Passive immunotherapy & Wholistic care

Passive immunotherapy

Convalescent plasma: A preliminary, uncontrolled case series of 5 critically ill Chinese patients with COVID-19 who received convalescent plasma with demonstrated IgG to SARS-CoV-2 was published on 27 March 2020.  While improvement in clinical status was reported following this intervention, the small sample size and uncontrolled nature of the study precludes drawing any conclusions regarding the efficacy of this intervention. Once again, further research is needed.

 Wholistic care

A global pandemic causes understandable fear and anxiety for many people in the community. For those at particular risk of worse outcomes of infection – older people, and those with significant pre-existing illness or multiple comorbidities, COVID-19 represents a threat. In addition, the health care workforce will be under substantial strain and facing a potentially overwhelming challenge in delivering care to their patients. Ensuring emotional care for those most vulnerable, and those experiencing high levels of stress, will be a fundamental determinant of the resilience of our society during this challenge.

For vulnerable and/or frail patients at particular risk of poor outcomes it is important to provide personalised care and develop an understanding of everyone’s perspectives and preferences for health management. Involving caregivers and family members in decision making and establishing goals of care is important. Discussing goals of care early, and where appropriate assisting patients to make advanced care directives or resuscitation plans early in illness (or prior to infection) may give substantial peace of mind and allow families to face the pandemic openly and with unity as they support vulnerable loved ones.

It is essential to ensure that all patients receive the best standard of care irrespective of the setting in which the care is delivered, or of the existence of any proposed limitations to life-extending interventions. Under no circumstances should the best possible symptom control and compassionate, individualised care be denied any patient affected by COVID-19.