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Efficacy and harms of convalescent plasma for treatment of hospitalized COVID-19 patients: a systematic review and meta-analysis.
Piscoya, Alejandro; Ng-Sueng, Luis F; Parra Del Riego, Angela; Cerna-Viacava, Renato; Pasupuleti, Vinay; Thota, Priyaleela; Roman, Yuani M; Hernandez, Adrian V.
Afiliação
  • Piscoya A; Unidad de Revisiones Sistemáticas y Meta-análisis, Guías de Práctica Clínica y Evaluaciones de Tecnologías Sanitarias (URSIGET), Universidad San Ignacio de Loyola, Lima, Peru.
  • Ng-Sueng LF; Hospital Guillermo Kaelin de la Fuente, Lima, Peru.
  • Parra Del Riego A; Unidad de Revisiones Sistemáticas y Meta-análisis, Guías de Práctica Clínica y Evaluaciones de Tecnologías Sanitarias (URSIGET), Universidad San Ignacio de Loyola, Lima, Peru.
  • Cerna-Viacava R; Department of Internal Medicine, Henry Ford Hospital, Detroit, MI, United States.
  • Pasupuleti V; Universidad Peruana de Ciencias Aplicadas, Lima, Peru.
  • Thota P; Universidad Peruana de Ciencias Aplicadas, Lima, Peru.
  • Roman YM; MedErgy Health Group Inc., Yardley, PA, United States.
  • Hernandez AV; Hemex Health Inc., Portland, OR, United States.
Arch Med Sci ; 17(5): 1251-1261, 2021.
Article em En | MEDLINE | ID: mdl-34522254
INTRODUCTION: We systematically reviewed benefits and harms of convalescent plasma (CP) in hospitalized COVID-19 patients. MATERIAL AND METHODS: Randomized controlled trials (RCTs) and observational studies assessing CP effects on hospitalized, adult COVID-19 patients were searched until November 24, 2020. We assessed risk of bias (RoB) using Cochrane RoB 2.0 and ROBINS-I tools. Inverse variance random effect meta-analyses were performed. Quality of evidence was evaluated using GRADE methodology. Primary outcomes were all-cause mortality, clinical improvement, and adverse events. RESULTS: Five RCTs (n = 1067) and 6 cohorts (n = 881) were included. Three and 1 RCTs had some concerns and high RoB, respectively; and there was serious RoB in all cohorts. Convalescent plasma did not reduce all-cause mortality in RCTs of severe (RR = 0.60, 95% CI: 0.33-1.10) or moderate (RR = 0.60, 95% CI: 0.09-3.86) COVID-19 vs. standard of care (SOC); CP reduced all-cause mortality vs. SOC in cohorts (RR = 0.66, 95% CI: 0.49-0.91). Convalescent plasma did not reduce invasive ventilation vs. SOC in moderate disease (RR = 0.85, 95% CI: 0.47-1.55). In comparison to placebo + SOC, CP did not affect all-cause mortality (RR = 0.75, 95% CI: 0.48-1.16) or clinical improvement (HR = 1.07, 95% CI: 0.82-1.40) in severe patients. Adverse and serious adverse events were scarce, similar between CP and controls. Quality of evidence was low or very low for most outcomes. CONCLUSIONS: In comparison to SOC or placebo + SOC, CP did not reduce all-cause mortality in RCTs of hospitalized COVID-19 patients. Convalescent plasma did not have an effect on other clinical or safety outcomes. Until now there is no good quality evidence to recommend CP for hospitalized COVID-19 patients.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Clinical_trials / Observational_studies / Systematic_reviews Idioma: En Revista: Arch Med Sci Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Peru País de publicação: Polônia
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Clinical_trials / Observational_studies / Systematic_reviews Idioma: En Revista: Arch Med Sci Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Peru País de publicação: Polônia