Cargando…

Convalescent Plasma—A Light at the End of the Tunnel: A Systematic Review and Meta-analysis of Randomized Controlled Trials

In the absence of a definitive therapy during this ongoing unprecedented crisis, coronavirus disease-2019 (COVID-19) pandemic, convalescent plasma transfusion (CPT) has shown some promising results. This review summarizes the existing evidence of the efficacy of CPT in COVID-19 patients based upon s...

Descripción completa

Detalles Bibliográficos
Autores principales: Sarkar, Soumya, Khanna, Puneet, Singh, Akhil K
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Jaypee Brothers Medical Publishers 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8608648/
https://www.ncbi.nlm.nih.gov/pubmed/34866829
http://dx.doi.org/10.5005/jp-journals-10071-24023
_version_ 1784602787119628288
author Sarkar, Soumya
Khanna, Puneet
Singh, Akhil K
author_facet Sarkar, Soumya
Khanna, Puneet
Singh, Akhil K
author_sort Sarkar, Soumya
collection PubMed
description In the absence of a definitive therapy during this ongoing unprecedented crisis, coronavirus disease-2019 (COVID-19) pandemic, convalescent plasma transfusion (CPT) has shown some promising results. This review summarizes the existing evidence of the efficacy of CPT in COVID-19 patients based upon scientific publications to date. We have included only the randomized controlled trials (RCTs) through an extensive screening of electronic databases up to July 31, 2021. In 19 RCTs, with a total of 16,476 COVID-19 patients we found low-quality evidence of significant reduction in mortality (odds ratio (OR) = 0.80; 95% confidence interval (CI): 0.66–0.96, I(2) = 40%), better clinical outcome when applied <7 days (OR = 2.13, 95% CI 1.28–3.53, I(2) = 0%), and improved viral clearance (OR = 2.6, 95% CI: 1.3–5.45, I(2) = 74%). Meta-regression analysis found that as a covariate, intubation on admission (p = 0.007) had a significant impact. However, there was any significant reduction neither in duration for clinical improvement (MD = −0.79, 95% CI: −2.76–1.18, I(2) = 98%), nor in total period of hospital stay (MD = 0.02, 95% CI: −0.75–0.78, I(2) = 81%). Early application of CPT is still relevant in reducing morbidity and mortality in critically ill patients and is too early to write it off as a potential therapeutic modality for COVID-19 patients. HOW TO CITE THIS ARTICLE: Sarkar S, Khanna P, Singh AK. Convalescent —Plasma—A Light at the End of the Tunnel: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Indian J Crit Care Med 2021;25(11):1292–1300.
format Online
Article
Text
id pubmed-8608648
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Jaypee Brothers Medical Publishers
record_format MEDLINE/PubMed
spelling pubmed-86086482021-12-02 Convalescent Plasma—A Light at the End of the Tunnel: A Systematic Review and Meta-analysis of Randomized Controlled Trials Sarkar, Soumya Khanna, Puneet Singh, Akhil K Indian J Crit Care Med Systematic Review In the absence of a definitive therapy during this ongoing unprecedented crisis, coronavirus disease-2019 (COVID-19) pandemic, convalescent plasma transfusion (CPT) has shown some promising results. This review summarizes the existing evidence of the efficacy of CPT in COVID-19 patients based upon scientific publications to date. We have included only the randomized controlled trials (RCTs) through an extensive screening of electronic databases up to July 31, 2021. In 19 RCTs, with a total of 16,476 COVID-19 patients we found low-quality evidence of significant reduction in mortality (odds ratio (OR) = 0.80; 95% confidence interval (CI): 0.66–0.96, I(2) = 40%), better clinical outcome when applied <7 days (OR = 2.13, 95% CI 1.28–3.53, I(2) = 0%), and improved viral clearance (OR = 2.6, 95% CI: 1.3–5.45, I(2) = 74%). Meta-regression analysis found that as a covariate, intubation on admission (p = 0.007) had a significant impact. However, there was any significant reduction neither in duration for clinical improvement (MD = −0.79, 95% CI: −2.76–1.18, I(2) = 98%), nor in total period of hospital stay (MD = 0.02, 95% CI: −0.75–0.78, I(2) = 81%). Early application of CPT is still relevant in reducing morbidity and mortality in critically ill patients and is too early to write it off as a potential therapeutic modality for COVID-19 patients. HOW TO CITE THIS ARTICLE: Sarkar S, Khanna P, Singh AK. Convalescent —Plasma—A Light at the End of the Tunnel: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Indian J Crit Care Med 2021;25(11):1292–1300. Jaypee Brothers Medical Publishers 2021-11 /pmc/articles/PMC8608648/ /pubmed/34866829 http://dx.doi.org/10.5005/jp-journals-10071-24023 Text en Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd. https://creativecommons.org/licenses/by-nc/4.0/© The Author(s). 2021 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated.
spellingShingle Systematic Review
Sarkar, Soumya
Khanna, Puneet
Singh, Akhil K
Convalescent Plasma—A Light at the End of the Tunnel: A Systematic Review and Meta-analysis of Randomized Controlled Trials
title Convalescent Plasma—A Light at the End of the Tunnel: A Systematic Review and Meta-analysis of Randomized Controlled Trials
title_full Convalescent Plasma—A Light at the End of the Tunnel: A Systematic Review and Meta-analysis of Randomized Controlled Trials
title_fullStr Convalescent Plasma—A Light at the End of the Tunnel: A Systematic Review and Meta-analysis of Randomized Controlled Trials
title_full_unstemmed Convalescent Plasma—A Light at the End of the Tunnel: A Systematic Review and Meta-analysis of Randomized Controlled Trials
title_short Convalescent Plasma—A Light at the End of the Tunnel: A Systematic Review and Meta-analysis of Randomized Controlled Trials
title_sort convalescent plasma—a light at the end of the tunnel: a systematic review and meta-analysis of randomized controlled trials
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8608648/
https://www.ncbi.nlm.nih.gov/pubmed/34866829
http://dx.doi.org/10.5005/jp-journals-10071-24023
work_keys_str_mv AT sarkarsoumya convalescentplasmaalightattheendofthetunnelasystematicreviewandmetaanalysisofrandomizedcontrolledtrials
AT khannapuneet convalescentplasmaalightattheendofthetunnelasystematicreviewandmetaanalysisofrandomizedcontrolledtrials
AT singhakhilk convalescentplasmaalightattheendofthetunnelasystematicreviewandmetaanalysisofrandomizedcontrolledtrials