Thoracic Surgery

Maria Lucia Madariaga, MD

Testing Convalescent Plasma in the Age of Pandemic

Maria Lucia Madariaga, MD, did not let the fact that she was our newest thoracic surgeon stop her from plunging headfirst into the fight against COVID-19. Dr. Madariaga joined the University of Chicago Medicine in February 2020 and by the end of March had launched a clinical trial to study whether blood plasma transfusions from people who have tested positive for the virus and recovered are a viable treatment for critically ill patients with COVID-19.

An extra boost from plasma

Plasma is the fluid in which blood cells are suspended. When someone is infected with a virus, the body’s immune system produces proteins called antibodies that can seek out and neutralize the virus. Transfusing plasma containing these antibodies to severely ill patients could give their immune systems extra resources to fight off the infection.

After a patient recovers, the antibodies stay in the blood and can provide immunity; however, it is not yet known how long a patient will be immune following recovery from COVID-19. Donating plasma for the trial is similar to donating blood.

The first step

Dr. Madariaga’s clinical trial recruited qualifying convalescent plasma donors from among current UChicago Medicine patients and other Chicagoans. Those plasma donations are being used to treat patients currently hospitalized at UChicago Medicine.

The initial study investigated the safety and feasibility of identifying donors, collecting plasma donations and administering transfusions. Further study of the effectiveness of such a treatment will require additional trials. As the COVID-19 pandemic spread, hospitals around the world began testing convalescent plasma as a potential treatment.

Cross-disciplinary collaboration under one roof

“A major barrier to widespread study in the United States has been that it requires broad cross-disciplinary collaboration,” said Dr. Madariaga. “At UChicago Medicine, we are really fortunate that we have all the teams required to perform a convalescent plasma trial under one roof—the Biological Sciences Division, Blood Donation Center, Department of Medicine, Transplant Institute and Department of Surgery.”

A promising turnaround

Edgardo Diaz, 30, was one of the recipients of donor plasma—and it was not his first time in the hospital for a procedure of this gravity. Just a year earlier he had undergone a successful lung transplant at UChicago Medicine, but he recently returned to the medical center in critical condition with COVID-19.

Diaz’s lung transplant surgeons included Tae H. Song, MD, also a member of our cardiothoracic faculty. The team knew Diaz’s transplant disqualified him from most trials, but because he had severe and possibly life-threatening COVID-19, he met the FDA criteria for the convalescent plasma trial. Running out of time and options, Diaz’s doctors invited him to participate.

Within hours after receiving the convalescent plasma on April 25, Diaz’s 104-degree fever started going down. Days later, his breathing and kidney function improved. Nine days after receiving the plasma, Diaz tested negative for COVID-19. He was released from the hospital May 1 and continues to test negative for the virus.

Now that he’s home, Diaz said he feels “even better than I did before I had COVID-19.” He’s been able to resume his workouts, and has returned to his job.

Maria Lucia Madariaga, MD

Seeing patients safely home

“It’s a pretty safe therapy,” Dr. Madariaga said of convalescent plasma, adding that early reports she’s seen nationwide about treating COVID-19 patients with plasma have shown very few side effects. “We have given it to high-risk, immunocompromised patients, and it still seems safe.”

“This trial is just the first step,” she said. “One of the best parts of this experience was meeting so many fantastic people who were motivated to work together and get this trial off the ground.

Maria Lucia Madariaga, MD

Parts of this article were previously published on the UChicago Medicine website on April 13, 2020, and were written by Matt Wood; and on the UChicago News website on June 29, 2020, and were written by Jamie Bartosch.