Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials.
Creators: name: Axfors, Cathrine
name: Janiaud, Perrine
name: Schmitt, Andreas M
name: Van't Hooft, Janneke
name: Smith, Emily R
name: Haber, Noah A
name: Abayomi, Akin
name: Abduljalil, Manal
name: Abdulrahman, Abdulkarim
name: Acosta-Ampudia, Yeny
name: Aguilar-Guisado, Manuela
name: Al-Beidh, Farah
name: Alejandria, Marissa M
name: Alfonso, Rachelle N
name: Ali, Mohammad
name: AlQahtani, Manaf
name: AlZamrooni, Alaa
name: Anaya, Juan-Manuel
name: Ang, Mark Angelo C
name: Aomar, Ismael F
name: Argumanis, Luis E
name: Averyanov, Alexander
name: Baklaushev, Vladimir P
name: Balionis, Olga
name: Benfield, Thomas
name: Berry, Scott
name: Birocco, Nadia
name: Bonifacio, Lynn B
name: Bowen, Asha C
name: Bown, Abbie
name: Cabello-Gutierrez, Carlos
name: Camacho, Bernardo
name: Camacho-Ortiz, Adrian
name: Campbell-Lee, Sally
name: Cao, Damon H
name: Cardesa, Ana
name: Carnate, Jose M
name: Castillo, German Jr J
name: Cavallo, Rossana
name: Chowdhury, Fazle R
name: Chowdhury, Forhad UH
name: Ciccone, Giovannino
name: Cingolani, Antonella
name: Climacosa, Fresthel Monica M
name: Compernolle, Veerle
name: Cortez, Carlo Francisco N
name: Costa Neto, Abel
name: D'Antico, Sergio
name: Daly, James
name: Danielle, Franca
name: Davis, Joshua S
name: De Rosa, Francesco Giuseppe
name: Denholm, Justin T
name: Denkinger, Claudia M
name: Desmecht, Daniel
name: Díaz-Coronado, Juan C
name: Díaz Ponce-Medrano, Juan A
name: Donneau, Anne-Françoise
name: Dumagay, Teresita E
name: Dunachie, Susanna
name: Dungog, Cecile C
name: Erinoso, Olufemi
name: Escasa, Ivy Mae S
name: Estcourt, Lise J
name: Evans, Amy
name: Evasan, Agnes LM
name: Fareli, Christian J
name: Fernandez-Sanchez, Veronica
name: Galassi, Claudia
name: Gallo, Juan E
name: Garcia, Patricia J
name: Garcia, Patricia L
name: Garcia, Jesus A
name: Garigliany, Mutien
name: Garza-Gonzalez, Elvira
name: Gauiran, Deonne Thaddeus V
name: Gaviria García, Paula A
name: Giron-Gonzalez, Jose-Antonio
name: Gómez-Almaguer, David
name: Gordon, Anthony C
name: Gothot, André
name: Grass Guaqueta, Jeser Santiago
name: Green, Cameron
name: Grimaldi, David
name: Hammond, Naomi E
name: Harvala, Heli
name: Heralde, Francisco M
name: Herrick, Jesica
name: Higgins, Alisa M
name: Hills, Thomas E
name: Hines, Jennifer
name: Holm, Karin
name: Hoque, Ashraful
name: Hoste, Eric
name: Ignacio, Jose M
name: Ivanov, Alexander V
name: Janssen, Maike
name: Jennings, Jeffrey H
name: Jha, Vivekanand
name: King, Ruby Anne N
name: Kjeldsen-Kragh, Jens
name: Klenerman, Paul
name: Kotecha, Aditya
name: Krapp, Fiorella
name: Labanca, Luciana
name: Laing, Emma
name: Landin-Olsson, Mona
name: Laterre, Pierre-François
name: Lim, Lyn-Li
name: Lim, Jodor
name: Ljungquist, Oskar
name: Llaca-Díaz, Jorge M
name: López-Robles, Concepción
name: López-Cárdenas, Salvador
name: Lopez-Plaza, Ileana
name: Lucero, Josephine Anne C
name: Lundgren, Maria
name: Macías, Juan
name: Maganito, Sandy C
name: Malundo, Anna Flor G
name: Manrique, Rubén D
name: Manzini, Paola M
name: Marcos, Miguel
name: Marquez, Ignacio
name: Martínez-Marcos, Francisco Javier
name: Mata, Ana M
name: McArthur, Colin J
name: McQuilten, Zoe K
name: McVerry, Bryan J
name: Menon, David K
name: Meyfroidt, Geert
name: Mirasol, Ma Angelina L
name: Misset, Benoît
name: Molton, James S
name: Mondragon, Alric V
name: Monsalve, Diana M
name: Moradi Choghakabodi, Parastoo
name: Morpeth, Susan C
name: Mouncey, Paul R
name: Moutschen, Michel
name: Müller-Tidow, Carsten
name: Murphy, Erin
name: Najdovski, Tome
name: Nichol, Alistair D
name: Nielsen, Henrik
name: Novak, Richard M
name: O'Sullivan, Matthew VN
name: Olalla, Julian
name: Osibogun, Akin
name: Osikomaiya, Bodunrin
name: Oyonarte, Salvador
name: Pardo-Oviedo, Juan M
name: Patel, Mahesh C
name: Paterson, David L
name: Peña-Perez, Carlos A
name: Perez-Calatayud, Angel A
name: Pérez-Alba, Eduardo
name: Perkina, Anastasia
name: Perry, Naomi
name: Pouladzadeh, Mandana
name: Poyato, Inmaculada
name: Price, David J
name: Quero, Anne Kristine H
name: Rahman, Md M
name: Rahman, Md S
name: Ramesh, Mayur
name: Ramírez-Santana, Carolina
name: Rasmussen, Magnus
name: Rees, Megan A
name: Rego, Eduardo
name: Roberts, Jason A
name: Roberts, David J
name: Rodríguez, Yhojan
name: Rodríguez-Baño, Jesús
name: Rogers, Benjamin A
name: Rojas, Manuel
name: Romero, Alberto
name: Rowan, Kathryn M
name: Saccona, Fabio
name: Safdarian, Mehdi
name: Santos, Maria Clariza M
name: Sasadeusz, Joe
name: Scozzari, Gitana
name: Shankar-Hari, Manu
name: Sharma, Gorav
name: Snelling, Thomas
name: Soto, Alonso
name: Tagayuna, Pedrito Y
name: Tang, Amy
name: Tatem, Geneva
name: Teofili, Luciana
name: Tong, Steven YC
name: Turgeon, Alexis F
name: Veloso, Januario D
name: Venkatesh, Balasubramanian
name: Ventura-Enriquez, Yanet
name: Webb, Steve A
name: Wiese, Lothar
name: Wikén, Christian
name: Wood, Erica M
name: Yusubalieva, Gaukhar M
name: Zacharowski, Kai
name: Zarychanski, Ryan
name: Khanna, Nina
name: Moher, David
name: Goodman, Steven N
name: Ioannidis, John PA
name: Hemkens, Lars G
Publisher: name: Apollo - University of Cambridge Repository
Year: 2021
Subjects: Research Article
Meta-analysis
SARS-CoV-2
COVID-19
Convalescent plasma

description: Funder: laura and john arnold foundation; doi: http://dx.doi.org/10.13039/100009827
description: 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.