Early Administration of Convalescent Plasma Improves Survival in Patients with Hematological Malignancies and COVID-19

Biernat, Monika; Kolasińska, Anna; Kwiatkowski, J; Urbaniak-Kujda, Donata; Biernat, Paweł; Janocha-Litwin, Justyna; Szymczyk-Nużka, M.; Bursy, Dawid; Kalicińska, Elżbieta; Simon, Krzysztof; Mazur, Grzegorz; Wróbel, Tomasz

doi:10.3390/v13030436

Cited by 28 publications

(42 citation statements)

References 15 publications

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“…In contrast to RCTs, matched-control studies have generally observed a survival benefit associated with convalescent plasma therapy. Inspection of available Kaplan–Meier survival data from nine published matched-control studies showed a consistent pattern whereby convalescent plasma appeared to improve COVID-19 patient survival compared to non-transfused patients ( Figure 1 ) ( 50 , 52 , 59 – 62 , 64 , 69 , 70 ). Combining these available survival data demonstrated an 11% relative improvement in 28-day survival associated with convalescent plasma compared to control patients (82 vs. 74%) ( Figure 2C ).…”

Section: Convalescent Plasma Therapy For Covid-19: Mosaic Of Clinical Evidencementioning

confidence: 91%

“…Qualitative inspection of the available Kaplan–Meier survival data from 16 controlled studies revealed a directionally consistent pattern whereby convalescent plasma transfusion was associated with greater patient survival compared to non-transfused patients ( Figure 1 ) ( 11 , 27 , 41 , 43 , 46 , 47 , 50 , 52 , 59 – 62 , 64 , 69 – 71 ). Pooling all available Kaplan–Meier survival data showed a 14% relative improvement in COVID-19 patient 28-day survival associated with convalescent plasma (84 vs. 74%) ( Figure 2A ).…”

Section: Convalescent Plasma Therapy For Covid-19: Mosaic Of Clinical Evidencementioning

confidence: 98%

“…To date, 11 RCTs ( 11 , 27 , 30 , 40 – 47 ) and 24 matched-control studies ( 3 , 4 , 48 – 69 ) have investigated convalescent plasma therapy for COVID-19. Of these studies, 16 presented survival data using a Kaplan–Meier diagram ( 11 , 27 , 41 , 43 , 46 , 47 , 50 , 52 , 59 – 62 , 64 , 69 – 71 ). To investigate the impact of convalescent plasma on COVID-19 patient survival over time, we extracted daily survival data from all available Kaplan–Meier diagrams using an online data extraction tool (WebPlotDigitizer v4.4, Pacifica, CA, USA).…”

Section: Convalescent Plasma Therapy For Covid-19: Mosaic Of Clinical Evidencementioning

confidence: 99%

“… Kaplan–Meier survival plots from worldwide controlled studies investigating convalescent plasma therapy for coronavirus disease 2019 (COVID-19). Available Kaplan–Meier survival data from worldwide controlled studies [ n = 7 randomized clinical trials ( 11 , 27 , 41 , 43 , 46 , 47 , 71 ) and n = 9 matched-control studies ( 50 , 52 , 59 – 62 , 64 , 69 , 70 )] was extracted and replotted. Each panel represents data from one study, where the orange line represents the survival of the cohort transfused with convalescent plasma, and the blue line represents the survival of the cohort that received standard of care or placebo transfusion.…”

Section: Convalescent Plasma Therapy For Covid-19: Mosaic Of Clinical Evidencementioning

confidence: 99%

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Convalescent Plasma Therapy for COVID-19: A Graphical Mosaic of the Worldwide Evidence

et al. 2021

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Convalescent plasma has been used worldwide to treat patients hospitalized with coronavirus disease 2019 (COVID-19) and prevent disease progression. Despite global usage, uncertainty remains regarding plasma efficacy, as randomized controlled trials (RCTs) have provided divergent evidence regarding the survival benefit of convalescent plasma. Here, we argue that during a global health emergency, the mosaic of evidence originating from multiple levels of the epistemic hierarchy should inform contemporary policy and healthcare decisions. Indeed, worldwide matched-control studies have generally found convalescent plasma to improve COVID-19 patient survival, and RCTs have demonstrated a survival benefit when transfused early in the disease course but limited or no benefit later in the disease course when patients required greater supportive therapies. RCTs have also revealed that convalescent plasma transfusion contributes to improved symptomatology and viral clearance. To further investigate the effect of convalescent plasma on patient mortality, we performed a meta-analytical approach to pool daily survival data from all controlled studies that reported Kaplan–Meier survival plots. Qualitative inspection of all available Kaplan–Meier survival data and an aggregate Kaplan–Meier survival plot revealed a directionally consistent pattern among studies arising from multiple levels of the epistemic hierarchy, whereby convalescent plasma transfusion was generally associated with greater patient survival. Given that convalescent plasma has a similar safety profile as standard plasma, convalescent plasma should be implemented within weeks of the onset of future infectious disease outbreaks.

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Section: Convalescent Plasma Therapy For Covid-19: Mosaic Of Clinical Evidencementioning

confidence: 91%

Section: Convalescent Plasma Therapy For Covid-19: Mosaic Of Clinical Evidencementioning

confidence: 98%

Section: Convalescent Plasma Therapy For Covid-19: Mosaic Of Clinical Evidencementioning

confidence: 99%

Section: Convalescent Plasma Therapy For Covid-19: Mosaic Of Clinical Evidencementioning

confidence: 99%

See 2 more Smart Citations

Convalescent Plasma Therapy for COVID-19: A Graphical Mosaic of the Worldwide Evidence

et al. 2021

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“…For example, in a cohort study, an early administration of convalescent plasma improved survival in COVID-19 patients with hematological malignancies. 55 Additionally, in a nationwide observational multicenter study, the administration of convalescent plasma improved clinical outcomes in B-cell-depleted patients with protracted COVID-19. 56 Overall, these data suggested that application of convalescent plasma in COVID-19 might be limited.…”

Section: Immune System Modulation In Covid-19mentioning

confidence: 99%

Immunomodulation as a Potent COVID-19 Pharmacotherapy: Past, Present and Future

Hertanto¹,

Wiratama²,

Sutanto³

et al. 2021

JIR

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In the first year of its appearance, the 2019 coronavirus disease (COVID-19) has affected more than 150 million individuals and killed 3 million people worldwide. The pandemic has also triggered numerous global initiatives to tackle the newly emerging disease, including the development of SARS-CoV-2 vaccines and the attempt to discover potential pharmacological therapies. Nonetheless, despite the success of SARS-CoV-2 vaccine development, COVID-19 therapy remains challenging. Several repurposed drugs that were documented to be useful in small clinical trials have been shown to be ineffective in larger studies. Additionally, the pathophysiology of SARS-CoV-2 infection displayed the predominance of hyperinflammation and immune dysregulation in inducing multiorgan damage. Therefore, the potential benefits of both immune modulation and suppression in COVID-19 have been extensively discussed. Here, we reviewed the roles of immunomodulation as potential COVID-19 pharmacological modalities based on the existing data and proposed several new immunologic targets to be tested in the foreseeable future.

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COVID-19 Convalescent Plasma for the Treatment of Immunocompromised Patients: A Systematic Review and Meta-analysis

et al. 2023

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ImportancePatients who are immunocompromised have increased risk for morbidity and mortality associated with coronavirus disease 2019 (COVID-19) because they less frequently mount antibody responses to vaccines. Although neutralizing anti-spike monoclonal-antibody treatment has been widely used to treat COVID-19, evolutions of SARS-CoV-2 have been associated with monoclonal antibody-resistant SARS-CoV-2 variants and greater virulence and transmissibility of SARS-CoV-2. Thus, the therapeutic use of COVID-19 convalescent plasma has increased on the presumption that such plasma contains potentially therapeutic antibodies to SARS-CoV-2 that can be passively transferred to the plasma recipient.ObjectiveTo assess the growing number of reports of clinical experiences of patients with COVID-19 who are immunocompromised and treated with specific neutralizing antibodies via COVID-19 convalescent plasma transfusion.Data SourcesOn August 12, 2022, a systematic search was performed for clinical studies of COVID-19 convalescent plasma use in patients who are immunocompromised.Study SelectionRandomized clinical trials, matched cohort studies, and case report or series on COVID-19 convalescent plasma use in patients who are immunocompromised were included. The electronic search yielded 462 unique records, of which 199 were considered for full-text screening.Data Extraction and SynthesisThe study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data were extracted by 3 independent reviewers in duplicate and pooled.Main Outcomes and MeauresThe prespecified end point was all-cause mortality after COVID-19 convalescent plasma transfusion; exploratory subgroup analyses were performed based on putative factors associated with the potential mortality benefit of convalescent plasma.ResultsThis systematic review and meta-analysis included 3 randomized clinical trials enrolling 1487 participants and 5 controlled studies. Additionally, 125 case series or reports enrolling 265 participants and 13 uncontrolled large case series enrolling 358 participants were included. Separate meta-analyses, using models both stratified and pooled by study type (ie, randomized clinical trials and matched cohort studies), demonstrated that transfusion of COVID-19 convalescent plasma was associated with a decrease in mortality compared with the control cohort for the amalgam of both randomized clinical trials and matched cohort studies (risk ratio [RR], 0.63 [95% CI, 0.50-0.79]).Conclusions and RelevanceThese findings suggest that transfusion of COVID-19 convalescent plasma is associated with mortality benefit for patients who are immunocompromised and have COVID-19.

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Early Administration of Convalescent Plasma Improves Survival in Patients with Hematological Malignancies and COVID-19

Cited by 28 publications

References 15 publications

Convalescent Plasma Therapy for COVID-19: A Graphical Mosaic of the Worldwide Evidence

Convalescent Plasma Therapy for COVID-19: A Graphical Mosaic of the Worldwide Evidence

Immunomodulation as a Potent COVID-19 Pharmacotherapy: Past, Present and Future

COVID-19 Convalescent Plasma for the Treatment of Immunocompromised Patients: A Systematic Review and Meta-analysis

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