Convalescent plasma a tool to treat or a reason to retreat in COVID-19 infection: a systematic review and meta-analysis

Authors

  • Raksha Kundal Department of Anesthesia, Lady Hardinge Medical College, New Delhi, India
  • Vishal Kant Department of Anesthesia, Lady Hardinge Medical College, New Delhi, India
  • Vijay K. Kundal Department of Pediatric Surgery, ABVIMS Ram Manohar Lohiya Hospital, New Delhi, India
  • Maitree Pandey Department of Anesthesia, Lady Hardinge Medical College, New Delhi, India
  • Manish Goel Department of Preventive and Social Medicine, Lady Hardinge Medical College, New Delhi, India
  • Ritika Basnotra Department of transfusion medicine, NCI-AIIMS, Jhajjar, New Delhi, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20222278

Keywords:

Convalescent plasma, COVID-19, Randomized control trials, SARS-CoV-2, Standard of care, Mortality, Efficacy

Abstract

For management of Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, different therapeutic approaches are being given for mitigating symptoms that reduce hospital and intensive care unit (ICU) stay and decreasing the mortality. Convalescent plasma therapy is among one of the therapeutic approaches and to determine its effect on COVID-19, we aggregated patient outcome data from 8 randomized clinical trials (RCT). Studies published between 01 January 2020 to 28 February 2021 were identified via a thorough systematic search of PubMed, Embase, Medline and preprint platforms MedRxiv databases and data was analysed for its efficacy. Random-effects analyses of RCT demonstrated that COVID-19 patients who received convalescent plasma therapy along with standard of care showed a similar mortality rate when compared to patients receiving only standard of care treatments. Additional data showed that these data doesn’t provide evidence favoring the efficacy of human convalescent plasma as a therapeutic agent in hospitalized COVID-19 patients.

Author Biographies

Raksha Kundal, Department of Anesthesia, Lady Hardinge Medical College, New Delhi, India

MD, Associate Professor Anaesthesia

Vishal Kant, Department of Anesthesia, Lady Hardinge Medical College, New Delhi, India

MD, Senior Resident

Maitree Pandey, Department of Anesthesia, Lady Hardinge Medical College, New Delhi, India

MD, Head of Department & Director Professor Anesthesia

Manish Goel, Department of Preventive and Social Medicine, Lady Hardinge Medical College, New Delhi, India

MD, Professor, Preventive and social medicine

Ritika Basnotra, Department of transfusion medicine, NCI-AIIMS, Jhajjar, New Delhi, India

 MD, Senior resident, Department of Transfusion medicine

References

Center for Disease control and prevention. Clinical care guidance, 2022. Available at: https://www.cdc.gov/infectioncontrol/guidelines/index.html. Accessed on 24 March 2022.

Cao Y, Hiyoshi A, Montgomery S. COVID-19 case-fatality rate and demographic and socioeconomic influencers: worldwide spatial regression analysis based on country-level data. BMJ Open. 2020;10(11):e043560.

Kalil AC. Treating COVID-19-Off-Label Drug Use, Compassionate Use, and Randomized Clinical Trials During Pandemics. JAMA. 2020;323(19):1897-8.

Wooding DJ, Bach H. Treatment of COVID-19 with convalescent plasma: lessons from past coronavirus outbreaks. Clin Microbiol Infect. 2020;26(10):1436-46.

Xi Y. Convalescent plasma therapy for COVID-19: a tried-and-true old strategy? Signal Transduct Target Ther. 2020;5(1):203.

Zhu M, Hu K, Zhu Z. Use of convalescent plasma in COVID-19 patients in China. Transfus Clin Biol. 2020;27(3):168-9.

Cheng Y, Wong R, Soo YO, Wong WS, Lee CK, Ng MH, et al. Use of convalescent plasma therapy in SARS patients in Hong Kong. Eur J Clin Microbiol Infect Dis. 2005;24(1):44-6.

Duan K, Liu B, Li C, Zhang H, Yu T, Qu J, et al. Effectiveness of convalescent plasma therapy in severe COVID-19 patients. Proc Natl Acad Sci U S A. 2020;117(17):9490-6.

Ye M, Fu D, Ren Y, Wang F, Wang D, Zhang F, Xia X, Lv T. Treatment with convalescent plasma for COVID-19 patients in Wuhan, China. J Med Virol. 2020;92(10):1890-901.

Sarkar S, Soni KD, Khanna P. Convalescent plasma is a clutch at straws in COVID-19 management! A systematic review and meta-analysis. J Med Virol. 2021;93(2):1111-8.

Sun M, Xu Y, He H, Zhang L, Wang X, Qiu Q, Sun C, Guo Y, Qiu S, Ma K. A potentially effective treatment for COVID-19: A systematic review and meta-analysis of convalescent plasma therapy in treating severe infectious disease. Int J Infect Dis. 2020;98:334-46.

Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:l4898.

Agarwal A, Mukherjee A, Kumar G, Chatterjee P, Bhatnagar T, Malhotra P; PLACID Trial Collaborators. Convalescent plasma in the management of moderate COVID-19 in adults in India: open label phase II multicentre randomized controlled trial (PLACID Trial). BMJ. 2020;371:m3939.

Rasheed AM, Fatak DF, Hashim HA, Maulood MF, Kabah KK, Almusawi YA, Abdulmir AS. The therapeutic potential of convalescent plasma therapy on treating critically-ill COVID-19 patients residing in respiratory care unitsin hospitals in Baghdad, Iraq. Infez Med. 2020;28(3):357-66.

Simonovich VA, Burgos Pratx LD, Scibona P, Beruto MV, Vellone MG, Vazquez C, et al. A randomized trial of convalescent plasma in Covid-19 severe pneumonia. N Engl J Med. 2021;384:619-29.

Libster R, Perez Marc G, Wappner D, Coviello S, Bianchi A, Braem V, et al. Early high-titer plasma therapy to prevent severe Covid-19 in older adults. N Engl J Med. 2021;384: 610-8.

Li L, ZhangW, Hu Y, Tong X, Zheng S, Yang J, et al. Effect of convalescent plasma therapy on time to clinical improvement in patients with severe and life-threatening COVID-19: a randomized clinical trial. JAMA. 2020;324(5):460-70.

AlQahtani M, Abdulrahman A, Almadani A, Alali SY, Zamrooni AM, Hezab AH, et al. Randomized controlled trial of convalescent plasma therapy against standard therapy in patients with severe COVID-19 disease. medRxiv. Sci Rep. 2021;11:9927.

Gharbharan A, Jordans CCE, Geurtsvankessel C, Hollander JG, Karim F, Mollema FPN, et al. Convalescent plasma for COVID-19: a randomized clinical trial. medRxiv. 2020.

Bajpai M, Kumar S, Maheshwari A, Chhabra K, Kale P, Gupta A, et al. Efficacy of convalescent plasma therapy compared to fresh frozen plasma in severely ill COVID-19 patients: a pilot randomized controlled trial. medRxiv. 2020.

Avendano-Sola C, Ramos-Martinez A, Munez-Rubio E, Antorán BR, de Molina RM, Torres F, et al. Convalescent plasma for COVID-19: a multicenter, randomized clinical trial. medRxiv. 2020.

Ray Y, Paul SR, Bandopadhyay P, D’Rozario R, Sarif J, Lahiri A, et al. Clinical and immunological benefits of convalescent plasma therapy in severe COVID-19: insights from a single center open label randomised control trial. medRxiv. 2020.

Vegivinti CTR, Pederson JM, Saravu K, Gupta N, Evanson KW, Kamrowski S, et al. Efficacy of convalescent plasma therapy for COVID-19: A systematic review and meta-analysis. J Clin Apher. 2021;36(3):470-82.

Janiaud P, Axfors C, Schmitt AM, Gloy V, Ebrahimi F, Hepprich M, et al. Association of Convalescent Plasma Treatment With Clinical Outcomes in Patients With COVID-19: A Systematic Review and Meta-analysis. JAMA. 2021;325(12):1185-95.

RECOVERY Trial. Randomized evaluation of COVID-19 therapy (RECOVERY protocol), 2021. Available at: https://www.recoverytrial.net/ files/recovery-protocol-v12-1. Accessed on 27 January 2022.

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Published

2022-08-29

How to Cite

Kundal, R., Kant, V., Kundal, V. K., Pandey, M., Goel, M., & Basnotra, R. (2022). Convalescent plasma a tool to treat or a reason to retreat in COVID-19 infection: a systematic review and meta-analysis. International Journal of Research in Medical Sciences, 10(9), 1988–1997. https://doi.org/10.18203/2320-6012.ijrms20222278

Issue

Section

Meta-Analysis