Open AccessConvalescent Plasma—A Light at the End of the Tunnel: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Author(s) -
Soumya Sarkar,
Puneet Khanna,
Akhil Kant Singh
Publication year - 2021
Publication title -
indian journal of critical care medicine/indian journal of critical care medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.317
H-Index - 30
eISSN - 1998-359X
pISSN - 0972-5229
DOI - 10.5005/jp-journals-10071-24023
Subject(s) - medicine , confidence interval , randomized controlled trial , meta analysis , odds ratio , covid-19 , disease , infectious disease (medical specialty)
In the absence of a definitive therapy during this ongoing unprecedented crisis, coronavirus disease-2019 (COVID-19) pandemic, convalescent plasma transfusion (CPT) has shown some promising results. This review summarizes the existing evidence of the efficacy of CPT in COVID-19 patients based upon scientific publications to date. We have included only the randomized controlled trials (RCTs) through an extensive screening of electronic databases up to July 31, 2021. In 19 RCTs, with a total of 16,476 COVID-19 patients we found low-quality evidence of significant reduction in mortality (odds ratio (OR) = 0.80; 95% confidence interval (CI): 0.66-0.96, I 2 = 40%), better clinical outcome when applied <7 days (OR = 2.13, 95% CI 1.28-3.53, I 2 = 0%), and improved viral clearance (OR = 2.6, 95% CI: 1.3-5.45, I 2 = 74%). Meta-regression analysis found that as a covariate, intubation on admission ( p = 0.007) had a significant impact. However, there was any significant reduction neither in duration for clinical improvement (MD = -0.79, 95% CI: -2.76-1.18, I 2 = 98%), nor in total period of hospital stay (MD = 0.02, 95% CI: -0.75-0.78, I 2 = 81%). Early application of CPT is still relevant in reducing morbidity and mortality in critically ill patients and is too early to write it off as a potential therapeutic modality for COVID-19 patients.