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Convalescent Plasma Treatment in Patients with Covid-19: A Systematic Review and Meta-Analysis

Anselm Jorda1, Manuel Kussmann2, Nebu Kolenchery3

  • 1Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.

Frontiers in Immunology
|February 24, 2022
PubMed

Insights

Convalescent plasma (CP) treatment for Coronavirus disease 2019 (Covid-19) did not significantly reduce all-cause mortality in a large meta-analysis. CP showed no benefit across different disease severities or baseline antibody statuses.

Area of Science:

  • Infectious Diseases
  • Immunology
  • Critical Care Medicine

Background:

  • Convalescent plasma (CP) emerged as a potential therapy for Coronavirus disease 2019 (Covid-19).
  • Uncertainty existed regarding its clinical efficacy and impact on patient outcomes.
  • This study aimed to rigorously assess CP's effectiveness in Covid-19 patients.

Approach:

  • A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted.
  • Searched major databases (Medline, Embase, Web of Science, Cochrane Library, medRxiv) up to October 17th, 2021.
  • Included 16 RCTs with 16,317 Covid-19 patients, assessing all-cause mortality as the primary outcome.

Key Points:

  • Overall all-cause mortality was similar between CP and standard care (23.8% vs. 24.4%, high-certainty evidence).
  • No significant differences in mortality were observed in critically ill or non-critically ill subgroups.
  • CP did not improve survival in patients negative for anti-SARS-CoV-2 antibodies at baseline.

Conclusions:

  • Convalescent plasma treatment, compared to control, was not associated with reduced all-cause mortality in Covid-19 patients.
  • Disease progression metrics, including mechanical ventilation and time to discharge, showed no significant improvement with CP.
  • Findings indicate CP lacks efficacy irrespective of disease severity or baseline antibody status.

Keywords:
SARS-CoV-2antibodiesconvalescent plasma (CP) therapycoronavirus – COVID-19hyperimmune globulinpassive immunizationserotherapy

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