CONVALESCENT plasma for COVID-19: A meta-analysis of clinical trials and real-world evidence.
Chiraphat Kloypan,Matthanaporn Saesong,Juthamat Sangsuemoon,Prawat Chantharit,Pajaree Mongkhon,Pajaree Mongkhon +5 more
TLDR
In this article, the authors performed a systematic review and meta-analysis to investigate the efficacy of convalescent plasma vs standard treatment/non-CP on clinical outcomes in COVID-19 patients.Abstract:
BACKGROUND: There is still a lack of consensus on the efficacy of convalescent plasma (CP) treatment in COVID-19 patients. We performed a systematic review and meta-analysis to investigate the efficacy of CP vs standard treatment/non-CP on clinical outcomes in COVID-19 patients. METHODS: Cochrane Library, PubMed, EMBASE and ClinicalTrials.gov were searched from December 2019 to 16 July 2021, for data from clinical trials and observational studies. The primary outcome was all-cause mortality. Risk estimates were pooled using a random-effect model. Risk of bias was assessed by Cochrane Risk of Bias tool for clinical trials and Newcastle-Ottawa Scale for observational studies. RESULTS: In total, 18 peer-reviewed clinical trials, 3 preprints and 26 observational studies met the inclusion criteria. In the meta-analysis of 18 peer-reviewed trials, CP use had a 31% reduced risk of all-cause mortality compared with standard treatment use (pooled risk ratio [RR] = 0.69, 95% confidence interval [CI]: 0.56-0.86, P = .001, I2 = 50.1%). Based on severity and region, CP treatment significantly reduced risk of all-cause mortality in patients with severe and critical disease and studies conducted in Asia, pooled RR = 0.61, 95% CI: 0.47-0.81, P = .001, I2 = 0.0%; pooled RR = 0.67, 95% CI: 0.49-0.92, P = .013, I2 = 0.0%; and pooled RR = 0.62, 95% CI: 0.48-0.80, P < .001, I2 = 20.3%, respectively. The meta-analysis of observational studies showed the similar results to the clinical trials. CONCLUSIONS: Convalescent plasma use was associated with reduced risk of all-cause mortality in severe or critical COVID-19 patients. However, the findings were limited with a moderate degree of heterogeneity. Further studies with well-designed and larger sample size are needed.read more
Citations
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Journal ArticleDOI
COVID-19 Convalescent Plasma and Clinical Trials: Understanding Conflicting Outcomes
Daniele Focosi,Massimo Franchini,Liise Anne Pirofski,Thierry Burnouf,Nigel Paneth,Michael J. Joyner,Arturo Casadevall +6 more
TL;DR: A review of 30 available RCTs demonstrated that signals of efficacy were more likely if the CCP neutralizing titer was higher than 160 and the time to randomization was less than 9 days, demonstrating confusion for both clinicians and patients about the appropriate use of CCP.
Journal ArticleDOI
Safety and Efficacy of Convalescent Plasma in COVID-19: An Overview of Systematic Reviews.
TL;DR: In this paper, the authors summarize the evidence from the available systematic reviews on the efficacy and safety of convalescent plasma (CP) in COVID-19 through an overview of the published systematic reviews (SRs).
Journal ArticleDOI
Convalescent plasma therapy against the emerging SARS-CoV-2 variants: Delineation of the potentialities and risks
Hamana, Takashi,Anne Martin +1 more
TL;DR: In this article , convalescent plasma therapy (CPT) has been considered a potential immunotherapeutic strategy in treating various viral infections, including SARS-CoV-2.
Posted ContentDOI
COVID-19 convalescent plasma and randomized clinical trials: rebuilding confidence by explaining failures and finding signals of efficacy.
Daniele Focosi,Massimo Franchini,Liise Anne Pirofski,Thierry Burnouf,Nigel Paneth,Michael J. Joyner,Arturo Casadevall +6 more
TL;DR: In this paper, the authors analyzed variables associated with efficacy such as clinical settings, disease severity, CCP SARS-CoV-2 antibody levels and function, dose, timing of administration, outcomes (defined as hospitalization, requirement for ventilation, clinical improvement or mortality), CCP provenance and time for collection, and criteria for efficacy.
Journal ArticleDOI
COVID-19 in Patients with Hematologic Malignancies: Outcomes and Options for Treatments
TL;DR: Despite the historical exclusion of cancer patients from COVID-19 therapy trials, the emerging evidence that patients with hematologic malignancies benefit from specific treatments such as convalescent plasma is reviewed.
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Effect of Convalescent Plasma Therapy on Time to Clinical Improvement in Patients With Severe and Life-threatening COVID-19: A Randomized Clinical Trial.
Ling Li,Zhang Wei,Yu Hu,Xunliang Tong,Shangen Zheng,Juntao Yang,Yujie Kong,Lili Ren,Qing Wei,Heng Mei,Caiying Hu,Cuihua Tao,Ru Yang,Jue Wang,Yongpei Yu,Guo Yong,Xiaoxiong Wu,Zhihua Xu,Li Zeng,Nian Xiong,Lifeng Chen,Juan Wang,Ning Man,Yu Liu,Haixia Xu,E. Deng,Xuejun Zhang,Chenyue Li,Conghui Wang,Shisheng Su,Linqi Zhang,Jianwei Wang,Yanyun Wu,Zhong Liu +33 more
TL;DR: Among patients with severe or life-threatening COVID-19, convalescent plasma therapy added to standard treatment, compared with standard treatment alone, did not result in a statistically significant improvement in time to clinical improvement within 28 days.
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