Convalescent Plasma Treatment in Patients with Covid-19: A Systematic Review and Meta-Analysis

Jorda, Anselm; Kussmann, Manuel; Kolenchery, Nebu; Siller‐Matula, Jolanta M.; Zeitlinger, Markus; Jilma, Bernd; Gelbenegger, Georg

doi:10.3389/fimmu.2022.817829

Cited by 33 publications

(38 citation statements)

References 40 publications

(86 reference statements)

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“…Coinciding with other studies, HP was a safe therapy [ 11 , 18 , 19 , 20 ], and no differences were found in other endpoints [ 19 , 21 , 22 ]. Our results are in line with the information summarized by Jorda et al [ 23 ]—sixteen clinical trials focused on the use of plasma for the treatment of COVID-19. The clinical improvement was analyzed in four out of the sixteen trials, varying the definition of clinical improvement among them and without consensus on the results; therefore, the hypothesis of an effect on the time of clinical improvement was downgraded due to concerns regarding the risk of bias or incomplete sample recruitment, as is the case with this trial.…”

Section: Discussionsupporting

confidence: 92%

Reinforcement of the Standard Therapy with Two Infusions of Convalescent Plasma for Patients with COVID-19: A Randomized Clinical Trial

Bargay-Lleonart

Sarubbo

Arrizabalaga

et al. 2022

JCM

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Background: The aim was to evaluate the reinforcement of the standard therapy with hyperimmune plasma (HP) in Coronavirus-19 disease (COVID-19) patients. Methods: Open-label, multicenter, randomized clinical trial performed in three hospitals in the Balearic Islands. Non-severe COVID-19 hospitalized patients with clinical time evolution equal to/less than 7 days were included, and randomized in: plasma group (PG) (n = 37), receiving 600 mL divided into two doses from convalescent plasma donor, administered on days 1 and 2 after the enrollment; and control group (CG) (n = 17). Primary outcome was the time for clinical improvement within 21 days, defined as patient achievement of categories 8, 7, and 6 in the Adaptive COVID-19 Treatment Trial scale (ACTT). The trial was terminated early due to the impossibility of recruitment due to the pandemic. Results: PG presented better scores on the ACTT scale at 7 days after HP infusion, whereas CG was needed 14 days to achieve similar results. The plasma infusion was safe. Conclusions: Despite the tendency observed in the plasma group to achieve slightly earlier better physical condition compared with the standard treatment alone. The administration of HP has been shown to be a safe therapy. No robust evidence was found to affirm a therapeutic effect of the early administration of two infusions of HP for non-severe COVID-19 infected patients. The interpretation is limited by the early termination of the trial, which resulted in a small sample size.

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Section: Discussionsupporting

confidence: 92%

Reinforcement of the Standard Therapy with Two Infusions of Convalescent Plasma for Patients with COVID-19: A Randomized Clinical Trial

Bargay-Lleonart

Sarubbo

Arrizabalaga

et al. 2022

JCM

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“…We primarily stratified our analyses by type of population: hospitalized and non-hospitalized COVID-19 patients, and high risk of COVID-19 infection (prophylaxis). We performed random effects meta-analyses using the inverse variance method, the Paule-Mandel method to calculate the between study variance tau 2 , and the Hartnung-Knapp method to adjust 95% confidence intervals (CIs) 8 , 9 . Effects were reported as relative risks (RR) with their 95%CIs for dichotomous outcomes and mean differences (MD) with their 95%CIs for continuous outcomes.…”

Section: Methodsmentioning

confidence: 99%

“…Several therapies have received emergency use authorization to prevent hospitalizations or death in COVID-19 patients or to prevent high risk people from becoming infected by SARS-CoV-2. Convalescent plasma, a therapy based on neutralizing SARS-CoV-2 virus with a previously infected person's antibodies, was given emergency authorization; however, it did not demonstrate significant clinical benefits in systematic reviews 2 , 3 .…”

Section: Introductionmentioning

confidence: 99%

Beneficial and Harmful Effects of Monoclonal Antibodies for the Treatment and Prophylaxis of COVID-19: Systematic Review and Meta-Analysis

Hernandez¹,

Piscoya²,

Pasupuleti³

et al. 2022

The American Journal of Medicine

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“…The selection and definition of outcomes referred to the previous meta-analysis ( 8 , 12 ) and RCTs. The primary outcome was the 28-d mortality.…”

Section: Methodsmentioning

confidence: 99%

The efficiency of convalescent plasma in COVID-19 patients: A systematic review and meta-analysis of randomized controlled clinical trials

et al. 2022

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The objective of this study was to assess whether convalescent plasma therapy could offer survival advantages for patients with novel coronavirus disease 2019 (COVID-19). An electronic search of Pubmed, Web of Science, Embase, Cochrane library and MedRxiv was performed from January 1st, 2020 to April 1st, 2022. We included studies containing patients with COVID-19 and treated with CCP. Data were independently extracted by two reviewers and synthesized with a random-effect analysis model. The primary outcome was 28-d mortality. Secondary outcomes included length of hospital stay, ventilation-free days, 14-d mortality, improvements of symptoms, progression of diseases and requirements of mechanical ventilation. Safety outcomes included the incidence of all adverse events (AEs) and serious adverse events (SAEs). The Cochrane risk-of-bias assessment tool 2.0 was used to assess the potential risk of bias in eligible studies. The heterogeneity of results was assessed by I^2 test and Q statistic test. The possibility of publication bias was assessed by conducting Begg and Egger test. GRADE (Grading of Recommendations Assessment, Development and Evaluation) method were used for quality of evidence. This study had been registered on PROSPERO, CRD42021273608. 32 RCTs comprising 21478 patients with Covid-19 were included. Compared to the control group, COVID-19 patients receiving CCP were not associated with significantly reduced 28-d mortality (CCP 20.0% vs control 20.8%; risk ratio 0.94; 95% CI 0.87-1.02; p = 0.16; I² = 8%). For all secondary outcomes, there were no significant differences between CCP group and control group. The incidence of AEs (26.9% vs 19.4%,; risk ratio 1.14; 95% CI 0.99-01.31; p = 0.06; I² = 38%) and SAEs (16.3% vs 13.5%; risk ratio 1.03; 95% CI 0.87-1.20; p = 0.76; I² = 42%) tended to be higher in the CCP group compared to the control group, while the differences did not reach statistical significance. In all, CCP therapy was not related to significantly improved 28-d mortality or symptoms recovery, and should not be viewed as a routine treatment for COVID-19 patients.Trial registration numberCRD42021273608. Registration on February 28, 2022Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, Identifier CRD42022313265.

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Convalescent Plasma Treatment in Patients with Covid-19: A Systematic Review and Meta-Analysis

Cited by 33 publications

References 40 publications

Reinforcement of the Standard Therapy with Two Infusions of Convalescent Plasma for Patients with COVID-19: A Randomized Clinical Trial

Reinforcement of the Standard Therapy with Two Infusions of Convalescent Plasma for Patients with COVID-19: A Randomized Clinical Trial

Beneficial and Harmful Effects of Monoclonal Antibodies for the Treatment and Prophylaxis of COVID-19: Systematic Review and Meta-Analysis

The efficiency of convalescent plasma in COVID-19 patients: A systematic review and meta-analysis of randomized controlled clinical trials

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