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Meta-Analysis
. 2020 Sep:98:334-346.
doi: 10.1016/j.ijid.2020.06.107. Epub 2020 Jul 4.

A potentially effective treatment for COVID-19: A systematic review and meta-analysis of convalescent plasma therapy in treating severe infectious disease

Mengyao Sun  1 , Yinghui Xu  1 , Hua He  1 , Li Zhang  2 , Xu Wang  1 , Qing Qiu  3 , Chao Sun  1 , Ye Guo  1 , Shi Qiu  1 , Kewei Ma  4
Affiliations
Meta-Analysis

A potentially effective treatment for COVID-19: A systematic review and meta-analysis of convalescent plasma therapy in treating severe infectious disease

Mengyao Sun et al. Int J Infect Dis. 2020 Sep.

Abstract

Background: Convalescent plasma (CP) has been used successfully to treat many types of infectious disease, and has shown initial effects in the treatment of the emerging 2019 coronavirus disease (COVID-19). However, its curative effects and feasibility have yet to be confirmed by formal evaluation and well-designed clinical trials. To explore the effectiveness of treatment and predict the potential effects of CP with COVID-19, studies of different types of infectious disease treated with CP were included in this systematic review and meta-analysis.

Methods: Related studies were obtained from databases and screened according to the inclusion criteria. The data quality was assessed, and the data were extracted and pooled for analysis.

Results: 40 studies on CP treatment for infectious diseases were included. Our study found that CP treatment could reduce the risk of mortality, with a low incidence of adverse events, promote the production of antibodies, lead to a decline in viral load, and shorten the disease course. A meta-analysis of 15 controlled studies showed that there was a significantly lower mortality rate in the group treated with CP (pooled OR=0.32; 95% CI=0.19-0.52; p<0.001, I2=54%) compared with the control groups. Studies were mostly of low or very low quality, with a moderate or high risk of bias. The sources of clinical and methodological heterogeneity were identified. The exclusion of heterogeneity indicated that the results were stable.

Conclusions: CP therapy has some curative effect and is well tolerated in treating infectious diseases. It is a potentially effective treatment for COVID-19.

Keywords: Convalescent plasma (CP); Coronavirus disease 2019 (COVID-19); Infectious disease; Meta-analysis.

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Conflict of interest statement

Declaration of Competing Interest The authors report no declarations of interest.

Figures

Figure 1
Figure 1
Flow diagram of the systematic review.
Figure 2
Figure 2
Forest plot of pooled odds ratios (ORs) for mortality following treatment with convalescent plasma or convalescent serum. The labels ‘Protective’ and ‘Harmful’ on x-axis represent the convalescent plasma or convalescent serum group and the control group, respectively.
Figure 3
Figure 3
Forest plot of pooled odds ratios (ORs) for mortality following treatment with convalescent plasma or convalescent serum, excluding a study with high heterogeneity.
See this image and copyright information in PMC

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