Convalescent plasma may not be an effective treatment for severe and critically ill covid-19 patients: A Systematic Review & Meta-Analysis of Randomized Controlled Trials.
Penglei Yang, Jing Wang, Ruiqiang Zheng and 8 others
PMID 35149308WHAT IT FOUND
Convalescent plasma did not significantly improve symptoms or reduce mortality in severe or critically ill COVID-19.
Hospital discharge timing and discharge rate also showed no significant difference.
Key findings
01Convalescent plasma did not significantly increase clinical improvement or reduce mortality compared with control.
02Convalescent plasma did not significantly reduce time to hospital discharge or increase discharge rate.
03Subgroup analyses showed no significant benefit for clinical improvement or mortality in either severe or critically ill patients.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The included trials varied in plasma dose, timing, antibody titer, and control treatment, so the pooled result may not apply to one specific protocol. Control care was not uniform across countries and resource settings. None of the included studies had a large cohort adequately powered across diverse populations. Mortality showed publication bias, and trial sequential analysis did not reach the required sample size. The analysis did not account for new coronavirus variants. Some respiratory support and hospital discharge data could not be converted for meta-analysis. The included patient count was 4543, but trial sequential analysis reported an actual sample size of 4290.
Declared interests
The authors declared no competing interests.
The easy way to misread this
Do not read the mortality risk ratio of 0.94 as evidence that convalescent plasma reduces death. The 95% confidence interval was 0.85 to 1.03, p = 0.18, and trial sequential analysis did not reach the required sample size.