Efficacy of convalescent plasma in the treatment of coronavirus disease 2019: a systematic review_Chinese Journal of Evidence-Based Medicine

Authors：

PENG Hongyan , CHEN Feiyan , ZUO Yunlong , DANG Run ,  YANG Yiyu

Department of Pediatric Intensive Care Unit, Guangzhou Women and Children Medical Center, Guangzhou 510120, P. R. China;

Corresponding author：

YANG Yiyu, Email: yangyy65@yahoo.com

Keywords：

Convalescent plasma; Coronavirus disease 2019; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.202110046

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To systematically review the efficacy of convalescent plasma (CP) in the treatment of coronavirus disease 2019 (COVID-19). Methods PubMed, EMbase, The Cochrane Library, VIP, WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy of CP in the treatment of COVID-19 from inception to September 15^th, 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, meta-analysis was performed using RevMan 5.4.1 software. Results A total of 16 RCTs involving 15 301 patients were included. The results of meta-analysis showed that CP treatment did not reduce mortality compared with no-placebo (RR=0.99, 95%CI 0.93 to 1.05, P=0.63) or normal saline (RR=1.06, 95%CI 0.60 to 1.86, P=0.84). However, compared with standard plasma, the mortality of CP group was lower (RR=0.59, 95%CI 0.37 to 0.95, P=0.03). In addition, compared with no-placebo or normal saline, CP treatment could not improve the clinical condition at 28-30 days, reduce mortality at early treatment and in patients without invasive mechanical ventilation when randomized. Conclusion Current evidence shows that compared with no-placebo or normal saline, CP does not reduce mortality in patients with COVID-19. However, when the disease progresses to the point where standard plasma is required, CP may reduce mortality. In addition, use of CP in patients with early or non-critical COVID-19 failed to reduce mortality. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusion.

Citation： PENG Hongyan, CHEN Feiyan, ZUO Yunlong, DANG Run, YANG Yiyu. Efficacy of convalescent plasma in the treatment of coronavirus disease 2019: a systematic review. Chinese Journal of Evidence-Based Medicine, 2022, 22(2): 211-216. doi: 10.7507/1672-2531.202110046 Copy

1.	van Griensven J, Edwards T, de Lamballerie X, et al. Evaluation of convalescent plasma for Ebola virus disease in guinea. N Engl J Med, 2016, 374(1): 33-42.
2.	Arabi YM, Hajeer AH, Luke T, et al. Feasibility of using convalescent plasma immunotherapy for MERS-CoV infection, Saudi Arabia. Emerg Infect Dis, 2016, 22(9): 1554-1561.
3.	Yeh KM, Chiueh TS, Siu LK, et al. Experience of using convalescent plasma for severe acute respiratory syndrome among healthcare workers in a Taiwan hospital. J Antimicrob Chemother, 2005, 56(5): 919-922.
4.	Mair-Jenkins J, Saavedra-Campos M, Baillie JK, et al. The effectiveness of convalescent plasma and hyperimmune immunoglobulin for the treatment of severe acute respiratory infections of viral etiology: a systematic review and exploratory meta-analysis. J Infect Dis, 2015, 211(1): 80-90.
5.	Barreira DF, Lourenço RA, Calisto R, et al. Assessment of the safety and therapeutic benefits of convalescent plasma in COVID-19 treatment: a systematic review and meta-analysis. Front Med (Lausanne), 2021, 8: 660688.
6.	Piscoya A, Ng-Sueng LF, Parra Del Riego A, et al. Efficacy and harms of convalescent plasma for treatment of hospitalized COVID-19 patients: a systematic review and meta-analysis. Arch Med Sci, 2021, 17(5): 1251-1261.
7.	RECOVERY Collaborative Group. Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial. Lancet, 2021, 397(10289): 2049-2059.
8.	Pouladzadeh M, Safdarian M, Eshghi P, et al. A randomized clinical trial evaluating the immunomodulatory effect of convalescent plasma on COVID-19-related cytokine storm. Intern Emerg Med, 2021, 16(8): 2181-2191.
9.	Avendaño-Solá C, Ramos-Martínez A, Muñez-Rubio E, et al. A multicenter randomized open-label clinical trial for convalescent plasma in patients hospitalized with COVID-19 pneumonia. J Clin Invest, 2021, 131(20): e152740.
10.	Bégin P, Callum J, Jamula E, et al. Convalescent plasma for hospitalized patients with COVID-19: an open-label, randomized controlled trial. Nat Med, 2021, Online ahead of print.
11.	Bennett-Guerrero E, Romeiser JL, Talbot LR, et al. Severe acute respiratory syndrome coronavirus 2 convalescent plasma versus standard plasma in coronavirus disease 2019 infected hospitalized patients in New York: a double-blind randomized trial. Crit Care Med, 2021, 49(7): 1015-1025.
12.	O'Donnell MR, Grinsztejn B, Cummings MJ, et al. A randomized double-blind controlled trial of convalescent plasma in adults with severe COVID-19. J Clin Invest, 2021, 131(13): e150646.
13.	Kirenga B, Byakika-Kibwika P, Muttamba W, et al. Efficacy of convalescent plasma for treatment of COVID-19 in Uganda. BMJ Open Respir Res, 2021, 8(1): e001017.
14.	Körper S, Weiss M, Zickler D, et al. Results of the CAPSID randomized trial for high-dose convalescent plasma in patients with severe COVID-19. J Clin Invest, 2021, 131(20): e152264.
15.	Libster R, Pérez Marc G, Wappner D, et al. Early high-titer plasma therapy to prevent severe covid-19 in older adults. N Engl J Med, 2021, 384(7): 610-618.
16.	Agarwal A, Mukherjee A, Kumar G, et al. Convalescent plasma in the management of moderate covid-19 in adults in India: open label phaseⅡmulticentre randomised controlled trial (PLACID Trial). BMJ, 2020, 371: m3939.
17.	Simonovich VA, Burgos Pratx LD, Scibona P, et al. A randomized trial of convalescent plasma in covid-19 severe pneumonia. N Engl J Med, 2021, 384(7): 619-629.
18.	Li L, Zhang W, Hu Y, et al. Effect of convalescent plasma therapy on time to clinical improvement in patients with severe and life-threatening COVID-19: a randomized clinical trial. JAMA, 2020, 324(5): 460-470.
19.	AlQahtani M, Abdulrahman A, Almadani A, et al. Randomized controlled trial of convalescent plasma therapy against standard therapy in patients with severe COVID-19 disease. Sci Rep, 2021, 11(1): 9927.
20.	Gharbharan A, Jordans CCE, GeurtsvanKessel C, et al. Effects of potent neutralizing antibodies from convalescent plasma in patients hospitalized for severe SARS-CoV-2 infection. Nat Commun, 2021, 12(1): 3189.
21.	Sekine L, Arns B, Fabro BR, et al. Convalescent plasma for COVID-19 in hospitalised patients: an open-label, randomised clinical trial. Eur Respir J, 2021, Online ahead of print.
22.	Korley FK, Durkalski-Mauldin V, Yeatts SD, et al. Early convalescent plasma for high-risk outpatients with Covid-19. N Engl J Med, 2021: 2103784.
23.	Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet, 2020, 395(10229): 1054-1062.
24.	Abraham J. Passive antibody therapy in COVID-19. Nat Rev Immunol, 2020, 20(7): 401-403.
25.	Joyner MJ, Carter RE, Senefeld JW, et al. Convalescent plasma antibody levels and the risk of death from Covid-19. N Engl J Med, 2021, 384(11): 1015-1027.

1. van Griensven J, Edwards T, de Lamballerie X, et al. Evaluation of convalescent plasma for Ebola virus disease in guinea. N Engl J Med, 2016, 374(1): 33-42.
2. Arabi YM, Hajeer AH, Luke T, et al. Feasibility of using convalescent plasma immunotherapy for MERS-CoV infection, Saudi Arabia. Emerg Infect Dis, 2016, 22(9): 1554-1561.
3. Yeh KM, Chiueh TS, Siu LK, et al. Experience of using convalescent plasma for severe acute respiratory syndrome among healthcare workers in a Taiwan hospital. J Antimicrob Chemother, 2005, 56(5): 919-922.
4. Mair-Jenkins J, Saavedra-Campos M, Baillie JK, et al. The effectiveness of convalescent plasma and hyperimmune immunoglobulin for the treatment of severe acute respiratory infections of viral etiology: a systematic review and exploratory meta-analysis. J Infect Dis, 2015, 211(1): 80-90.
5. Barreira DF, Lourenço RA, Calisto R, et al. Assessment of the safety and therapeutic benefits of convalescent plasma in COVID-19 treatment: a systematic review and meta-analysis. Front Med (Lausanne), 2021, 8: 660688.
6. Piscoya A, Ng-Sueng LF, Parra Del Riego A, et al. Efficacy and harms of convalescent plasma for treatment of hospitalized COVID-19 patients: a systematic review and meta-analysis. Arch Med Sci, 2021, 17(5): 1251-1261.
7. RECOVERY Collaborative Group. Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial. Lancet, 2021, 397(10289): 2049-2059.
8. Pouladzadeh M, Safdarian M, Eshghi P, et al. A randomized clinical trial evaluating the immunomodulatory effect of convalescent plasma on COVID-19-related cytokine storm. Intern Emerg Med, 2021, 16(8): 2181-2191.
9. Avendaño-Solá C, Ramos-Martínez A, Muñez-Rubio E, et al. A multicenter randomized open-label clinical trial for convalescent plasma in patients hospitalized with COVID-19 pneumonia. J Clin Invest, 2021, 131(20): e152740.
10. Bégin P, Callum J, Jamula E, et al. Convalescent plasma for hospitalized patients with COVID-19: an open-label, randomized controlled trial. Nat Med, 2021, Online ahead of print.
11. Bennett-Guerrero E, Romeiser JL, Talbot LR, et al. Severe acute respiratory syndrome coronavirus 2 convalescent plasma versus standard plasma in coronavirus disease 2019 infected hospitalized patients in New York: a double-blind randomized trial. Crit Care Med, 2021, 49(7): 1015-1025.
12. O'Donnell MR, Grinsztejn B, Cummings MJ, et al. A randomized double-blind controlled trial of convalescent plasma in adults with severe COVID-19. J Clin Invest, 2021, 131(13): e150646.
13. Kirenga B, Byakika-Kibwika P, Muttamba W, et al. Efficacy of convalescent plasma for treatment of COVID-19 in Uganda. BMJ Open Respir Res, 2021, 8(1): e001017.
14. Körper S, Weiss M, Zickler D, et al. Results of the CAPSID randomized trial for high-dose convalescent plasma in patients with severe COVID-19. J Clin Invest, 2021, 131(20): e152264.
15. Libster R, Pérez Marc G, Wappner D, et al. Early high-titer plasma therapy to prevent severe covid-19 in older adults. N Engl J Med, 2021, 384(7): 610-618.
16. Agarwal A, Mukherjee A, Kumar G, et al. Convalescent plasma in the management of moderate covid-19 in adults in India: open label phaseⅡmulticentre randomised controlled trial (PLACID Trial). BMJ, 2020, 371: m3939.
17. Simonovich VA, Burgos Pratx LD, Scibona P, et al. A randomized trial of convalescent plasma in covid-19 severe pneumonia. N Engl J Med, 2021, 384(7): 619-629.
18. Li L, Zhang W, Hu Y, et al. Effect of convalescent plasma therapy on time to clinical improvement in patients with severe and life-threatening COVID-19: a randomized clinical trial. JAMA, 2020, 324(5): 460-470.
19. AlQahtani M, Abdulrahman A, Almadani A, et al. Randomized controlled trial of convalescent plasma therapy against standard therapy in patients with severe COVID-19 disease. Sci Rep, 2021, 11(1): 9927.
20. Gharbharan A, Jordans CCE, GeurtsvanKessel C, et al. Effects of potent neutralizing antibodies from convalescent plasma in patients hospitalized for severe SARS-CoV-2 infection. Nat Commun, 2021, 12(1): 3189.
21. Sekine L, Arns B, Fabro BR, et al. Convalescent plasma for COVID-19 in hospitalised patients: an open-label, randomised clinical trial. Eur Respir J, 2021, Online ahead of print.
22. Korley FK, Durkalski-Mauldin V, Yeatts SD, et al. Early convalescent plasma for high-risk outpatients with Covid-19. N Engl J Med, 2021: 2103784.
23. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet, 2020, 395(10229): 1054-1062.
24. Abraham J. Passive antibody therapy in COVID-19. Nat Rev Immunol, 2020, 20(7): 401-403.
25. Joyner MJ, Carter RE, Senefeld JW, et al. Convalescent plasma antibody levels and the risk of death from Covid-19. N Engl J Med, 2021, 384(11): 1015-1027.

Chinese Journal of Evidence-Based Medicine

Efficacy of convalescent plasma in the treatment of coronavirus disease 2019: a systematic review

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content