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; De Lisa 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. Tobian; Massimo 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

doi:10.1016/j.mayocpiqo.2023.09.001

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, De Lisa 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 journal › Article › peer-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 language	English (US)
Pages (from-to)	499-513
Number of pages	15
Journal	Mayo Clinic Proceedings: Innovations, Quality and Outcomes
Volume	7
Issue number	5
DOIs	https://doi.org/10.1016/j.mayocpiqo.2023.09.001
State	Published - Oct 2023

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General Medicine

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Senefeld, J. W., Gorman, E. K., Johnson, P. W., Moir, M. E., Klassen, S. A., Carter, R. E., Paneth, N. S., Sullivan, D. J., Morkeberg, O. H., Wright, R. S., Fairweather, D. L., Bruno, K. A., Shoham, S., Bloch, E. M., Focosi, D., Henderson, J. P., Juskewitch, J. E., Pirofski, L. A., Grossman, B. J., ... Joyner, M. J. (2023). Mortality Rates Among Hospitalized Patients With COVID-19 Treated With Convalescent Plasma: A Systematic Review and Meta-Analysis. Mayo Clinic Proceedings: Innovations, Quality and Outcomes, 7(5), 499-513. https://doi.org/10.1016/j.mayocpiqo.2023.09.001

Senefeld, JW, Gorman, EK, Johnson, PW, Moir, ME, Klassen, SA, Carter, RE, Paneth, NS, Sullivan, DJ, Morkeberg, OH, Wright, RS, Fairweather, DL, Bruno, KA, Shoham, S, Bloch, EM, Focosi, D, Henderson, JP, Juskewitch, JE, Pirofski, LA, Grossman, BJ, Tobian, AAR, Franchini, M, Ganesh, R, Hurt, RT, Kay, NE, Parikh, SA, Baker, SE, Buchholtz, ZA, Buras, MR, Clayburn, AJ, Dennis, JJ, Diaz Soto, JC, Herasevich, V, Klompas, AM, Kunze, KL, Larson, KF, Mills, JR, Regimbal, RJ, Ripoll, JG, Sexton, MA, Shepherd, JRA, Stubbs, JR, Theel, ES, van Buskirk, CM, van Helmond, N, Vogt, MNP, Whelan, ER, Wiggins, CC, Winters, JL, Casadevall, A & Joyner, MJ 2023, 'Mortality Rates Among Hospitalized Patients With COVID-19 Treated With Convalescent Plasma: A Systematic Review and Meta-Analysis', Mayo Clinic Proceedings: Innovations, Quality and Outcomes, vol. 7, no. 5, pp. 499-513. https://doi.org/10.1016/j.mayocpiqo.2023.09.001

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

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.",

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

year = "2023",

month = oct,

doi = "10.1016/j.mayocpiqo.2023.09.001",

language = "English (US)",

volume = "7",

pages = "499--513",

journal = "Mayo Clinic Proceedings: Innovations, Quality and Outcomes",

issn = "2542-4548",

publisher = "Elsevier B.V.",

number = "5",

}

TY - JOUR

T1 - Mortality Rates Among Hospitalized Patients With COVID-19 Treated With Convalescent Plasma

T2 - A Systematic Review and Meta-Analysis

AU - Senefeld, Jonathon W.

AU - Gorman, Ellen K.

AU - Johnson, Patrick W.

AU - Moir, M. Erin

AU - Klassen, Stephen A.

AU - Carter, Rickey E.

AU - Paneth, Nigel S.

AU - Sullivan, David J.

AU - Morkeberg, Olaf H.

AU - Wright, R. Scott

AU - Fairweather, De Lisa

AU - Bruno, Katelyn A.

AU - Shoham, Shmuel

AU - Bloch, Evan M.

AU - Focosi, Daniele

AU - Henderson, Jeffrey P.

AU - Juskewitch, Justin E.

AU - Pirofski, Liise Anne

AU - Grossman, Brenda J.

AU - Tobian, Aaron A.R.

AU - Franchini, Massimo

AU - Ganesh, Ravindra

AU - Hurt, Ryan T.

AU - Kay, Neil E.

AU - Parikh, Sameer A.

AU - Baker, Sarah E.

AU - Buchholtz, Zachary A.

AU - Buras, Matthew R.

AU - Clayburn, Andrew J.

AU - Dennis, Joshua J.

AU - Diaz Soto, Juan C.

AU - Herasevich, Vitaly

AU - Klompas, Allan M.

AU - Kunze, Katie L.

AU - Larson, Kathryn F.

AU - Mills, John R.

AU - Regimbal, Riley J.

AU - Ripoll, Juan G.

AU - Sexton, Matthew A.

AU - Shepherd, John R.A.

AU - Stubbs, James R.

AU - Theel, Elitza S.

AU - van Buskirk, Camille M.

AU - van Helmond, Noud

AU - Vogt, Matthew N.P.

AU - Whelan, Emily R.

AU - Wiggins, Chad C.

AU - Winters, Jeffrey L.

AU - Casadevall, Arturo

AU - Joyner, Michael J.

PY - 2023/10

Y1 - 2023/10

N2 - 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.

AB - 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.

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U2 - 10.1016/j.mayocpiqo.2023.09.001

DO - 10.1016/j.mayocpiqo.2023.09.001

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VL - 7

SP - 499

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JO - Mayo Clinic Proceedings: Innovations, Quality and Outcomes

JF - Mayo Clinic Proceedings: Innovations, Quality and Outcomes

IS - 5

ER -

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

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