receive the treatment at Harris Health Lyndon B. Johnson Hospital. The medical team of physicians from The University of Texas Health Science Center at Houston (UTHealth) received emergency use authorization from the U.S. Food and Drug Administration (FDA) for the treatment. The authorization allows unapproved medical treatments to be used in an emergency when there are no alternatives.
“The theory behind the therapy is that essentially you’re giving someone some immunity while their body builds up its own and it kicks in,” said Pamela Berens, MD, professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at McGovern Medical School at UTHealth and the chief of obstetrics and gynecology at LBJ Hospital. “I can’t say for sure that the plasma therapy is the reason for her rapid recovery, but I believe it helped.”
Convalescent plasma is the liquid portion of blood that contains antibodies – the proteins used by the body to fight off infection and disease.
“Like I was, I didn’t think I would get cured,” Chacon said. “It felt like I was drowning and would never be able to breathe. The treatment was like a miracle.”
The 22-year-old was only a week away from giving birth when she developed what she thought were pregnancy-related symptoms – swollen feet and a nagging fever. A few days later, however, she developed breathing difficulty.
Doctors at LBJ Hospital suspected COVID-19 and tests eventually confirmed it. Her concern shifted to her unborn child and her husband. Fortunately, her husband and her newborn baby both tested negative for the virus.
Following the healthy birth of her daughter, Chacon’s breathing problems became worse. It was now painful with the virus entrenched in her lungs. Her medical team considered intubating her, but opted instead to administer convalescent plasma therapy via transfusion. It took only a few days, but soon Chacon was breathing better and scans showed less disease in her lungs.
Because there are no randomized, controlled clinical trials on convalescent plasma therapy, physicians can’t say for sure whether the treatment is effective, said Rosa M. Estrada-y-Martin, MD, MSc, professor of medicine with McGovern Medical School and medical director of pulmonary and critical care medicine at LBJ Hospital, who has been treating COVID-19 patients in the intensive care unit.
“Pulmonary complications in pregnant patients can improve in few days after delivery, so in this case, it is hard to definitively say if the recovery can be attributed to the plasma,” Estrada-y-Martin said. “We know the treatment is safe, and we’re thrilled when patients improve, but more research will be necessary to confirm if the plasma therapy works.” Estrada-y-Martin is the director of the Lymphangioleiomyomatosis and Rare Lung Disease clinic at UT Physicians, the clinical practice of McGovern Medical School.
Chacon was just thankful that after 10 days in the hospital and away from her husband, she was now able to finally to go home and hold her baby.
In April, UTHealth and LBJ Hospital joined the Convalescent Plasma Expanded Access Program led by the Mayo Clinic. The FDA designated the program to allow academic medical centers access to the investigational therapy because there are limited treatment options for COVID-19. LBJ Hospital has treated 35 patients to date with convalescent plasma therapy through the program.
Karen Eldin, MD, professor in the Department of Pathology and Laboratory Medicine at McGovern Medical School and chief of pathology at LBJ Hospital, led the effort for LBJ patients to have access to the experimental therapy through the Mayo Clinic program.
“It was always a ‘when’ we were going to do it and not an ‘if’ – we knew convalescent plasma would be available in Houston and we wanted it available for all patients in Harris Health,” Eldin said. “Every hospital wants to do the best for their patient population. Now with the surge of COVID-19 patients, we are seeing increased requests.”
Eldin credits the collaboration among UTHealth critical care team members at the hospital for making the program successful.
“Transfusion medicine is our expertise in the pathology department, and we work closely with the critical care team for them to handle the clinical side – they identify the patients who need the therapy, walk them through the process, and care for them after the experimental treatment,” Eldin said. “The pathology and critical care physicians work closely together to ensure we are all aware of clinical changes in our patients – we complement each other well.”
Other McGovern Medical School convalescent plasma therapy team members include George Williams II, MD, associate professor of anesthesiology and medical co-director of the surgical intensive care unit at LBJ; and Sujith Cherian, MD, assistant professor of medicine and director of quality for pulmonary and critical care medicine at LBJ.
“In an epidemic like this one, where there are no approved treatment options, the idea of using antibodies to treat county patients is necessary because many of our patients are from a minority population, which we know are being disproportionately affected by COVID-19. We’re thankful that Dr. Eldin worked so hard to team up with the Mayo Clinic to offer this experimental therapy to our patients who really need it,” Estrada-y-Martin said.
“Though still experimental, these donations make this potentially disease-modifying therapy more accessible to treating physicians and COVID-19 patients throughout the greater-Houston area,” said Esmaeil Porsa, MD, president and CEO, Harris Health System. “As we continue to see severe cases of COVID-19 disease, being able to provide a plasma treatment option to patients in need is a tremendous step forward.”
Adapted from a Harris Health news release
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