Multi-center matched cohort study of convalescent plasma for hospitalized patients with COVID-19

Zhou, Cindy Ke; Villa, Carlos H.; Hammonds, Kendall; Lu, Yun; Ettlinger, Jason; Priest, Elisa L.; Gottlieb, Robert L; Davis, Steven J.; Mays, Edward; Clarke, Tainya C.; Shoaibi, Azadeh; Wong, Hui-Lee; Anderson, Steven A.; Kelly, Ronan J.

doi:10.1371/journal.pone.0273223

Cited by 5 publications

(3 citation statements)

References 45 publications

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“…Besides the above-mentioned signals of CCP efficacy in many RCTs, a recent RCT showed a statistically significant mortality reduction in a subgroup of critically ill COVID-19 patients under invasive mechanical ventilation treated early (within 5 days from intubation) with CCP in comparison with placebo [32]. The interesting finding of the clinical efficacy of an antibody-based therapy in mechanically ventilated severe COVID-19 patients has been already observed in previous trials [28][29][30][33][34][35][36] and it is probably related to a SARS-CoV-2-induced early acute respiratory distress syndrome (ARDS) rather than to an inflammatory-related late ARDS.…”

Section: Hospitalized Patientsmentioning

confidence: 67%

Hyperimmune Plasma and Immunoglobulins against COVID-19: A Narrative Review

Franchini,

Focosi

2024

Life

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Since late 2019, the new SARS-CoV-2 virus belonging to the Coronaviridae family has been responsible for COVID-19 pandemic, a severe acute respiratory syndrome. Several antiviral therapies, mostly derived from previous epidemics, were initially repurposed to fight this not rarely life-threatening respiratory illness. Among them, however, the only specific antibody-based therapy available against SARS-CoV-2 infection during the first year of the pandemic was represented by COVID-19 convalescent plasma (CCP). CCP, collected from recovered individuals, contains high levels of polyclonal antibodies of different subclasses able to neutralize SARS-CoV-2 infection. Tens of randomized controlled trials have been conducted during the last three years of the pandemic to evaluate the safety and the clinical efficacy of CCP in both hospitalized and ambulatory COVID-19 patients, whose main results will be summarized in this narrative review. In addition, we will present the current knowledge on the development of anti-SARS-CoV-2 hyperimmune polyclonal immunoglobulins.

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Section: Hospitalized Patientsmentioning

confidence: 67%

Hyperimmune Plasma and Immunoglobulins against COVID-19: A Narrative Review

Franchini,

Focosi

2024

Life

View full text Add to dashboard Cite

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“…Besides the above-mentioned signals of CCP efficacy in many RCTs, a recent RCT showed a statistically significant mortality reduction in a subgroup of critically ill COVID-19 patients under invasive mechanical ventilation treated early (within 5 days from intubation) with CCP in comparison to placebo [38]. The interesting finding of the clinical efficacy of an antibody-based therapy in mechanically ventilated severe COVID-19 patients has been already observed in previous trials [34][35][36][39][40][41][42] and it is probably related to a SARS-CoV-2-induced early acute respiratory distress syndrome (ARDS) rather than to an inflammatory-related late ARDS.…”

Section: Study Year [Reference]mentioning

confidence: 84%

Hyperimmune Plasma and Immunoglobulins Against COVID-19: A Narrative Review

Franchini,

Focosi

2023

Preprint

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Since late 2019, COVID-19, a severe acute respiratory syndrome pandemic, was caused by the new SARS-CoV-2 virus belonging to the Coronaviridae family, . Several antiviral therapies, mostly derived from previous epidemics, were initially repurposed to fight this not rarely life-threatening respiratory illness. Among them, however, the only specific antibody-based therapy available against SARS-CoV-2 infection during the first year of the pandemic was represented by COVID-19 convalescent plasma (CCP). CCP, collected from recovered individuals, contains high levels of polyclonal antibodies of different subclasses able to neutralize SARS-CoV-2 infection. Tens of randomized controlled trials have been conducted during the last three years of the pandemic to evaluate the safety and the clinical efficacy of CCP in both hospitalized and ambulatory COVID-19 patients, whose main results will be summarized in this narrative review. In addition, we will present the current knowledge on the development of anti-SARS-CoV-2 hyperimmune polyclonal immunoglobulins.

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“…The process of study selection is represented in the PRISMA flow diagram (Figure 1) . Thirty-nine randomized clinical trials 10-48 enrolling 21,529 participants and 70 matched cohort studies 2,59-127 enrolling 50,160 participants were included in the primary analyses. Although controlled studies were the focus of this systematic review and meta-analysis, secondary analyses on COVID-19 convalescent plasma antibody levels and timing of COVID-19 convalescent plasma transfusion encompass findings from case series, as delineated below.…”

Section: Resultsmentioning

confidence: 99%

Mortality rates among hospitalized patients with COVID-19 treated with convalescent plasma A Systematic review and meta-analysis

Senefeld

Gorman

Johnson

et al. 2023

Preprint

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IMPORTANCE. Many hospitalized patients with COVID-19 have been treated with convalescent plasma. However, it is uncertain whether this therapy lowers mortality and if so, if the mortality benefit is larger among specific subgroups, such as recipients of plasma with high antibody content and patients treated early in the disease course. OBJECTIVE. To examine the association of COVID-19 convalescent plasma transfusion with mortality and the differences between subgroups in hospitalized patients with COVID-19. DATA SOURCES. On October 26, 2022, a systematic search was performed for clinical studies of COVID-19 convalescent plasma in the literature. STUDY SELECTION. Randomized clinical trials and matched cohort studies investigating COVID-19 convalescent plasma transfusion compared with standard of care treatment or placebo among hospitalized patients with confirmed COVID-19 were included. The electronic search yielded 3,841 unique records, of which 744 were considered for full-text screening. The selection process was performed independently by a panel of five reviewers. DATA EXTRACTION AND SYNTHESIS. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data were extracted by 5 independent reviewers in duplicate and pooled using inverse-variance random-effects model. MAIN OUTCOMES AND MEASURES. Prespecified end point was all-cause mortality during hospitalization. RESULTS. Thirty-nine randomized clinical trials enrolling 21,529 participants and 70 matched cohort studies enrolling 50,160 participants were included in the systematic review. Separate meta-analyses demonstrated that transfusion of COVID-19 convalescent plasma was associated with a significant decrease in mortality compared with the control cohort for both randomized clinical trials (odds ratio (OR), 0.87 [95% CI, 0.76-1.00]) and matched cohort studies (OR, 0.77 [95% CI, 0.64-0.94]). Meta-analysis of subgroups revealed two important findings. First, treatment with convalescent plasma containing high antibody levels was associated with a decrease in mortality compared to convalescent plasma containing low antibody levels (OR, 0.85 [95% CI, 0.73 to 0.99]). Second, earlier treatment with COVID-19 convalescent plasma was associated with a significant decrease in mortality compared with the later treatment cohort (OR, 0.63 [95% CI, 0.48 to 0.82]). CONCLUSIONS AND RELEVANCE. COVID-19 convalescent plasma use was associated with a 13% reduced risk in mortality, implying a mortality benefit for hospitalized patients with COVID-19, particularly those treated with convalescent plasma containing high antibody levels treated earlier in the disease course.

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Multi-center matched cohort study of convalescent plasma for hospitalized patients with COVID-19

Cited by 5 publications

References 45 publications

Hyperimmune Plasma and Immunoglobulins against COVID-19: A Narrative Review

Hyperimmune Plasma and Immunoglobulins against COVID-19: A Narrative Review

Hyperimmune Plasma and Immunoglobulins Against COVID-19: A Narrative Review

Mortality rates among hospitalized patients with COVID-19 treated with convalescent plasma A Systematic review and meta-analysis

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