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Convalescent plasma for people with COVID-19
Claire Iannizzi1, Khai Li Chai2, Vanessa Piechotta3
1Cochrane Haematology and Cochrane ESU Germany/UK, Institute of Public Health, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
The Cochrane Database of Systematic Reviews
|May 12, 2026
Summary
Convalescent plasma (CP) does not reduce mortality for moderate to severe COVID-19 patients. Evidence suggests CP has little to no effect on clinical improvement or adverse events in these patients.
Area of Science:
- Infectious Diseases
- Immunology
- Critical Care Medicine
Background:
- Convalescent plasma (CP) has been investigated as a potential therapy for COVID-19.
- Understanding the benefits and risks of CP for viral respiratory diseases, including COVID-19, is crucial.
Purpose of the Study:
- To assess the effectiveness and safety of convalescent plasma transfusion in treating COVID-19 patients.
- To evaluate CP's impact on mortality, clinical status, and adverse events across different disease severities.
Main Methods:
- Systematic review and meta-analysis of 48 randomized controlled trials (RCTs) including 24,518 participants.
- Searched multiple databases and clinical trial registries up to October 2024.
- Assessed risk of bias using RoB 2 and certainty of evidence using GRADE.
Main Results:
- For moderate to severe COVID-19, high-certainty evidence shows CP does not reduce all-cause mortality up to day 28 compared to placebo or standard care.
- CP had little to no impact on invasive mechanical ventilation, hospital discharge, or quality of life.
- Evidence is uncertain regarding CP's effect on mortality and clinical outcomes for mild COVID-19, though it may reduce hospital admission or death when compared to standard plasma.
Conclusions:
- Convalescent plasma (CP) shows no significant benefit in reducing mortality or improving clinical outcomes for patients with moderate to severe COVID-19 when compared to placebo or standard care.
- CP likely has minimal impact on serious adverse events in this patient group.
- Further research on CP for asymptomatic or mild COVID-19 is needed, though the research priority for this intervention has decreased.
