Mortality Rates Among Hospitalized Patients With COVID-19 Treated With Convalescent Plasma: A Systematic Review and Meta-Analysis

Jonathon W. Senefeld, Ellen K. Gorman, Patrick W. Johnson, M. Erin Moir, Stephen A. Klassen, Rickey E. Carter, Nigel S. Paneth, David J. Sullivan, Olaf H. Morkeberg, R. Scott Wright, DeLisa Fairweather, Katelyn A. Bruno, Shmuel Shoham, Evan M. Bloch, Daniele Focosi, Jeffrey P. Henderson, Justin E. Juskewitch, Liise-Anne Pirofski, Brenda J. Grossman, Aaron A.R. TobianMassimo Franchini, Ravindra Ganesh, Ryan T. Hurt, Neil E. Kay, Sameer A. Parikh, Sarah E. Baker, Zachary A. Buchholtz, Matthew R. Buras, Andrew J. Clayburn, Joshua J. Dennis, Juan C. Diaz Soto, Vitaly Herasevich, Allan M. Klompas, Katie L. Kunze, Kathryn F. Larson, John R. Mills, Riley J. Regimbal, Juan G. Ripoll, Matthew A. Sexton, John R.A. Shepherd, James R. Stubbs, Elitza S. Theel, Camille M. van Buskirk, Noud van Helmond, Matthew N.P. Vogt, Emily R. Whelan, Chad C. Wiggins, Jeffrey L. Winters, Arturo Casadevall, Michael J. Joyner

Research output: Contribution to journalArticlepeer-review

Abstract

Objective To examine the association of COVID-19 convalescent plasma transfusion with mortality and the differences between subgroups in hospitalized patients with COVID-19. Patients and Methods On October 26, 2022, a systematic search was performed for clinical studies of COVID-19 convalescent plasma in the literature from January 1, 2020, to October 26, 2022. Randomized clinical trials and matched cohort studies investigating COVID-19 convalescent plasma transfusion compared with standard of care treatment or placebo among hospitalized patients with confirmed COVID-19 were included. The electronic search yielded 3841 unique records, of which 744 were considered for full-text screening. The selection process was performed independently by a panel of 5 reviewers. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data were extracted by 5 independent reviewers in duplicate and pooled using an inverse-variance random effects model. The prespecified end point was all-cause mortality during hospitalization. Results Thirty-nine randomized clinical trials enrolling 21,529 participants and 70 matched cohort studies enrolling 50,160 participants were included in the systematic review. Separate meta-analyses reported that transfusion of COVID-19 convalescent plasma was associated with a decrease in mortality compared with the control cohort for both randomized clinical trials (odds ratio [OR], 0.87; 95% CI, 0.76-1.00) and matched cohort studies (OR, 0.76; 95% CI, 0.66-0.88). The meta-analysis of subgroups revealed 2 important findings. First, treatment with convalescent plasma containing high antibody levels was associated with a decrease in mortality compared with convalescent plasma containing low antibody levels (OR, 0.85; 95% CI, 0.73 to 0.99). Second, earlier treatment with COVID-19 convalescent plasma was associated with a decrease in mortality compared with the later treatment cohort (OR, 0.63; 95% CI, 0.48 to 0.82). Conclusion During COVID-19 convalescent plasma use was associated with a 13% reduced risk of mortality, implying a mortality benefit for hospitalized patients with COVID-19, particularly those treated with convalescent plasma containing high antibody levels treated earlier in the disease course.
Original languageEnglish (US)
Pages (from-to)499-513
Number of pages15
JournalMayo Clinic Proceedings: Innovations, Quality & Outcomes
Volume7
Issue number5
DOIs
StatePublished - Oct 2023

Fingerprint

Dive into the research topics of 'Mortality Rates Among Hospitalized Patients With COVID-19 Treated With Convalescent Plasma: A Systematic Review and Meta-Analysis'. Together they form a unique fingerprint.

Cite this