Efficacy and Safety of COVID-19 Treatment Using Convalescent Plasma Transfusion: Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials

Hyun-Jun Lee; Jun-Hyeong Lee; Yejin Cho; Le Thi Nhu Ngoc; Young-Chul Lee

doi:10.3390/ijerph191710622

Efficacy and Safety of COVID-19 Treatment Using Convalescent Plasma Transfusion: Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials

Int J Environ Res Public Health. 2022 Aug 25;19(17):10622. doi: 10.3390/ijerph191710622.

Authors

Hyun-Jun Lee¹, Jun-Hyeong Lee¹, Yejin Cho¹, Le Thi Nhu Ngoc², Young-Chul Lee¹

Affiliations

¹ Department of BioNano Technology, Gachon University, 1342 Seongnam-Daero, Sujeong-Gu, Seongnam-si 13120, Gyeonggi-Do, Korea.
² Department of Industrial and Environmental Engineering, Graduate School of Environment, Gachon University, 1342 Seongnam-Daero, Sujeong-Gu, Seongnam-si 13120, Gyeonggi-Do, Korea.

Abstract

This study investigated the efficacy and safety of convalescent plasma (CP) transfusion against the coronavirus disease 2019 (COVID-19) via a systematic review and meta-analysis of randomized controlled trials (RCTs). A total of 5467 articles obtained from electronic databases were assessed; however, only 34 RCTs were eligible after manually screening and eliminating unnecessary studies. The beneficial effect was addressed by assessing the risk ratio (RR) and standardized mean differences (SMDs) of the meta-analysis. It was demonstrated that CP therapy is not effective in improving clinical outcomes, including reducing mortality with an RR of 0.88 [0.76; 1.03] (I² = 68% and p = 0.10) and length of hospitalization with SMD of -0.47 [-0.95; 0.00] (I² = 99% and p = 0.05). Subgroup analysis provided strong evidence that CP transfusion does not significantly reduce all-cause mortality compared to standard of care (SOC) with an RR of 1.01 [0.99; 1.03] (I² = 70% and p = 0.33). In addition, CP was found to be safe for and well-tolerated by COVID-19 patients as was the SOC in healthcare settings. Overall, the results suggest that CP should not be applied outside of randomized trials because of less benefit in improving clinical outcomes for COVID-19 treatment.

Keywords: COVID-19; adverse events; clinical outcomes; convalescent plasma transfusion; meta-analysis; systematic review.

Publication types

Meta-Analysis
Review
Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

COVID-19 Drug Treatment*
COVID-19 Serotherapy
COVID-19* / therapy
Humans
Immunization, Passive / methods
Randomized Controlled Trials as Topic

Grants and funding

This work was supported by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education (2021R1F1A1047906), Basic Science Research Capacity Enhancement Project through Korea Basic Science Institute (National research Facilities and Equipment Center) grant funded by the Ministry of Education (2019R1A6C1010016), and a grant from R&D Program (PK2202D2) of the Korea Railroad Research Institute.