Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials

Abstract Background Convalescent plasma has been widely used to treat COVID-19 and is under investigation in numerous randomized clinical trials, but results are publicly available only for a small number of trials. The objective of this study was to assess the benefits of convalescent plasma treatm...

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Autores principales:	Cathrine Axfors, Perrine Janiaud, Andreas M. Schmitt, Janneke van’t Hooft, Emily R. Smith, Noah A. Haber, Akin Abayomi, Manal Abduljalil, Abdulkarim Abdulrahman, Yeny Acosta-Ampudia, Manuela Aguilar-Guisado, Farah Al-Beidh, Marissa M. Alejandria, Rachelle N. Alfonso, Mohammad Ali, Manaf AlQahtani, Alaa AlZamrooni, Juan-Manuel Anaya, Mark Angelo C. Ang, Ismael F. Aomar, Luis E. Argumanis, Alexander Averyanov, Vladimir P. Baklaushev, Olga Balionis, Thomas Benfield, Scott Berry, Nadia Birocco, Lynn B. Bonifacio, Asha C. Bowen, Abbie Bown, Carlos Cabello-Gutierrez, Bernardo Camacho, Adrian Camacho-Ortiz, Sally Campbell-Lee, Damon H. Cao, Ana Cardesa, Jose M. Carnate, German Jr. J. Castillo, Rossana Cavallo, Fazle R. Chowdhury, Forhad U. H. Chowdhury, Giovannino Ciccone, Antonella Cingolani, Fresthel Monica M. Climacosa, Veerle Compernolle, Carlo Francisco N. Cortez, Abel Costa Neto, Sergio D’Antico, James Daly, Franca Danielle, Joshua S. Davis, Francesco Giuseppe De Rosa, Justin T. Denholm, Claudia M. Denkinger, Daniel Desmecht, Juan C. Díaz-Coronado, Juan A. Díaz Ponce-Medrano, Anne-Françoise Donneau, Teresita E. Dumagay, Susanna Dunachie, Cecile C. Dungog, Olufemi Erinoso, Ivy Mae S. Escasa, Lise J. Estcourt, Amy Evans, Agnes L. M. Evasan, Christian J. Fareli, Veronica Fernandez-Sanchez, Claudia Galassi, Juan E. Gallo, Patricia J. Garcia, Patricia L. Garcia, Jesus A. Garcia, Mutien Garigliany, Elvira Garza-Gonzalez, Deonne Thaddeus V. Gauiran, Paula A. Gaviria García, Jose-Antonio Giron-Gonzalez, David Gómez-Almaguer, Anthony C. Gordon, André Gothot, Jeser Santiago Grass Guaqueta, Cameron Green, David Grimaldi, Naomi E. Hammond, Heli Harvala, Francisco M. Heralde, Jesica Herrick, Alisa M. Higgins, Thomas E. Hills, Jennifer Hines, Karin Holm, Ashraful Hoque, Eric Hoste, Jose M. Ignacio, Alexander V. Ivanov, Maike Janssen, Jeffrey H. Jennings, Vivekanand Jha, Ruby Anne N. King, Jens Kjeldsen-Kragh, Paul Klenerman, Aditya Kotecha, Fiorella Krapp, Luciana Labanca, Emma Laing, Mona Landin-Olsson, Pierre-François Laterre, Lyn-Li Lim, Jodor Lim, Oskar Ljungquist, Jorge M. Llaca-Díaz, Concepción López-Robles, Salvador López-Cárdenas, Ileana Lopez-Plaza, Josephine Anne C. Lucero, Maria Lundgren, Juan Macías, Sandy C. Maganito, Anna Flor G. Malundo, Rubén D. Manrique, Paola M. Manzini, Miguel Marcos, Ignacio Marquez, Francisco Javier Martínez-Marcos, Ana M. Mata, Colin J. McArthur, Zoe K. McQuilten, Bryan J. McVerry, David K. Menon, Geert Meyfroidt, Ma. Angelina L. Mirasol, Benoît Misset, James S. Molton, Alric V. Mondragon, Diana M. Monsalve, Parastoo Moradi Choghakabodi, Susan C. Morpeth, Paul R. Mouncey, Michel Moutschen, Carsten Müller-Tidow, Erin Murphy, Tome Najdovski, Alistair D. Nichol, Henrik Nielsen, Richard M. Novak, Matthew V. N. O’Sullivan, Julian Olalla, Akin Osibogun, Bodunrin Osikomaiya, Salvador Oyonarte, Juan M. Pardo-Oviedo, Mahesh C. Patel, David L. Paterson, Carlos A. Peña-Perez, Angel A. Perez-Calatayud, Eduardo Pérez-Alba, Anastasia Perkina, Naomi Perry, Mandana Pouladzadeh, Inmaculada Poyato, David J. Price, Anne Kristine H. Quero, Md. M. Rahman, Md. S. Rahman, Mayur Ramesh, Carolina Ramírez-Santana, Magnus Rasmussen, Megan A. Rees, Eduardo Rego, Jason A. Roberts, David J. Roberts, Yhojan Rodríguez, Jesús Rodríguez-Baño, Benjamin A. Rogers, Manuel Rojas, Alberto Romero, Kathryn M. Rowan, Fabio Saccona, Mehdi Safdarian, Maria Clariza M. Santos, Joe Sasadeusz, Gitana Scozzari, Manu Shankar-Hari, Gorav Sharma, Thomas Snelling, Alonso Soto, Pedrito Y. Tagayuna, Amy Tang, Geneva Tatem, Luciana Teofili, Steven Y. C. Tong, Alexis F. Turgeon, Januario D. Veloso, Balasubramanian Venkatesh, Yanet Ventura-Enriquez, Steve A. Webb, Lothar Wiese, Christian Wikén, Erica M. Wood, Gaukhar M. Yusubalieva, Kai Zacharowski, Ryan Zarychanski, Nina Khanna, David Moher, Steven N. Goodman, John P. A. Ioannidis, Lars G. Hemkens
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Meta-analysis SARS-CoV-2 COVID-19 Convalescent plasma Infectious and parasitic diseases RC109-216
Acceso en línea:	https://doaj.org/article/6bad8c19b16b4268afed0c169d14cf14
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id	oai:doaj.org-article:6bad8c19b16b4268afed0c169d14cf14
record_format	dspace
institution	DOAJ
collection	DOAJ
language	EN
topic	Meta-analysis SARS-CoV-2 COVID-19 Convalescent plasma Infectious and parasitic diseases RC109-216
spellingShingle	Meta-analysis SARS-CoV-2 COVID-19 Convalescent plasma Infectious and parasitic diseases RC109-216 Cathrine Axfors Perrine Janiaud Andreas M. Schmitt Janneke van’t Hooft Emily R. Smith Noah A. Haber Akin Abayomi Manal Abduljalil Abdulkarim Abdulrahman Yeny Acosta-Ampudia Manuela Aguilar-Guisado Farah Al-Beidh Marissa M. Alejandria Rachelle N. Alfonso Mohammad Ali Manaf AlQahtani Alaa AlZamrooni Juan-Manuel Anaya Mark Angelo C. Ang Ismael F. Aomar Luis E. Argumanis Alexander Averyanov Vladimir P. Baklaushev Olga Balionis Thomas Benfield Scott Berry Nadia Birocco Lynn B. Bonifacio Asha C. Bowen Abbie Bown Carlos Cabello-Gutierrez Bernardo Camacho Adrian Camacho-Ortiz Sally Campbell-Lee Damon H. Cao Ana Cardesa Jose M. Carnate German Jr. J. Castillo Rossana Cavallo Fazle R. Chowdhury Forhad U. H. Chowdhury Giovannino Ciccone Antonella Cingolani Fresthel Monica M. Climacosa Veerle Compernolle Carlo Francisco N. Cortez Abel Costa Neto Sergio D’Antico James Daly Franca Danielle Joshua S. Davis Francesco Giuseppe De Rosa Justin T. Denholm Claudia M. Denkinger Daniel Desmecht Juan C. Díaz-Coronado Juan A. Díaz Ponce-Medrano Anne-Françoise Donneau Teresita E. Dumagay Susanna Dunachie Cecile C. Dungog Olufemi Erinoso Ivy Mae S. Escasa Lise J. Estcourt Amy Evans Agnes L. M. Evasan Christian J. Fareli Veronica Fernandez-Sanchez Claudia Galassi Juan E. Gallo Patricia J. Garcia Patricia L. Garcia Jesus A. Garcia Mutien Garigliany Elvira Garza-Gonzalez Deonne Thaddeus V. Gauiran Paula A. Gaviria García Jose-Antonio Giron-Gonzalez David Gómez-Almaguer Anthony C. Gordon André Gothot Jeser Santiago Grass Guaqueta Cameron Green David Grimaldi Naomi E. Hammond Heli Harvala Francisco M. Heralde Jesica Herrick Alisa M. Higgins Thomas E. Hills Jennifer Hines Karin Holm Ashraful Hoque Eric Hoste Jose M. Ignacio Alexander V. Ivanov Maike Janssen Jeffrey H. Jennings Vivekanand Jha Ruby Anne N. King Jens Kjeldsen-Kragh Paul Klenerman Aditya Kotecha Fiorella Krapp Luciana Labanca Emma Laing Mona Landin-Olsson Pierre-François Laterre Lyn-Li Lim Jodor Lim Oskar Ljungquist Jorge M. Llaca-Díaz Concepción López-Robles Salvador López-Cárdenas Ileana Lopez-Plaza Josephine Anne C. Lucero Maria Lundgren Juan Macías Sandy C. Maganito Anna Flor G. Malundo Rubén D. Manrique Paola M. Manzini Miguel Marcos Ignacio Marquez Francisco Javier Martínez-Marcos Ana M. Mata Colin J. McArthur Zoe K. McQuilten Bryan J. McVerry David K. Menon Geert Meyfroidt Ma. Angelina L. Mirasol Benoît Misset James S. Molton Alric V. Mondragon Diana M. Monsalve Parastoo Moradi Choghakabodi Susan C. Morpeth Paul R. Mouncey Michel Moutschen Carsten Müller-Tidow Erin Murphy Tome Najdovski Alistair D. Nichol Henrik Nielsen Richard M. Novak Matthew V. N. O’Sullivan Julian Olalla Akin Osibogun Bodunrin Osikomaiya Salvador Oyonarte Juan M. Pardo-Oviedo Mahesh C. Patel David L. Paterson Carlos A. Peña-Perez Angel A. Perez-Calatayud Eduardo Pérez-Alba Anastasia Perkina Naomi Perry Mandana Pouladzadeh Inmaculada Poyato David J. Price Anne Kristine H. Quero Md. M. Rahman Md. S. Rahman Mayur Ramesh Carolina Ramírez-Santana Magnus Rasmussen Megan A. Rees Eduardo Rego Jason A. Roberts David J. Roberts Yhojan Rodríguez Jesús Rodríguez-Baño Benjamin A. Rogers Manuel Rojas Alberto Romero Kathryn M. Rowan Fabio Saccona Mehdi Safdarian Maria Clariza M. Santos Joe Sasadeusz Gitana Scozzari Manu Shankar-Hari Gorav Sharma Thomas Snelling Alonso Soto Pedrito Y. Tagayuna Amy Tang Geneva Tatem Luciana Teofili Steven Y. C. Tong Alexis F. Turgeon Januario D. Veloso Balasubramanian Venkatesh Yanet Ventura-Enriquez Steve A. Webb Lothar Wiese Christian Wikén Erica M. Wood Gaukhar M. Yusubalieva Kai Zacharowski Ryan Zarychanski Nina Khanna David Moher Steven N. Goodman John P. A. Ioannidis Lars G. Hemkens Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials
description	Abstract Background Convalescent plasma has been widely used to treat COVID-19 and is under investigation in numerous randomized clinical trials, but results are publicly available only for a small number of trials. The objective of this study was to assess the benefits of convalescent plasma treatment compared to placebo or no treatment and all-cause mortality in patients with COVID-19, using data from all available randomized clinical trials, including unpublished and ongoing trials (Open Science Framework, https://doi.org/10.17605/OSF.IO/GEHFX ). Methods In this collaborative systematic review and meta-analysis, clinical trial registries (ClinicalTrials.gov, WHO International Clinical Trials Registry Platform), the Cochrane COVID-19 register, the LOVE database, and PubMed were searched until April 8, 2021. Investigators of trials registered by March 1, 2021, without published results were contacted via email. Eligible were ongoing, discontinued and completed randomized clinical trials that compared convalescent plasma with placebo or no treatment in COVID-19 patients, regardless of setting or treatment schedule. Aggregated mortality data were extracted from publications or provided by investigators of unpublished trials and combined using the Hartung–Knapp–Sidik–Jonkman random effects model. We investigated the contribution of unpublished trials to the overall evidence. Results A total of 16,477 patients were included in 33 trials (20 unpublished with 3190 patients, 13 published with 13,287 patients). 32 trials enrolled only hospitalized patients (including 3 with only intensive care unit patients). Risk of bias was low for 29/33 trials. Of 8495 patients who received convalescent plasma, 1997 died (23%), and of 7982 control patients, 1952 died (24%). The combined risk ratio for all-cause mortality was 0.97 (95% confidence interval: 0.92; 1.02) with between-study heterogeneity not beyond chance (I2 = 0%). The RECOVERY trial had 69.8% and the unpublished evidence 25.3% of the weight in the meta-analysis. Conclusions Convalescent plasma treatment of patients with COVID-19 did not reduce all-cause mortality. These results provide strong evidence that convalescent plasma treatment for patients with COVID-19 should not be used outside of randomized trials. Evidence synthesis from collaborations among trial investigators can inform both evidence generation and evidence application in patient care.
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author	Cathrine Axfors Perrine Janiaud Andreas M. Schmitt Janneke van’t Hooft Emily R. Smith Noah A. Haber Akin Abayomi Manal Abduljalil Abdulkarim Abdulrahman Yeny Acosta-Ampudia Manuela Aguilar-Guisado Farah Al-Beidh Marissa M. Alejandria Rachelle N. Alfonso Mohammad Ali Manaf AlQahtani Alaa AlZamrooni Juan-Manuel Anaya Mark Angelo C. Ang Ismael F. Aomar Luis E. Argumanis Alexander Averyanov Vladimir P. Baklaushev Olga Balionis Thomas Benfield Scott Berry Nadia Birocco Lynn B. Bonifacio Asha C. Bowen Abbie Bown Carlos Cabello-Gutierrez Bernardo Camacho Adrian Camacho-Ortiz Sally Campbell-Lee Damon H. Cao Ana Cardesa Jose M. Carnate German Jr. J. Castillo Rossana Cavallo Fazle R. Chowdhury Forhad U. H. Chowdhury Giovannino Ciccone Antonella Cingolani Fresthel Monica M. Climacosa Veerle Compernolle Carlo Francisco N. Cortez Abel Costa Neto Sergio D’Antico James Daly Franca Danielle Joshua S. Davis Francesco Giuseppe De Rosa Justin T. Denholm Claudia M. Denkinger Daniel Desmecht Juan C. Díaz-Coronado Juan A. Díaz Ponce-Medrano Anne-Françoise Donneau Teresita E. Dumagay Susanna Dunachie Cecile C. Dungog Olufemi Erinoso Ivy Mae S. Escasa Lise J. Estcourt Amy Evans Agnes L. M. Evasan Christian J. Fareli Veronica Fernandez-Sanchez Claudia Galassi Juan E. Gallo Patricia J. Garcia Patricia L. Garcia Jesus A. Garcia Mutien Garigliany Elvira Garza-Gonzalez Deonne Thaddeus V. Gauiran Paula A. Gaviria García Jose-Antonio Giron-Gonzalez David Gómez-Almaguer Anthony C. Gordon André Gothot Jeser Santiago Grass Guaqueta Cameron Green David Grimaldi Naomi E. Hammond Heli Harvala Francisco M. Heralde Jesica Herrick Alisa M. Higgins Thomas E. Hills Jennifer Hines Karin Holm Ashraful Hoque Eric Hoste Jose M. Ignacio Alexander V. Ivanov Maike Janssen Jeffrey H. Jennings Vivekanand Jha Ruby Anne N. King Jens Kjeldsen-Kragh Paul Klenerman Aditya Kotecha Fiorella Krapp Luciana Labanca Emma Laing Mona Landin-Olsson Pierre-François Laterre Lyn-Li Lim Jodor Lim Oskar Ljungquist Jorge M. Llaca-Díaz Concepción López-Robles Salvador López-Cárdenas Ileana Lopez-Plaza Josephine Anne C. Lucero Maria Lundgren Juan Macías Sandy C. Maganito Anna Flor G. Malundo Rubén D. Manrique Paola M. Manzini Miguel Marcos Ignacio Marquez Francisco Javier Martínez-Marcos Ana M. Mata Colin J. McArthur Zoe K. McQuilten Bryan J. McVerry David K. Menon Geert Meyfroidt Ma. Angelina L. Mirasol Benoît Misset James S. Molton Alric V. Mondragon Diana M. Monsalve Parastoo Moradi Choghakabodi Susan C. Morpeth Paul R. Mouncey Michel Moutschen Carsten Müller-Tidow Erin Murphy Tome Najdovski Alistair D. Nichol Henrik Nielsen Richard M. Novak Matthew V. N. O’Sullivan Julian Olalla Akin Osibogun Bodunrin Osikomaiya Salvador Oyonarte Juan M. Pardo-Oviedo Mahesh C. Patel David L. Paterson Carlos A. Peña-Perez Angel A. Perez-Calatayud Eduardo Pérez-Alba Anastasia Perkina Naomi Perry Mandana Pouladzadeh Inmaculada Poyato David J. Price Anne Kristine H. Quero Md. M. Rahman Md. S. Rahman Mayur Ramesh Carolina Ramírez-Santana Magnus Rasmussen Megan A. Rees Eduardo Rego Jason A. Roberts David J. Roberts Yhojan Rodríguez Jesús Rodríguez-Baño Benjamin A. Rogers Manuel Rojas Alberto Romero Kathryn M. Rowan Fabio Saccona Mehdi Safdarian Maria Clariza M. Santos Joe Sasadeusz Gitana Scozzari Manu Shankar-Hari Gorav Sharma Thomas Snelling Alonso Soto Pedrito Y. Tagayuna Amy Tang Geneva Tatem Luciana Teofili Steven Y. C. Tong Alexis F. Turgeon Januario D. Veloso Balasubramanian Venkatesh Yanet Ventura-Enriquez Steve A. Webb Lothar Wiese Christian Wikén Erica M. Wood Gaukhar M. Yusubalieva Kai Zacharowski Ryan Zarychanski Nina Khanna David Moher Steven N. Goodman John P. A. Ioannidis Lars G. Hemkens
author_facet	Cathrine Axfors Perrine Janiaud Andreas M. Schmitt Janneke van’t Hooft Emily R. Smith Noah A. Haber Akin Abayomi Manal Abduljalil Abdulkarim Abdulrahman Yeny Acosta-Ampudia Manuela Aguilar-Guisado Farah Al-Beidh Marissa M. Alejandria Rachelle N. Alfonso Mohammad Ali Manaf AlQahtani Alaa AlZamrooni Juan-Manuel Anaya Mark Angelo C. Ang Ismael F. Aomar Luis E. Argumanis Alexander Averyanov Vladimir P. Baklaushev Olga Balionis Thomas Benfield Scott Berry Nadia Birocco Lynn B. Bonifacio Asha C. Bowen Abbie Bown Carlos Cabello-Gutierrez Bernardo Camacho Adrian Camacho-Ortiz Sally Campbell-Lee Damon H. Cao Ana Cardesa Jose M. Carnate German Jr. J. Castillo Rossana Cavallo Fazle R. Chowdhury Forhad U. H. Chowdhury Giovannino Ciccone Antonella Cingolani Fresthel Monica M. Climacosa Veerle Compernolle Carlo Francisco N. Cortez Abel Costa Neto Sergio D’Antico James Daly Franca Danielle Joshua S. Davis Francesco Giuseppe De Rosa Justin T. Denholm Claudia M. Denkinger Daniel Desmecht Juan C. Díaz-Coronado Juan A. Díaz Ponce-Medrano Anne-Françoise Donneau Teresita E. Dumagay Susanna Dunachie Cecile C. Dungog Olufemi Erinoso Ivy Mae S. Escasa Lise J. Estcourt Amy Evans Agnes L. M. Evasan Christian J. Fareli Veronica Fernandez-Sanchez Claudia Galassi Juan E. Gallo Patricia J. Garcia Patricia L. Garcia Jesus A. Garcia Mutien Garigliany Elvira Garza-Gonzalez Deonne Thaddeus V. Gauiran Paula A. Gaviria García Jose-Antonio Giron-Gonzalez David Gómez-Almaguer Anthony C. Gordon André Gothot Jeser Santiago Grass Guaqueta Cameron Green David Grimaldi Naomi E. Hammond Heli Harvala Francisco M. Heralde Jesica Herrick Alisa M. Higgins Thomas E. Hills Jennifer Hines Karin Holm Ashraful Hoque Eric Hoste Jose M. Ignacio Alexander V. Ivanov Maike Janssen Jeffrey H. Jennings Vivekanand Jha Ruby Anne N. King Jens Kjeldsen-Kragh Paul Klenerman Aditya Kotecha Fiorella Krapp Luciana Labanca Emma Laing Mona Landin-Olsson Pierre-François Laterre Lyn-Li Lim Jodor Lim Oskar Ljungquist Jorge M. Llaca-Díaz Concepción López-Robles Salvador López-Cárdenas Ileana Lopez-Plaza Josephine Anne C. Lucero Maria Lundgren Juan Macías Sandy C. Maganito Anna Flor G. Malundo Rubén D. Manrique Paola M. Manzini Miguel Marcos Ignacio Marquez Francisco Javier Martínez-Marcos Ana M. Mata Colin J. McArthur Zoe K. McQuilten Bryan J. McVerry David K. Menon Geert Meyfroidt Ma. Angelina L. Mirasol Benoît Misset James S. Molton Alric V. Mondragon Diana M. Monsalve Parastoo Moradi Choghakabodi Susan C. Morpeth Paul R. Mouncey Michel Moutschen Carsten Müller-Tidow Erin Murphy Tome Najdovski Alistair D. Nichol Henrik Nielsen Richard M. Novak Matthew V. N. O’Sullivan Julian Olalla Akin Osibogun Bodunrin Osikomaiya Salvador Oyonarte Juan M. Pardo-Oviedo Mahesh C. Patel David L. Paterson Carlos A. Peña-Perez Angel A. Perez-Calatayud Eduardo Pérez-Alba Anastasia Perkina Naomi Perry Mandana Pouladzadeh Inmaculada Poyato David J. Price Anne Kristine H. Quero Md. M. Rahman Md. S. Rahman Mayur Ramesh Carolina Ramírez-Santana Magnus Rasmussen Megan A. Rees Eduardo Rego Jason A. Roberts David J. Roberts Yhojan Rodríguez Jesús Rodríguez-Baño Benjamin A. Rogers Manuel Rojas Alberto Romero Kathryn M. Rowan Fabio Saccona Mehdi Safdarian Maria Clariza M. Santos Joe Sasadeusz Gitana Scozzari Manu Shankar-Hari Gorav Sharma Thomas Snelling Alonso Soto Pedrito Y. Tagayuna Amy Tang Geneva Tatem Luciana Teofili Steven Y. C. Tong Alexis F. Turgeon Januario D. Veloso Balasubramanian Venkatesh Yanet Ventura-Enriquez Steve A. Webb Lothar Wiese Christian Wikén Erica M. Wood Gaukhar M. Yusubalieva Kai Zacharowski Ryan Zarychanski Nina Khanna David Moher Steven N. Goodman John P. A. Ioannidis Lars G. Hemkens
author_sort	Cathrine Axfors
title	Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials
title_short	Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials
title_full	Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials
title_fullStr	Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials
title_full_unstemmed	Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials
title_sort	association between convalescent plasma treatment and mortality in covid-19: a collaborative systematic review and meta-analysis of randomized clinical trials
publisher	BMC
publishDate	2021
url	https://doaj.org/article/6bad8c19b16b4268afed0c169d14cf14
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spelling	oai:doaj.org-article:6bad8c19b16b4268afed0c169d14cf142021-11-21T12:42:38ZAssociation between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials10.1186/s12879-021-06829-71471-2334https://doaj.org/article/6bad8c19b16b4268afed0c169d14cf142021-11-01T00:00:00Zhttps://doi.org/10.1186/s12879-021-06829-7https://doaj.org/toc/1471-2334Abstract Background Convalescent plasma has been widely used to treat COVID-19 and is under investigation in numerous randomized clinical trials, but results are publicly available only for a small number of trials. The objective of this study was to assess the benefits of convalescent plasma treatment compared to placebo or no treatment and all-cause mortality in patients with COVID-19, using data from all available randomized clinical trials, including unpublished and ongoing trials (Open Science Framework, https://doi.org/10.17605/OSF.IO/GEHFX ). Methods In this collaborative systematic review and meta-analysis, clinical trial registries (ClinicalTrials.gov, WHO International Clinical Trials Registry Platform), the Cochrane COVID-19 register, the LOVE database, and PubMed were searched until April 8, 2021. Investigators of trials registered by March 1, 2021, without published results were contacted via email. Eligible were ongoing, discontinued and completed randomized clinical trials that compared convalescent plasma with placebo or no treatment in COVID-19 patients, regardless of setting or treatment schedule. Aggregated mortality data were extracted from publications or provided by investigators of unpublished trials and combined using the Hartung–Knapp–Sidik–Jonkman random effects model. We investigated the contribution of unpublished trials to the overall evidence. Results A total of 16,477 patients were included in 33 trials (20 unpublished with 3190 patients, 13 published with 13,287 patients). 32 trials enrolled only hospitalized patients (including 3 with only intensive care unit patients). Risk of bias was low for 29/33 trials. Of 8495 patients who received convalescent plasma, 1997 died (23%), and of 7982 control patients, 1952 died (24%). The combined risk ratio for all-cause mortality was 0.97 (95% confidence interval: 0.92; 1.02) with between-study heterogeneity not beyond chance (I2 = 0%). The RECOVERY trial had 69.8% and the unpublished evidence 25.3% of the weight in the meta-analysis. Conclusions Convalescent plasma treatment of patients with COVID-19 did not reduce all-cause mortality. These results provide strong evidence that convalescent plasma treatment for patients with COVID-19 should not be used outside of randomized trials. Evidence synthesis from collaborations among trial investigators can inform both evidence generation and evidence application in patient care.Cathrine AxforsPerrine JaniaudAndreas M. SchmittJanneke van’t HooftEmily R. SmithNoah A. HaberAkin AbayomiManal AbduljalilAbdulkarim AbdulrahmanYeny Acosta-AmpudiaManuela Aguilar-GuisadoFarah Al-BeidhMarissa M. AlejandriaRachelle N. AlfonsoMohammad AliManaf AlQahtaniAlaa AlZamrooniJuan-Manuel AnayaMark Angelo C. AngIsmael F. AomarLuis E. ArgumanisAlexander AveryanovVladimir P. BaklaushevOlga BalionisThomas BenfieldScott BerryNadia BiroccoLynn B. BonifacioAsha C. BowenAbbie BownCarlos Cabello-GutierrezBernardo CamachoAdrian Camacho-OrtizSally Campbell-LeeDamon H. CaoAna CardesaJose M. CarnateGerman Jr. J. CastilloRossana CavalloFazle R. ChowdhuryForhad U. H. ChowdhuryGiovannino CicconeAntonella CingolaniFresthel Monica M. ClimacosaVeerle CompernolleCarlo Francisco N. CortezAbel Costa NetoSergio D’AnticoJames DalyFranca DanielleJoshua S. DavisFrancesco Giuseppe De RosaJustin T. DenholmClaudia M. DenkingerDaniel DesmechtJuan C. Díaz-CoronadoJuan A. Díaz Ponce-MedranoAnne-Françoise DonneauTeresita E. DumagaySusanna DunachieCecile C. DungogOlufemi ErinosoIvy Mae S. EscasaLise J. EstcourtAmy EvansAgnes L. M. EvasanChristian J. FareliVeronica Fernandez-SanchezClaudia GalassiJuan E. GalloPatricia J. GarciaPatricia L. GarciaJesus A. GarciaMutien GariglianyElvira Garza-GonzalezDeonne Thaddeus V. GauiranPaula A. Gaviria GarcíaJose-Antonio Giron-GonzalezDavid Gómez-AlmaguerAnthony C. GordonAndré GothotJeser Santiago Grass GuaquetaCameron GreenDavid GrimaldiNaomi E. HammondHeli HarvalaFrancisco M. HeraldeJesica HerrickAlisa M. HigginsThomas E. HillsJennifer HinesKarin HolmAshraful HoqueEric HosteJose M. IgnacioAlexander V. IvanovMaike JanssenJeffrey H. JenningsVivekanand JhaRuby Anne N. KingJens Kjeldsen-KraghPaul KlenermanAditya KotechaFiorella KrappLuciana LabancaEmma LaingMona Landin-OlssonPierre-François LaterreLyn-Li LimJodor LimOskar LjungquistJorge M. Llaca-DíazConcepción López-RoblesSalvador López-CárdenasIleana Lopez-PlazaJosephine Anne C. LuceroMaria LundgrenJuan MacíasSandy C. MaganitoAnna Flor G. MalundoRubén D. ManriquePaola M. ManziniMiguel MarcosIgnacio MarquezFrancisco Javier Martínez-MarcosAna M. MataColin J. McArthurZoe K. McQuiltenBryan J. McVerryDavid K. MenonGeert MeyfroidtMa. Angelina L. MirasolBenoît MissetJames S. MoltonAlric V. MondragonDiana M. MonsalveParastoo Moradi ChoghakabodiSusan C. MorpethPaul R. MounceyMichel MoutschenCarsten Müller-TidowErin MurphyTome NajdovskiAlistair D. NicholHenrik NielsenRichard M. NovakMatthew V. N. O’SullivanJulian OlallaAkin OsibogunBodunrin OsikomaiyaSalvador OyonarteJuan M. Pardo-OviedoMahesh C. PatelDavid L. PatersonCarlos A. Peña-PerezAngel A. Perez-CalatayudEduardo Pérez-AlbaAnastasia PerkinaNaomi PerryMandana PouladzadehInmaculada PoyatoDavid J. PriceAnne Kristine H. QueroMd. M. RahmanMd. S. RahmanMayur RameshCarolina Ramírez-SantanaMagnus RasmussenMegan A. ReesEduardo RegoJason A. RobertsDavid J. RobertsYhojan RodríguezJesús Rodríguez-BañoBenjamin A. RogersManuel RojasAlberto RomeroKathryn M. RowanFabio SacconaMehdi SafdarianMaria Clariza M. SantosJoe SasadeuszGitana ScozzariManu Shankar-HariGorav SharmaThomas SnellingAlonso SotoPedrito Y. TagayunaAmy TangGeneva TatemLuciana TeofiliSteven Y. C. TongAlexis F. TurgeonJanuario D. VelosoBalasubramanian VenkateshYanet Ventura-EnriquezSteve A. WebbLothar WieseChristian WikénErica M. WoodGaukhar M. YusubalievaKai ZacharowskiRyan ZarychanskiNina KhannaDavid MoherSteven N. GoodmanJohn P. A. IoannidisLars G. HemkensBMCarticleMeta-analysisSARS-CoV-2COVID-19Convalescent plasmaInfectious and parasitic diseasesRC109-216ENBMC Infectious Diseases, Vol 21, Iss 1, Pp 1-23 (2021)

Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials

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