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Meta-Analysis
. 2021 Jun;36(3):470-482.
doi: 10.1002/jca.21881. Epub 2021 Feb 5.

Efficacy of convalescent plasma therapy for COVID-19: A systematic review and meta-analysis

Charan T R Vegivinti  1 , John M Pederson  2 , Kavitha Saravu  3 , Nitin Gupta  3 , Kirk W Evanson  4 , Shelby Kamrowski  2 , Megan Schmidt  2 , Averi Barrett  2 , Hannah Trent  2 , Mahmoud Dibas  5 , Natalie L Reierson  2 , Nick Mikoff  2 , Sailaja Pisipati  6 , Betsy A Joseph  2 , Pragadeesh T Selvan  1 , Adam A Dmytriw  7 , Yashwitha S Pulakurthi  8 , Praneeth R Keesari  8 , Varsha Sriram  9 , Spandana Chittajallu  10 , Waleed Brinjikji  11 , Rewanth R Katamreddy  12 , Richa Chibbar  13 , Amber R Davis  4 , Manashree Malpe  4 , Hemant K Mishra  14 , Kevin M Kallmes  2 , Ameer E Hassan  15
Affiliations
Meta-Analysis

Efficacy of convalescent plasma therapy for COVID-19: A systematic review and meta-analysis

Charan T R Vegivinti et al. J Clin Apher. 2021 Jun.

Abstract

The purpose of this systematic review and meta-analysis was to examine clinical outcomes associated with convalescent plasma therapy in COVID-19 patients. We performed a literature search on PubMed, medRxiv, Web of Science, and Scopus to identify studies published up to December 10th, 2020 that examined the efficacy of convalescent plasma treatment for COVID-19. The primary endpoints were mortality, clinical improvement, and hospital length of stay. We screened 859 studies that met the search criteria, performed full-text reviews of 56 articles, and identified 15 articles that fulfilled inclusion criteria for meta-analysis. The odds of mortality were significantly lower in the convalescent plasma group compared to the control group (OR = 0.59 [95% CI = 0.44; 0.78], P < .001), although results from two key randomized controlled trials did not support the mortality benefit. The odds of clinical improvement were significantly higher in the convalescent plasma group compared to the control group (OR = 2.02 [95% CI = 1.54; 2.65], P < .001). There was no difference in hospital length of stay between the convalescent plasma group and the control group (MD = -0.49 days [95% CI = -3.11; 2.12], P = .713). In all, these data indicate that a mortality benefit with convalescent plasma is unclear, although there remain benefits with convalescent plasma therapy for COVID-19.

Keywords: COVID-19; convalescent plasma; coronavirus; meta-analysis.

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Conflict of interest statement

The authors declare no interests with the subject of this manuscript. N.M., N.R., S.K., and M.S. work for Nested Knowledge and Superior Medical Experts. J.M.P. is employed by Nested Knowledge, Superior Medical Experts, and Marblehead Medical. K.M.K. works for and holds equity in Nested Knowledge, Superior Medical Experts, and Marblehead Medical. A.R.D., K.W.E., and M.M. are employed by Superior Medical Experts.

Figures

FIGURE 1
FIGURE 1
PRISMA diagram of search records and included studies
FIGURE 2
FIGURE 2
Forest plot of subgroup comparisons of mortality. A, Overall mortality across all follow‐up times. B, Mortality at 28 to 30 day follow‐up. Pooled results were computed using restricted effects maximum likelihood with 95% confidence intervals computed using the Q‐profile method. A 95% prediction interval was also computed (black bar)
FIGURE 3
FIGURE 3
Forest plot of subgroup comparisons of clinical improvement. A, Overall clinical improvement across all follow‐up times. B, Clinical improvement at 28 to 30 day follow‐up. Pooled results were computed using restricted effects maximum likelihood with 95% confidence intervals computed using the Q‐profile method. A 95% prediction interval was also computed (black bar)
FIGURE 4
FIGURE 4
Forest plot of subgroup comparisons of hospital length of stay. Pooled results were computed using restricted effects maximum likelihood with 95% confidence intervals computed using the Q‐profile method. A 95% prediction interval was also computed (black bar)
See this image and copyright information in PMC

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