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.
Betacoronavirus
/ pathogenicity
COVID-19
Clinical Trials as Topic
Coronavirus Infections
/ physiopathology
Evidence-Based Medicine
Humans
Immunization, Passive
Influenza, Human
/ physiopathology
Pandemics
Pneumonia, Viral
/ physiopathology
Respiratory Tract Infections
/ physiopathology
Risk Assessment
SARS-CoV-2
Treatment Outcome
COVID-19 Serotherapy
Journal
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
ISSN: 1488-2329
Titre abrégé: CMAJ
Pays: Canada
ID NLM: 9711805
Informations de publication
Date de publication:
06 07 2020
06 07 2020
Historique:
accepted:
01
05
2020
pubmed:
24
5
2020
medline:
18
7
2020
entrez:
24
5
2020
Statut:
ppublish
Résumé
The safety and efficacy of convalescent plasma in severe coronavirus disease 2019 (COVID-19) remain uncertain. To support a guideline on COVID-19 management, we conducted a systematic review and meta-analysis of convalescent plasma in COVID-19 and other severe respiratory viral infections. In March 2020, we searched international and Chinese biomedical literature databases, clinical trial registries and prepublication sources for randomized controlled trials (RCTs) and nonrandomized studies comparing patients receiving and not receiving convalescent plasma. We included patients with acute coronavirus, influenza and Ebola virus infections. We conducted a meta-analysis using random-effects models and assessed the quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Of 1099 unique records, 6 studies were eligible, and none of these included patients with COVID-19. One nonrandomized study ( Studies of non-COVID-19 severe respiratory viral infections provide indirect, very low-quality evidence that raises the possibility that convalescent plasma has minimal or no benefit in the treatment of COVID-19 and low-quality evidence that it does not cause serious adverse events.
Sections du résumé
BACKGROUND
The safety and efficacy of convalescent plasma in severe coronavirus disease 2019 (COVID-19) remain uncertain. To support a guideline on COVID-19 management, we conducted a systematic review and meta-analysis of convalescent plasma in COVID-19 and other severe respiratory viral infections.
METHODS
In March 2020, we searched international and Chinese biomedical literature databases, clinical trial registries and prepublication sources for randomized controlled trials (RCTs) and nonrandomized studies comparing patients receiving and not receiving convalescent plasma. We included patients with acute coronavirus, influenza and Ebola virus infections. We conducted a meta-analysis using random-effects models and assessed the quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.
RESULTS
Of 1099 unique records, 6 studies were eligible, and none of these included patients with COVID-19. One nonrandomized study (
INTERPRETATION
Studies of non-COVID-19 severe respiratory viral infections provide indirect, very low-quality evidence that raises the possibility that convalescent plasma has minimal or no benefit in the treatment of COVID-19 and low-quality evidence that it does not cause serious adverse events.
Identifiants
pubmed: 32444482
pii: cmaj.200642
doi: 10.1503/cmaj.200642
pmc: PMC7828893
doi:
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
E745-E755Informations de copyright
© 2020 Joule Inc. or its licensors.
Déclaration de conflit d'intérêts
Competing interests: Mark Loeb has received personal fees and nonfinancial support from Sanofi, nonfinancial support from the World Health Organization, grant funding and personal fees from Seqirus, and personal fees from Pfizer, Medicago and the National Institutes of Health. Philippe Bégin is the co–principal investigator of a multicentre randomized controlled trial investigating the use of convalescent plasma in coronavirus disease 2019 (COVID-19). Philippe Bégin reports personal fees from Novartis, Pfizer, Sanofi, ALK and Aralez, as well as grants from DBV Technologies, Regeneron and Sanofi outside the submitted work. No other competing interests were declared.
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