Convalescent plasma as a possible treatment for COVID-19

Added August 10, 2020

What is this? Convalescent plasma and hyperimmune immunoglobulin have been suggested as possible treatments for COVID-19; and several systematic reviews have been done. More details of these reviews, including citations and links to them, are provided further down this summary.

What was found: At the time of the July 2020 Piechotta et al. version of the Cochrane rapid review, the included studies showed that the benefits and harms of using convalescent plasma or hyperimmune immunoglobulin for COVID-19 patients are very uncertain, with only very low certainty evidence that convalescent plasma is a safe treatment for COVID-19. The review is being updated periodically as a living systematic review.

At the time of the Rajendran et al. (2020) review, the included studies were judged to be of low-quality with a high risk of bias, but reported promising evidence on effectiveness and safety of convalescent plasma treatment.

Devasenapathy et al. (2020) concluded that studies of non-COVID-19 severe respiratory infections provide indirect very low quality evidence that convalescent plasma may have minimal or no benefit for COVID-19 patients, and low-quality evidence that it does not cause serious adverse events.

Mair-Jenkins et al. (2015) reported that there is very low and low quality evidence that convalescent plasma may reduce mortality in patients with severe acute viral respiratory infections, if administered early after symptom onset, compared to placebo or no therapy.

What are the reviews:

Citation: Piechotta V, Chai KL, Valk SJ, et al. Convalescent plasma or hyperimmune immunoglobulin for people with COVID‐19: a living systematic review. Cochrane Database of Systematic Reviews 2020;(7):CD013600

In this Cochrane rapid review, the authors searched for studies that evaluated convalescent plasma or hyperimmune immunoglobulin for people with COVID‐19, irrespective of disease severity, age, gender or ethnicity. They did not restrict their searches by type or language of publication and searched for articles published between 1 January 2019 and 23 April 2020. In the 10 July 2020 version of this living review (10 July 2020) they included 1 randomized trial, 3 non-randomized, controlled studies and 16 non-controlled non-randomized studies (total: 5443 participants of whom 5211 received convalescent plasma). The overall risk of bias within the included studies was determined as high. The authors also identified a further 98 ongoing studies, of which 50 were randomized trials. A podcast is available here.

Citation: Rajendran K, Narayanasamy K, Rangarajan J, et al. Convalescent plasma transfusion for the treatment of COVID‐19: Systematic review. Journal of Medical Virology. 2020 May 1.

In this rapid review, the authors searched for studies of the effects of convalescent plasma transfusions for COVID-19 patients. The restricted their search to articles published between 1 December 2019 and 19 April 2020. They did not restrict their searches by language of publication. They included 5 studies from Asia (total: 27 patients), including 1 pilot study and 4 descriptive studies.

Citation: Devasenapathy N, Ye Z, Loeb M, et al. Efficacy and safety of convalescent plasma for severe COVID-19 based on evidence in other severe respiratory viral infections: a systematic review and meta-analysis. CMAJ. 2020 Jul 06;192(27):E745-55.

In this systematic review and meta-analysis, the authors searched for studies of the effects of convalescent plasma in severe respiratory infections (including coronavirus, influenza and Ebola infections). They completed their searches in March 2020 and included 4 randomized trials, 1 prospective non-randomized study, and 1 retrospective cohort study. None of the studies included COVID-19 patients.

Citation: Mair-Jenkins J, Saavedra-Campos M, Baillie JK, et al. The effectiveness of convalescent plasma and hyperimmune immunoglobulin for the treatment of severe acute respiratory infections of viral etiology: a systematic review and exploratory meta-analysis. The Journal of infectious diseases. 2015 Jan 1;211(1):80-90.

In this systematic review and meta-analysis, the authors searched for studies assessing the effects of convalescent plasma or hyperimmune immunoglobulin for the treatment of severe acute viral respiratory infections in hospitalised patients. They did not restrict their searches by language or date of publication and did the search in July 2013. They included 32 studies in the narrative synthesis, of which 27 were included in the meta-analysis.

Other Reviews of this Topic:

Citation: Sun M, Xu Y, He H, et al. Potential effective treatment for COVID-19: systematic review and meta-analysis of the severe infectious disease with convalescent plasma therapy. International Journal of Infectious Diseases. 2020 Sep;98:334-46

 

Disclaimer: This summary has been written by staff and volunteers of Evidence Aid in order to make the content of the original document accessible to decision makers who are searching for the available evidence on the coronavirus (COVID-19) but may not have the time, initially, to read the original report in full. This summary is not intended as a substitute for the medical advice of physicians, other health workers, professional associations, guideline developers, or national governments and international agencies. If readers of this summary think that the evidence that is presented within it is relevant to their decision-making they should refer to the content and details of the original article, and the advice and guidelines offered by other sources of expertise, before making decisions. Evidence Aid cannot be held responsible for any decisions made about the coronavirus (COVID-19) on the basis of this summary alone.

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