Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials

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dc.contributor.authorAxfors, Cathrine
dc.contributor.authorJaniaud, Perrine
dc.contributor.authorSchmitt, Andreas M.
dc.contributor.authorvan’t Hooft, Janneke
dc.contributor.authorSmith, Emily R.
dc.contributor.authorHaber, Noah A.
dc.contributor.authorAbayomi, Akin
dc.contributor.authorAbduljalil, Manal
dc.contributor.authorAbdulrahman, Abdulkarim
dc.contributor.authorAcosta-Ampudia, Yeny
dc.contributor.authorAguilar-Guisado, Manuela
dc.contributor.authorAl-Beidh, Farah
dc.contributor.authorAlejandria, Marissa M.
dc.contributor.authorAlfonso, Rachelle N.
dc.contributor.authorAli, Mohammad
dc.contributor.authorAlQahtani, Manaf
dc.contributor.authorAlZamrooni, Alaa
dc.contributor.authorAnaya, Juan-Manuel
dc.contributor.authorAng, Mark A. C.
dc.contributor.authorAomar, Ismael F.
dc.contributor.authorArgumanis, Luis E.
dc.contributor.authorAveryanov, Alexander
dc.contributor.authorBaklaushev, Vladimir P.
dc.contributor.authorBalionis, Olga
dc.contributor.authorBenfield, Thomas
dc.contributor.authorBerry, Scott
dc.contributor.authorBirocco, Nadia
dc.contributor.authorBonifacio, Lynn B.
dc.contributor.authorBowen, Asha C.
dc.contributor.authorBown, Abbie
dc.contributor.authorCabello-Gutierrez, Carlos
dc.contributor.authorCamacho, Bernardo
dc.contributor.authorCamacho-Ortiz, Adrian
dc.contributor.authorCampbell-Lee, Sally
dc.contributor.authorCao, Damon H.
dc.contributor.authorCardesa, Ana
dc.contributor.authorCarnate, Jose M.
dc.contributor.authorCastillo, German J. J.
dc.contributor.authorCavallo, Rossana
dc.contributor.authorChowdhury, Fazle R.
dc.contributor.authorChowdhury, Forhad U. H.
dc.contributor.authorCiccone, Giovannino
dc.contributor.authorCingolani, Antonella
dc.contributor.authorClimacosa, Fresthel M. M.
dc.contributor.authorCompernolle, Veerle
dc.contributor.authorCortez, Carlo F. N.
dc.contributor.authorCosta Neto, Abel
dc.contributor.authorD’Antico, Sergio
dc.contributor.authorDaly, James
dc.contributor.authorDanielle, Franca
dc.contributor.authorDavis, Joshua S.
dc.contributor.authorDe Rosa, Francesco G.
dc.contributor.authorDenholm, Justin T.
dc.contributor.authorDenkinger, Claudia M.
dc.contributor.authorDesmecht, Daniel
dc.contributor.authorDíaz-Coronado, Juan C.
dc.contributor.authorDíaz Ponce-Medrano, Juan A.
dc.contributor.authorDonneau, Anne-Françoise
dc.contributor.authorDumagay, Teresita E.
dc.contributor.authorDunachie, Susanna
dc.contributor.authorDungog, Cecile C.
dc.contributor.authorErinoso, Olufemi
dc.contributor.authorEscasa, Ivy M. S.
dc.contributor.authorEstcourt, Lise J.
dc.contributor.authorEvans, Amy
dc.contributor.authorEvasan, Agnes L. M.
dc.contributor.authorFareli, Christian J.
dc.contributor.authorFernandez-Sanchez, Veronica
dc.contributor.authorGalassi, Claudia
dc.contributor.authorGallo, Juan E.
dc.contributor.authorGarcia, Patricia J.
dc.contributor.authorGarcia, Patricia L.
dc.contributor.authorGarcia, Jesus A.
dc.contributor.authorGarigliany, Mutien
dc.contributor.authorGarza-Gonzalez, Elvira
dc.contributor.authorGauiran, Deonne T. V.
dc.contributor.authorGaviria García, Paula A.
dc.contributor.authorGiron-Gonzalez, Jose-Antonio
dc.contributor.authorGómez-Almaguer, David
dc.contributor.authorGordon, Anthony C.
dc.contributor.authorGothot, André
dc.contributor.authorGrass Guaqueta, Jeser S.
dc.contributor.authorGreen, Cameron
dc.contributor.authorGrimaldi, David
dc.contributor.authorHammond, Naomi E.
dc.contributor.authorHarvala, Heli
dc.contributor.authorHeralde, Francisco M.
dc.contributor.authorHerrick, Jesica
dc.contributor.authorHiggins, Alisa M.
dc.contributor.authorHills, Thomas E.
dc.contributor.authorHines, Jennifer
dc.contributor.authorHolm, Karin
dc.contributor.authorHoque, Ashraful
dc.contributor.authorHoste, Eric
dc.contributor.authorIgnacio, Jose M.
dc.contributor.authorIvanov, Alexander V.
dc.contributor.authorJanssen, Maike
dc.contributor.authorJennings, Jeffrey H.
dc.contributor.authorJha, Vivekanand
dc.contributor.authorKing, Ruby A. N.
dc.contributor.authorKjeldsen-Kragh, Jens
dc.contributor.authorKlenerman, Paul
dc.contributor.authorKotecha, Aditya
dc.contributor.authorKrapp, Fiorella
dc.contributor.authorLabanca, Luciana
dc.contributor.authorLaing, Emma
dc.contributor.authorLandin-Olsson, Mona
dc.contributor.authorLaterre, Pierre-François
dc.contributor.authorLim, Lyn-Li
dc.contributor.authorLim, Jodor
dc.contributor.authorLjungquist, Oskar
dc.contributor.authorLlaca-Díaz, Jorge M.
dc.contributor.authorLópez-Robles, Concepción
dc.contributor.authorLópez-Cárdenas, Salvador
dc.contributor.authorLopez-Plaza, Ileana
dc.contributor.authorLucero, Josephine A. C.
dc.contributor.authorLundgren, Maria
dc.contributor.authorMacías, Juan
dc.contributor.authorMaganito, Sandy C.
dc.contributor.authorMalundo, Anna F. G.
dc.contributor.authorManrique, Rubén D.
dc.contributor.authorManzini, Paola M.
dc.contributor.authorMarcos, Miguel
dc.contributor.authorMarquez, Ignacio
dc.contributor.authorMartínez-Marcos, Francisco J.
dc.contributor.authorMata, Ana M.
dc.contributor.authorMcArthur, Colin J.
dc.contributor.authorMcQuilten, Zoe K.
dc.contributor.authorMcVerry, Bryan J.
dc.contributor.authorMenon, David K.
dc.contributor.authorMeyfroidt, Geert
dc.contributor.authorMirasol, Ma. A. L.
dc.contributor.authorMisset, Benoît
dc.contributor.authorMolton, James S.
dc.contributor.authorMondragon, Alric V.
dc.contributor.authorMonsalve, Diana M.
dc.contributor.authorMoradi Choghakabodi, Parastoo
dc.contributor.authorMorpeth, Susan C.
dc.contributor.authorMouncey, Paul R.
dc.contributor.authorMoutschen, Michel
dc.contributor.authorMüller-Tidow, Carsten
dc.contributor.authorMurphy, Erin
dc.contributor.authorNajdovski, Tome
dc.contributor.authorNichol, Alistair D.
dc.contributor.authorNielsen, Henrik
dc.contributor.authorNovak, Richard M.
dc.contributor.authorO’Sullivan, Matthew V. N.
dc.contributor.authorOlalla, Julian
dc.contributor.authorOsibogun, Akin
dc.contributor.authorOsikomaiya, Bodunrin
dc.contributor.authorOyonarte, Salvador
dc.contributor.authorPardo-Oviedo, Juan M.
dc.contributor.authorPatel, Mahesh C.
dc.contributor.authorPaterson, David L.
dc.contributor.authorPeña-Perez, Carlos A.
dc.contributor.authorPerez-Calatayud, Angel A.
dc.contributor.authorPérez-Alba, Eduardo
dc.contributor.authorPerkina, Anastasia
dc.contributor.authorPerry, Naomi
dc.contributor.authorPouladzadeh, Mandana
dc.contributor.authorPoyato, Inmaculada
dc.contributor.authorPrice, David J.
dc.contributor.authorQuero, Anne K. H.
dc.contributor.authorRahman, Md. M.
dc.contributor.authorRahman, Md. S.
dc.contributor.authorRamesh, Mayur
dc.contributor.authorRamírez-Santana, Carolina
dc.contributor.authorRasmussen, Magnus
dc.contributor.authorRees, Megan A.
dc.contributor.authorRego, Eduardo
dc.contributor.authorRoberts, Jason A.
dc.contributor.authorRoberts, David J.
dc.contributor.authorRodríguez, Yhojan
dc.contributor.authorRodríguez-Baño, Jesús
dc.contributor.authorRogers, Benjamin A.
dc.contributor.authorRojas, Manuel
dc.contributor.authorRomero, Alberto
dc.contributor.authorRowan, Kathryn M.
dc.contributor.authorSaccona, Fabio
dc.contributor.authorSafdarian, Mehdi
dc.contributor.authorSantos, Maria C. M.
dc.contributor.authorSasadeusz, Joe
dc.contributor.authorScozzari, Gitana
dc.contributor.authorShankar-Hari, Manu
dc.contributor.authorSharma, Gorav
dc.contributor.authorSnelling, Thomas
dc.contributor.authorSoto, Alonso
dc.contributor.authorTagayuna, Pedrito Y.
dc.contributor.authorTang, Amy
dc.contributor.authorTatem, Geneva
dc.contributor.authorTeofili, Luciana
dc.contributor.authorTong, Steven Y. C.
dc.contributor.authorTurgeon, Alexis F.
dc.contributor.authorVeloso, Januario D.
dc.contributor.authorVenkatesh, Balasubramanian
dc.contributor.authorVentura-Enriquez, Yanet
dc.contributor.authorWebb, Steve A.
dc.contributor.authorWiese, Lothar
dc.contributor.authorWikén, Christian
dc.contributor.authorWood, Erica M.
dc.contributor.authorYusubalieva, Gaukhar M.
dc.contributor.authorZacharowski, Kai
dc.contributor.authorZarychanski, Ryan
dc.contributor.authorKhanna, Nina
dc.contributor.authorMoher, David
dc.contributor.authorGoodman, Steven N.
dc.contributor.authorIoannidis, John P. A.
dc.contributor.authorHemkens, Lars G.
dc.date.accessioned2021-12-01T05:30:54Z
dc.date.issued2021-11-20
dc.date.updated2021-12-01T05:30:54Z
dc.description.abstractAbstract 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.
dc.identifier.citationBMC Infectious Diseases. 2021 Nov 20;21(1):1170
dc.identifier.urihttps://doi.org/10.1186/s12879-021-06829-7
dc.identifier.urihttp://hdl.handle.net/1993/36126
dc.language.rfc3066en
dc.rightsopen accessen_US
dc.rights.holderThe Author(s)
dc.titleAssociation between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials
dc.typeJournal Article
local.author.affiliationRady Faculty of Health Sciencesen_US
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