TY - JOUR
T1 - Efficacy and harms of convalescent plasma for treatment of hospitalized COVID-19 patients
T2 - A systematic review and meta-analysis
AU - Hernández Diaz, Adrian Vladimir
AU - Ng-Sueng, Luis F.
AU - del Riego, Angela Parra
AU - Cerna-Viacava, Renato
AU - Pasupuleti, Vinay
AU - Thota, Priyaleela
AU - Roman, Yuani M.
AU - Piscoya Rivera, José Alejandro
N1 - Publisher Copyright:
Copyright © 2021 Termedia & Banach
PY - 2021/8/4
Y1 - 2021/8/4
N2 - Introduction: We systematically reviewed benefits and harms of convalescent plasma (CP) in hospitalized COVID-19 patients. Material and methods: Randomized controlled trials (RCTs) and observational studies assessing CP effects on hospitalized, adult COVID-19 patients were searched until November 24, 2020. We assessed risk of bias (RoB) using Cochrane RoB 2.0 and ROBINS-I tools. Inverse variance random effect meta-analyses were performed. Quality of evidence was evaluated using GRADE methodology. Primary outcomes were all-cause mortality, clinical improvement, and adverse events. Results: Five RCTs (n = 1067) and 6 cohorts (n = 881) were included. Three and 1 RCTs had some concerns and high RoB, respectively; and there was serious RoB in all cohorts. Convalescent plasma did not reduce all-cause mortality in RCTs of severe (RR = 0.60, 95% CI: 0.33-1.10) or moderate (RR = 0.60, 95% CI: 0.09-3.86) COVID-19 vs. standard of care (SOC); CP reduced all-cause mortality vs. SOC in cohorts (RR = 0.66, 95% CI: 0.49-0.91). Convalescent plasma did not reduce invasive ventilation vs. SOC in moderate disease (RR = 0.85, 95% CI: 0.47-1.55). In comparison to placebo + SOC, CP did not affect all-cause mortality (RR = 0.75, 95% CI: 0.48-1.16) or clinical improvement (HR = 1.07, 95% CI: 0.82-1.40) in severe patients. Adverse and serious adverse events were scarce, similar between CP and controls. Quality of evidence was low or very low for most outcomes. Conclusions: In comparison to SOC or placebo + SOC, CP did not reduce all-cause mortality in RCTs of hospitalized COVID-19 patients. Convalescent plasma did not have an effect on other clinical or safety outcomes. Until now there is no good quality evidence to recommend CP for hospitalized COVID-19 patients.
AB - Introduction: We systematically reviewed benefits and harms of convalescent plasma (CP) in hospitalized COVID-19 patients. Material and methods: Randomized controlled trials (RCTs) and observational studies assessing CP effects on hospitalized, adult COVID-19 patients were searched until November 24, 2020. We assessed risk of bias (RoB) using Cochrane RoB 2.0 and ROBINS-I tools. Inverse variance random effect meta-analyses were performed. Quality of evidence was evaluated using GRADE methodology. Primary outcomes were all-cause mortality, clinical improvement, and adverse events. Results: Five RCTs (n = 1067) and 6 cohorts (n = 881) were included. Three and 1 RCTs had some concerns and high RoB, respectively; and there was serious RoB in all cohorts. Convalescent plasma did not reduce all-cause mortality in RCTs of severe (RR = 0.60, 95% CI: 0.33-1.10) or moderate (RR = 0.60, 95% CI: 0.09-3.86) COVID-19 vs. standard of care (SOC); CP reduced all-cause mortality vs. SOC in cohorts (RR = 0.66, 95% CI: 0.49-0.91). Convalescent plasma did not reduce invasive ventilation vs. SOC in moderate disease (RR = 0.85, 95% CI: 0.47-1.55). In comparison to placebo + SOC, CP did not affect all-cause mortality (RR = 0.75, 95% CI: 0.48-1.16) or clinical improvement (HR = 1.07, 95% CI: 0.82-1.40) in severe patients. Adverse and serious adverse events were scarce, similar between CP and controls. Quality of evidence was low or very low for most outcomes. Conclusions: In comparison to SOC or placebo + SOC, CP did not reduce all-cause mortality in RCTs of hospitalized COVID-19 patients. Convalescent plasma did not have an effect on other clinical or safety outcomes. Until now there is no good quality evidence to recommend CP for hospitalized COVID-19 patients.
KW - All-cause mortality
KW - Convalescent plasma
KW - Coronavirus
UR - http://www.scopus.com/inward/record.url?scp=85115919801&partnerID=8YFLogxK
UR - https://www.mendeley.com/catalogue/49ed15a7-fb53-30b9-9f3e-8fd37a978917/
U2 - 10.5114/aoms/132492
DO - 10.5114/aoms/132492
M3 - Artículo
C2 - 34522254
AN - SCOPUS:85115919801
SN - 1734-1922
VL - 17
SP - 1251
EP - 1261
JO - Archives of Medical Science
JF - Archives of Medical Science
IS - 5
ER -