Rates Among Hospitalized Patients With COVID-19 Treated With Convalescent Plasma : A Systematic Review and Meta-Analysis
© 2023 The Authors..
Objective: To examine the association of COVID-19 convalescent plasma transfusion with mortality and the differences between subgroups in hospitalized patients with COVID-19.
Patients and Methods: On October 26, 2022, a systematic search was performed for clinical studies of COVID-19 convalescent plasma in the literature from January 1, 2020, to October 26, 2022. Randomized clinical trials and matched cohort studies investigating COVID-19 convalescent plasma transfusion compared with standard of care treatment or placebo among hospitalized patients with confirmed COVID-19 were included. The electronic search yielded 3841 unique records, of which 744 were considered for full-text screening. The selection process was performed independently by a panel of 5 reviewers. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data were extracted by 5 independent reviewers in duplicate and pooled using an inverse-variance random effects model. The prespecified end point was all-cause mortality during hospitalization.
Results: Thirty-nine randomized clinical trials enrolling 21,529 participants and 70 matched cohort studies enrolling 50,160 participants were included in the systematic review. Separate meta-analyses reported that transfusion of COVID-19 convalescent plasma was associated with a decrease in mortality compared with the control cohort for both randomized clinical trials (odds ratio [OR], 0.87; 95% CI, 0.76-1.00) and matched cohort studies (OR, 0.76; 95% CI, 0.66-0.88). The meta-analysis of subgroups revealed 2 important findings. First, treatment with convalescent plasma containing high antibody levels was associated with a decrease in mortality compared with convalescent plasma containing low antibody levels (OR, 0.85; 95% CI, 0.73 to 0.99). Second, earlier treatment with COVID-19 convalescent plasma was associated with a decrease in mortality compared with the later treatment cohort (OR, 0.63; 95% CI, 0.48 to 0.82).
Conclusion: During COVID-19 convalescent plasma use was associated with a 13% reduced risk of mortality, implying a mortality benefit for hospitalized patients with COVID-19, particularly those treated with convalescent plasma containing high antibody levels treated earlier in the disease course.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:7 |
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| Enthalten in: |
Mayo Clinic proceedings. Innovations, quality & outcomes - 7(2023), 5 vom: 01. Okt., Seite 499-513 |
| Sprache: |
Englisch |
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| Anmerkungen: |
Date Revised 21.10.2023 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1016/j.mayocpiqo.2023.09.001 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM363524029 |
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| 100 | 1 | |a Senefeld, Jonathon W |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Rates Among Hospitalized Patients With COVID-19 Treated With Convalescent Plasma |b A Systematic Review and Meta-Analysis |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Revised 21.10.2023 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © 2023 The Authors. | ||
| 520 | |a Objective: To examine the association of COVID-19 convalescent plasma transfusion with mortality and the differences between subgroups in hospitalized patients with COVID-19 | ||
| 520 | |a Patients and Methods: On October 26, 2022, a systematic search was performed for clinical studies of COVID-19 convalescent plasma in the literature from January 1, 2020, to October 26, 2022. Randomized clinical trials and matched cohort studies investigating COVID-19 convalescent plasma transfusion compared with standard of care treatment or placebo among hospitalized patients with confirmed COVID-19 were included. The electronic search yielded 3841 unique records, of which 744 were considered for full-text screening. The selection process was performed independently by a panel of 5 reviewers. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data were extracted by 5 independent reviewers in duplicate and pooled using an inverse-variance random effects model. The prespecified end point was all-cause mortality during hospitalization | ||
| 520 | |a Results: Thirty-nine randomized clinical trials enrolling 21,529 participants and 70 matched cohort studies enrolling 50,160 participants were included in the systematic review. Separate meta-analyses reported that transfusion of COVID-19 convalescent plasma was associated with a decrease in mortality compared with the control cohort for both randomized clinical trials (odds ratio [OR], 0.87; 95% CI, 0.76-1.00) and matched cohort studies (OR, 0.76; 95% CI, 0.66-0.88). The meta-analysis of subgroups revealed 2 important findings. First, treatment with convalescent plasma containing high antibody levels was associated with a decrease in mortality compared with convalescent plasma containing low antibody levels (OR, 0.85; 95% CI, 0.73 to 0.99). Second, earlier treatment with COVID-19 convalescent plasma was associated with a decrease in mortality compared with the later treatment cohort (OR, 0.63; 95% CI, 0.48 to 0.82) | ||
| 520 | |a Conclusion: During COVID-19 convalescent plasma use was associated with a 13% reduced risk of mortality, implying a mortality benefit for hospitalized patients with COVID-19, particularly those treated with convalescent plasma containing high antibody levels treated earlier in the disease course | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Gorman, Ellen K |e verfasserin |4 aut | |
| 700 | 1 | |a Johnson, Patrick W |e verfasserin |4 aut | |
| 700 | 1 | |a Moir, M Erin |e verfasserin |4 aut | |
| 700 | 1 | |a Klassen, Stephen A |e verfasserin |4 aut | |
| 700 | 1 | |a Carter, Rickey E |e verfasserin |4 aut | |
| 700 | 1 | |a Paneth, Nigel S |e verfasserin |4 aut | |
| 700 | 1 | |a Sullivan, David J |e verfasserin |4 aut | |
| 700 | 1 | |a Morkeberg, Olaf H |e verfasserin |4 aut | |
| 700 | 1 | |a Wright, R Scott |e verfasserin |4 aut | |
| 700 | 1 | |a Fairweather, DeLisa |e verfasserin |4 aut | |
| 700 | 1 | |a Bruno, Katelyn A |e verfasserin |4 aut | |
| 700 | 1 | |a Shoham, Shmuel |e verfasserin |4 aut | |
| 700 | 1 | |a Bloch, Evan M |e verfasserin |4 aut | |
| 700 | 1 | |a Focosi, Daniele |e verfasserin |4 aut | |
| 700 | 1 | |a Henderson, Jeffrey P |e verfasserin |4 aut | |
| 700 | 1 | |a Juskewitch, Justin E |e verfasserin |4 aut | |
| 700 | 1 | |a Pirofski, Liise-Anne |e verfasserin |4 aut | |
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| 700 | 1 | |a Hurt, Ryan T |e verfasserin |4 aut | |
| 700 | 1 | |a Kay, Neil E |e verfasserin |4 aut | |
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