The Effect of Convalescent Plasma Therapy on Mortality Among Patients With COVID-19: Systematic Review and Meta-analysis

Abstract

To determine the effect of COVID-19 convalescent plasma on mortality, we aggregated patient outcome data from 10 randomized clinical trials, 20 matched control studies, 2 dose-response studies, and 96 case reports or case series. Studies published between January 1, 2020, and January 16, 2021, were identified through a systematic search of online PubMed and MEDLINE databases. Random effects analyses of randomized clinical trials and matched control data demonstrated that patients with COVID-19 transfused with convalescent plasma exhibited a lower mortality rate compared with patients receiving standard treatments. Additional analyses showed that early transfusion (within 3 days of hospital admission) of higher titer plasma is associated with lower patient mortality. These data provide evidence favoring the efficacy of human convalescent plasma as a therapeutic agent in hospitalized patients with COVID-19.

Figure

The effect of human convalescent plasma therapy on mortality of patients with COVID-19. Forest plot illustrating odds ratios (ORs) and 95% CIs computed for each study and aggregated for each study type (DerSimonian-Laird random effects model). Data are separated by study type; randomized clinical trials are presented in blue, and matched control studies are presented in orange. The overall OR pooled across all controlled studies is presented in green. Relative study weights are provided. The I² values were 0 (randomized clinical trial model), 61 (matched control study model), and 53 (overall model combining randomized clinical trial and matched control studies). ^aRandom effects model excludes trial by Agarwal et al.