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Meta-Analysis
. 2022 Aug 25;19(17):10622.
doi: 10.3390/ijerph191710622.

Efficacy and Safety of COVID-19 Treatment Using Convalescent Plasma Transfusion: Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials

Hyun-Jun Lee  1 , Jun-Hyeong Lee  1 , Yejin Cho  1 , Le Thi Nhu Ngoc  2 , Young-Chul Lee  1
Affiliations
Meta-Analysis

Efficacy and Safety of COVID-19 Treatment Using Convalescent Plasma Transfusion: Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials

Hyun-Jun Lee et al. Int J Environ Res Public Health. .

Abstract

This study investigated the efficacy and safety of convalescent plasma (CP) transfusion against the coronavirus disease 2019 (COVID-19) via a systematic review and meta-analysis of randomized controlled trials (RCTs). A total of 5467 articles obtained from electronic databases were assessed; however, only 34 RCTs were eligible after manually screening and eliminating unnecessary studies. The beneficial effect was addressed by assessing the risk ratio (RR) and standardized mean differences (SMDs) of the meta-analysis. It was demonstrated that CP therapy is not effective in improving clinical outcomes, including reducing mortality with an RR of 0.88 [0.76; 1.03] (I2 = 68% and p = 0.10) and length of hospitalization with SMD of -0.47 [-0.95; 0.00] (I2 = 99% and p = 0.05). Subgroup analysis provided strong evidence that CP transfusion does not significantly reduce all-cause mortality compared to standard of care (SOC) with an RR of 1.01 [0.99; 1.03] (I2 = 70% and p = 0.33). In addition, CP was found to be safe for and well-tolerated by COVID-19 patients as was the SOC in healthcare settings. Overall, the results suggest that CP should not be applied outside of randomized trials because of less benefit in improving clinical outcomes for COVID-19 treatment.

Keywords: COVID-19; adverse events; clinical outcomes; convalescent plasma transfusion; meta-analysis; systematic review.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Systematic screening stages of literature review.
Figure 2
Figure 2
Comparison of reduction in all-cause mortality (number of events) between CP and SOC or placebo groups [8,14,16,17,18,19,20,21,22,24,25,26,27,28,29,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46]; (formula image) RR of individual studies; (◆) RR summary of the comparison.
Figure 3
Figure 3
Comparison of reduction in hospitalization length (days) between CP transfusion and control groups [8,14,16,18,19,20,24,25,29,32,36,37,38,41,42,43,45]; (formula image) SMD of individual studies; (◆) SMD summary of the comparison.
Figure 4
Figure 4
Comparison of adverse event caused by CP transfusion and control groups [15,16,18,20,21,22,27,28,29,34,39,40,41,44]; (formula image) RR of individual studies; (◆) RR summary of the comparison.
Figure 5
Figure 5
Subgroup analysis for mortality reduction based on six sub-criteria: country, confirmed titer, types of antibodies, sample size, study design, and severity of disease.
Figure 6
Figure 6
Funnel plots of included RCTs for investigating efficacy of CP transfusion against COVID-19, compared with SOC or placebo treatment.
See this image and copyright information in PMC

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