Efficacy and Safety of Convalescence Plasma Therapy in COVID-19 Patients: A Systematic Review and Meta-Analysis

Abstract

Background. The coronavirus disease 2019 (COVID-19) has outbroken into a global pandemic. The death rate for hospital patients varied between 11% and 15%. Although COVID-19 is extremely contagious and has a high fatality rate, the amount of knowledge available in the published literature and public sources is rapidly growing. The efficacy of convalescent plasma (CP) therapy for COVID-19 is controversial. Objective. This meta-analysis was designed to assess the efficacy of CP therapy for COVID-19 through a literature survey. Methods. Until August 30, 2021, a literature search was undertaken in Pubmed, Embase, Web of Science, Cochrane Central Register of Controlling Trials (Central), and China National Knowledge Infrastructure databases. The Risk Ratio (RR) and 95% confidence intervals (CIs) were pooled using a fixed or random effect model in dichotomous data. Mean difference (MD) and 95% confidence intervals (CIs) were pooled using a fixed or random effect model in continuous data. Studies with missing or unsuitable data were presented descriptively in the outcomes. Results. In total, thirteen randomized controlled trials (RCTs) were selected for the present meta-analysis, which included a total of 13232 participants. Our results revealed that the CP group has lower mortality compared to the control group, and there was a statistically significant difference (RR: 0.70, 95% CI: 0.55, 0.89, Z = 2.92, P = 0.004 < 0.01 ); other secondary outcomes such as the shortness of breath symptom improved significantly in CP group (RR:1.48, 95% CI: 1.13, 1.93, Z = 2.85, P = 0.004 < 0.01 ), as well as Interleukin-6 (IL-6) (MD: −4.46, 95% CI: −8.28, −0.63, Z = 2.28, P = 0.02 < 0.05 ) and Ferritin (MD: −447.68, 95% CI: −501.75, −393.6, Z = 16.23, P < 0.00001 ) are reduced significantly in CP group. However, there was no statistically significant change in the ventilator withdrawal rate, imaging results improvement, or days to hospital discharge. There was also no substantial difference in viral nucleic acid negative conversion rate and neutralizing antibody-positive conversion rate, as well as the incidence of adverse reactions. Conclusions. The safety and potential efficacy of convalescent plasma therapy offer a promising treatment strategy for COVID-19. CP therapy can reduce mortality and improve breath and inflammatory cytokines IL-6 and Ferritin in COVID-19 with no significant increase in adverse reactions. However, it does not affect improving virology indicators. In summary, more high-quality clinical trials are needed to verify the conclusion of the present study.

Effectiveness of COVID-19 Convalescent Plasma (CCP) During the Pandemic Era: A Literature Review

“…The SARS-CoV-2, a current recruit among coronavirus family with the most recent outbreak and designated with COVID-19. 1 The worldwide epidemic has been reported due to COVID-19 2 and, the WHO proclaimed worldwide pandemic immediately after its development and subsequent spread among human population during 2019. Around 4.4 million people have perished from virus affects, and infected with a minimum of 215 million.…”

“… 3 At that movement, WHO stated on March 11, 2020, the spread of COVID-19 may pose significant and ongoing problems to the entire globe. 2 …”

“…5 In addition to affecting people’s daily lives, the SARS-CoV-2 infection also led to organ damage. An evidence reported that the SARS-CoV-2 either directly or indirectly promotes inflammasomes and, by inducing pyroptosis, an inflammatory form of cell demise, and aggravating tissue injury with endothelial malfunction, vasodilation and, the inflammatory cytokines may promote tissue damage and, the patient may exhibit with several clinical manifestations, 2 , 6 and multiple-organ failure may occur as a severe side effect of this inflammatory reaction. 2 …”

“…Moreover, the amount of knowledge accessible in literary texts and official sources is steadily growing, despite the reality that COVID-19 is extremely contagious and has a high death rate. 2 Since late 2019, COVID-19 has become a concern for public health all around the world, and there has been a significant amount of debate and research towards finding a solution. Although, few strategies have proven to be effective, while others have failed.…”

“… The results thus indicate both the curative use of currently available Abs-based therapies, including the continuing use of CCP transfusion procedures, and the use of diverse vaccine portals in a prophylactic way. Rongjuan Dai et al 2 The SR and MA of CPT’s safety and efficacy in COVID-19 subjects (Review) Databases from the Cochrane Central Register of Controlling Trials, PubMed, Embase, Web of Science, and China National Knowledge Infrastructure. 13 RCTs with a total of 13,232 participants According to the study’s findings, there was a reduced MR in the CP group and an SS difference between the DR of the 2 groups compared to the CG (RR: 0.70, 95% CI: 0.55, 0.89, Z = 2.92, P < 0.004 0.01).…”