Convalescent Plasma Therapy for COVID-19: A Graphical Mosaic of the Worldwide Evidence

Author:

Klassen Stephen A.,Senefeld Jonathon W.,Senese Katherine A.,Johnson Patrick W.,Wiggins Chad C.,Baker Sarah E.,van Helmond Noud,Bruno Katelyn A.,Pirofski Liise-anne,Shoham Shmuel,Grossman Brenda J.,Henderson Jeffrey P.,Wright R. Scott,Fairweather DeLisa,Paneth Nigel S.,Carter Rickey E.,Casadevall Arturo,Joyner Michael J.

Abstract

Convalescent plasma has been used worldwide to treat patients hospitalized with coronavirus disease 2019 (COVID-19) and prevent disease progression. Despite global usage, uncertainty remains regarding plasma efficacy, as randomized controlled trials (RCTs) have provided divergent evidence regarding the survival benefit of convalescent plasma. Here, we argue that during a global health emergency, the mosaic of evidence originating from multiple levels of the epistemic hierarchy should inform contemporary policy and healthcare decisions. Indeed, worldwide matched-control studies have generally found convalescent plasma to improve COVID-19 patient survival, and RCTs have demonstrated a survival benefit when transfused early in the disease course but limited or no benefit later in the disease course when patients required greater supportive therapies. RCTs have also revealed that convalescent plasma transfusion contributes to improved symptomatology and viral clearance. To further investigate the effect of convalescent plasma on patient mortality, we performed a meta-analytical approach to pool daily survival data from all controlled studies that reported Kaplan–Meier survival plots. Qualitative inspection of all available Kaplan–Meier survival data and an aggregate Kaplan–Meier survival plot revealed a directionally consistent pattern among studies arising from multiple levels of the epistemic hierarchy, whereby convalescent plasma transfusion was generally associated with greater patient survival. Given that convalescent plasma has a similar safety profile as standard plasma, convalescent plasma should be implemented within weeks of the onset of future infectious disease outbreaks.

Funder

National Heart, Lung, and Blood Institute

National Institute of Diabetes and Digestive and Kidney Diseases

National Institute of Allergy and Infectious Diseases

National Institutes of Health

Publisher

Frontiers Media SA

Subject

General Medicine

Reference85 articles.

1. Clinical Memorandum for the Emergency Use Authorization of COVID-19 Convalescent Plasma2020

2. Timing of convalescent plasma administration and 28-day mortality for COVID-19 pneumonia;González;medRxiv [Preprint],2021

3. Effectiveness of convalescent plasma therapy in severe COVID-19 patients;Duan;Proc Natl Acad Sci USA.,2020

4. Mortality reduction in 46 severe Covid-19 patients treated with hyperimmune plasma. A proof of concept single arm multicenter trial;Perotti;Haematologica.,2020

5. Emergency Use Authorizations for Drug and Biological Products2021

Cited by 53 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3