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Effect of convalescent plasma transfusion on outcomes of coronavirus disease 2019: a meta-analysis with trial

Sameh M Hakim1, Ghosoun M A Chikhouni2, Mona A Ammar2

  • 1Department of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University, 15 Gamal Noah Street, Almaza, Heliopolis, Cairo, 11341, Egypt. hakimsm@med.asu.edu.eg.

Journal of Anesthesia
|February 22, 2023
PubMed

Insights

Convalescent plasma transfusion (CPT) does not significantly reduce mortality or the need for invasive mechanical ventilation (IMV) in COVID-19 patients. High-certainty evidence indicates CPT is futile, suggesting further trials are unnecessary.

Area of Science:

  • * Infectious Diseases and Virology
  • * Critical Care Medicine
  • * Evidence-Based Medicine

Background:

  • * The efficacy of convalescent plasma transfusion (CPT) for treating coronavirus disease 2019 (COVID-19) remains a critical research question.
  • * Evaluating CPT's impact on mortality and the need for invasive mechanical ventilation (IMV) is essential for clinical decision-making.

Approach:

  • * A comprehensive meta-analysis of 26 randomized controlled trials (RCTs) involving 19,816 patients was conducted to assess mortality outcomes.
  • * An additional meta-analysis of 17 RCTs (16,083 patients) evaluated the need for IMV.
  • * High-level evidence was confirmed through trim-and-fill adjustments and trial sequential analysis (TSA) to ensure robustness and assess futility.

Key Points:

  • * Meta-analysis revealed no statistically significant benefit of CPT in reducing mortality (RR = 0.97, 95% CI = 0.92 to 1.02).
  • * CPT showed no significant effect on the need for IMV (RR = 1.02, 95% CI = 0.95 to 1.10).
  • * Both analyses demonstrated unimportant heterogeneity and adequate information size, confirming the futility of CPT.

Conclusions:

  • * With a high level of certainty, CPT as an adjunct to standard treatment for COVID-19 does not decrease mortality or the need for IMV.
  • * The futility of CPT in COVID-19 treatment is established, supported by robust statistical analyses.
  • * Further clinical trials investigating the efficacy of CPT in COVID-19 patients are unlikely to yield positive results and are likely not needed.

Keywords:
COVID-19CPCPTConvalescent plasmaCoronavirus disease 2019Novel coronavirusSARS-COV-2Severe acute respiratory syndrome coronavirus 2Transfusion

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