Domenico Piccininni is one of the hundreds of thousands of people who have had a Covid-19 infection and recovered after a bit of misery, but with no lasting complications.
What sets him apart from many other survivors is that Piccininni is trying to help people who now have more severe Covid-19 infections.
On Thursday, the Atlanta-area resident donated his plasma. Plasma is a component of blood that contains antibodies, which are made by the immune system in response to a specific infection. Because the 50-year-old Piccininni recovered from a Covid-19 infection, his body now produces antibodies that are primed to fight the new coronavirus.
The hope is that giving his plasma and antibodies (called "convalescent plasma") will help kick-start the fight against the virus for people who are currently very sick with Covid-19 infections.
'My wife volunteered me'
Piccininni is a reluctant hero, though. At first, he thought he wouldn't want anyone to even know that he had been sick with Covid-19. He worried there might be a potential stigma.
"I felt like [having had the infection] might be like a scarlet letter, but the doctor said I should think of it more like a badge of honour, because I could help people," Piccininni said.
He also admitted to being a bit uneasy about the procedure because he didn't quite know what to expect.
"My wife volunteered me," he said, laughing. "I've never even donated blood before. But, we have five kids and if one of them were on the edge, I would hope someone would help. As nervous as it might make you feel, you have to think about your fellow humankind. How can you not think about saving a life if you can?"
The good news is that the donation process isn't a big deal – just a little bit of time and a needlestick.
Dr Kent Holland, medical director of the Blood and Marrow Transplant Program at Northside Hospital (the hospital where Piccininni donated) and Atlanta Blood Services in Atlanta, said, "The donation process is pretty straightforward. The whole process takes about 75 to 90 minutes, and there really aren't any significant risks."
Who can donate?
He added that some people may briefly get light-headed and some may have a bruise where the needle went in.
During the donation process, some blood is drawn from you. It's then run through a special machine that separates the plasma from the rest of the blood. Your blood is then returned to your body, minus the plasma, Holland explained.
Dr Jed Gorlin, medical director of Innovative Blood Resources (a New York Blood Center Enterprise) in St. Paul, Minnesota, said, "Your appointment may be an hour or an hour and a half altogether, but the actual collection time is only about 45 minutes."
Who can donate? Holland said people who have had a proven Covid-19 infection and have recovered may be eligible to donate. It needs to be at least two weeks since they last had symptoms.
Gorlin said loss of smell is one exception to that symptom rule, however. He said it can take longer than two weeks for the sense of smell to return to normal.
Both experts also said that all the usual rules of blood donation apply, and donors must be considered healthy. People can donate more than once.
Doctors are hopeful
For people receiving the convalescent plasma, it's like a blood infusion through an IV. Gorlin said it's only about a cup of fluid, so it's not a lot of volume. He said the risks to a patient are very low. The most common side effect is a mild allergic reaction.
Theoretically, a reaction might make the inflammatory response of a Covid-19 infection worse, but Gorlin said doctors just don't know yet if that's a concern because this hasn't been well-studied.
Both said convalescent plasma has been used in the past. Holland noted that it was used as far back as the 1918 Spanish flu, and as recently as the SARS (severe acute respiratory syndrome) and MERS (Middle East respiratory syndrome) viral infections.
Patients who are in hospitals participating in studies of convalescent plasma can access the treatment. If a patient is in a hospital that isn't conducting a study, doctors can apply for what's called an "Emergency IND" – that's individual expanded access for emergency use – from the US Food and Drug Administration.
Gorlin noted that physicians can also request convalescent plasma through the Mayo Clinic extended access programme.
Holland said that while doctors are hopeful the convalescent plasma will help patients recover faster, "It's too early to know yet. It's a relatively safe therapy, but I would caution people that while it looks promising, all the evidence right now is anecdotal."
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