{Reference Type}: Journal Article
{Title}: Convalescent plasma and predictors of mortality among hospitalized patients with COVID-19: a systematic review and meta-analysis.
{Author}: Franchini M;Cruciani M;Mengoli C;Casadevall A;Glingani C;Joyner MJ;Pirofski LA;Senefeld JW;Shoham S;Sullivan DJ;Zani M;Focosi D;
{Journal}: Clin Microbiol Infect
{Volume}: 0
{Issue}: 0
{Year}: 2024 Jul 26
{Factor}: 13.31
{DOI}: 10.1016/j.cmi.2024.07.020
{Abstract}: <B>BACKGROUND: </B>Plasma collected from recovered patients with COVID-19 (COVID-19 convalescent plasma [CCP]) was the first antibody-based therapy employed to fight the COVID-19 pandemic. While the therapeutic effect of early administration of CCP in COVID-19 outpatients has been recognized, conflicting data exist regarding the efficacy of CCP administration in hospitalized patients.<BR><B>OBJECTIVE: </B>To examine the effect of CCP compared to placebo or standard treatment, and to evaluate whether time from onset of symptoms to treatment initiation influenced the effect.<BR><B>METHODS: </B>Electronic databases were searched for studies published from January 2020 to January 2024.<BR><B>METHODS: </B>Randomized clinical trials (RCTs) investigating the effect of CCP on COVID-19 mortality in hospitalized patients with COVID-19.<BR><B>METHODS: </B>Hospitalized patients with COVID-19.<BR><B>METHODS: </B>CCP versus no CCP.<BR><B>UNASSIGNED: </B>Cochrane risk of bias tool for RCTs.<BR><B>UNASSIGNED: </B>The random-effects model was used to calculate the pooled risk ratio (RR) with 95% CI for the pooled effect estimates of CCP treatment. The Grading of Recommendations Assessment, Development and Evaluation was used to evaluate the certainty of evidence.<BR><B>RESULTS: </B>Twenty-seven RCTs were included, representing 18,877 hospitalized patients with COVID-19. When transfused within 7 days from symptom onset, CCP significantly reduced the risk of death compared to standard therapy or placebo (RR, 0.76; 95% CI, 0.61-0.95), while later CCP administration was not associated with a mortality benefit (RR, 0.98; 95% CI, 0.90-1.06). The certainty of the evidence was graded as moderate. Meta-regression analysis demonstrated increasing mortality effects for longer interval to transfusion or worse initial clinical severity.<BR><B>CONCLUSIONS: </B>In-hospital transfusion of CCP within 7 days from symptom onset conferred a mortality benefit.