Early Convalescent Plasma Therapy and Mortality Among US Veterans Hospitalized With Nonsevere COVID-19: An Observational Analysis Emulating a Target Trial

{ 'indexed': {'date-parts': [[2024, 3, 21]], 'date-time': '2024-03-21T05:40:55Z', 'timestamp': 1710999655881}, 'reference-count': 32, 'publisher': 'Oxford University Press (OUP)', 'issue': '6', 'funder': [ {'name': 'Department of Veterans Affairs (VA) Office of Research and Development'}, {'name': 'VA-CAUSAL Methods Core'}, {'name': 'VA Boston Healthcare System'}, {'name': 'VA Puget Sound Healthcare System'}, {'name': 'VA Informatics and Computing Infrastructure', 'award': ['VA HSR RES 13–457']}, { 'DOI': '10.13039/100000738', 'name': 'Department of Veterans Affairs', 'doi-asserted-by': 'publisher'}], 'content-domain': {'domain': [], 'crossmark-restriction': False}, 'published-print': {'date-parts': [[2021, 9, 17]]}, 'abstract': '<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Early ' 'convalescent plasma transfusion may reduce mortality in patients with nonsevere coronavirus ' 'disease 2019 ' '(COVID-19).</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>This study ' 'emulates a (hypothetical) target trial using observational data from a cohort of US veterans ' 'admitted to a Department of Veterans Affairs (VA) facility between 1 May and 17 November 2020 ' 'with nonsevere COVID-19. The intervention was convalescent plasma initiated within 2 days of ' 'eligibility. Thirty-day mortality was compared using cumulative incidence curves, risk ' 'differences, and hazard ratios estimated from pooled logistic models with inverse probability ' 'weighting to adjust for ' 'confounding.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Of 11 269 ' 'eligible person-trials contributed by 4755 patients, 402 trials were assigned to the ' 'convalescent plasma group. Forty and 671 deaths occurred within the plasma and nonplasma ' 'groups, respectively. The estimated 30-day mortality risk was 6.5% (95% confidence interval ' '[CI], 4.0%–9.7%) in the plasma group and 6.2% (95% CI, 5.6%–7.0%) in the nonplasma group. The ' 'associated risk difference was 0.30% (95% CI, −2.30% to 3.60%) and the hazard ratio was 1.04 ' '(95% CI, ' '.64–1.62).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Our ' 'target trial emulation estimated no meaningful differences in 30-day mortality between ' 'nonsevere COVID-19 patients treated and untreated with convalescent ' 'plasma.</jats:p><jats:p>Clinical Trials Registration. NCT04545047.</jats:p></jats:sec>', 'DOI': '10.1093/infdis/jiab330', 'type': 'journal-article', 'created': {'date-parts': [[2021, 6, 19]], 'date-time': '2021-06-19T11:08:01Z', 'timestamp': 1624100881000}, 'page': '967-975', 'source': 'Crossref', 'is-referenced-by-count': 14, 'title': 'Early Convalescent Plasma Therapy and Mortality Among US Veterans Hospitalized With Nonsevere ' 'COVID-19: An Observational Analysis Emulating a Target Trial', 'prefix': '10.1093', 'volume': '224', 'author': [ { 'ORCID': 'http://orcid.org/0000-0003-1727-7076', 'authenticated-orcid': False, 'given': 'Kelly', 'family': 'Cho', 'sequence': 'first', 'affiliation': [ { 'name': 'Massachusetts Veterans Epidemiology Research and Information ' 'Center, Department of Veterans Affairs Office of Research and ' 'Development, Boston, Massachusetts, USA'}, { 'name': 'Department of Medicine, Brigham and Women’s Hospital, Harvard ' 'Medical School, Boston, Massachusetts, USA'}]}, { 'given': 'Sarah C', 'family': 'Keithly', 'sequence': 'additional', 'affiliation': [ { 'name': 'Seattle Epidemiologic Research and Information Center, ' 'Department of Veterans Affairs Office of Research and ' 'Development, Seattle, Washington, USA'}]}, { 'given': 'Katherine E', 'family': 'Kurgansky', 'sequence': 'additional', 'affiliation': [ { 'name': 'Massachusetts Veterans Epidemiology Research and Information ' 'Center, Department of Veterans Affairs Office of Research and ' 'Development, Boston, Massachusetts, USA'}]}, { 'ORCID': 'http://orcid.org/0000-0003-1258-7278', 'authenticated-orcid': False, 'given': 'Arin L', 'family': 'Madenci', 'sequence': 'additional', 'affiliation': [ { 'name': 'Departments of Epidemiology and Biostatistics, Harvard T. 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' 'Chan School of Public Health, Boston, Massachusetts, USA'}]}, { 'ORCID': 'http://orcid.org/0000-0002-6700-2129', 'authenticated-orcid': False, 'given': 'Hanna', 'family': 'Gerlovin', 'sequence': 'additional', 'affiliation': [ { 'name': 'Massachusetts Veterans Epidemiology Research and Information ' 'Center, Department of Veterans Affairs Office of Research and ' 'Development, Boston, Massachusetts, USA'}]}, { 'given': 'Helen', 'family': 'Marucci-Wellman', 'sequence': 'additional', 'affiliation': [ { 'name': 'Massachusetts Veterans Epidemiology Research and Information ' 'Center, Department of Veterans Affairs Office of Research and ' 'Development, Boston, Massachusetts, USA'}]}, { 'given': 'Annie', 'family': 'Doubleday', 'sequence': 'additional', 'affiliation': [ { 'name': 'Seattle Epidemiologic Research and Information Center, ' 'Department of Veterans Affairs Office of Research and ' 'Development, Seattle, Washington, USA'}]}, { 'given': 'Eva R', 'family': 'Thomas', 'sequence': 'additional', 'affiliation': [ { 'name': 'Seattle Epidemiologic Research and Information Center, ' 'Department of Veterans Affairs Office of Research and ' 'Development, Seattle, Washington, USA'}]}, { 'given': 'Yojin', 'family': 'Park', 'sequence': 'additional', 'affiliation': [ { 'name': 'Massachusetts Veterans Epidemiology Research and Information ' 'Center, Department of Veterans Affairs Office of Research and ' 'Development, Boston, Massachusetts, USA'}]}, { 'given': 'Yuk-Lam', 'family': 'Ho', 'sequence': 'additional', 'affiliation': [ { 'name': 'Massachusetts Veterans Epidemiology Research and Information ' 'Center, Department of Veterans Affairs Office of Research and ' 'Development, Boston, Massachusetts, USA'}]}, { 'given': 'Jonathan D', 'family': 'Sugimoto', 'sequence': 'additional', 'affiliation': [ { 'name': 'Seattle Epidemiologic Research and Information Center, ' 'Department of Veterans Affairs Office of Research and ' 'Development, Seattle, Washington, USA'}, { 'name': 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Massachusetts, USA'}]}, { 'given': 'Kalpana', 'family': 'Gupta', 'sequence': 'additional', 'affiliation': [ { 'name': 'Boston Healthcare System, Department of Veterans Affairs, ' 'Boston, Massachusetts, USA'}, { 'name': 'Department of Medicine, Boston University School of Medicine, ' 'Boston, Massachusetts, USA'}]}, { 'given': 'Karen', 'family': 'Jeans', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Veterans Affairs Office of Research and ' 'Development, Washington, District of Columbia, USA'}]}, { 'given': 'Molly', 'family': 'Klote', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Veterans Affairs Office of Research and ' 'Development, Washington, District of Columbia, USA'}]}, { 'given': 'Rachel', 'family': 'Ramoni', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Veterans Affairs Office of Research and ' 'Development, Washington, District of Columbia, USA'}]}, { 'given': 'Grant D', 'family': 'Huang', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Veterans Affairs Office of Research and ' 'Development, Washington, District of Columbia, USA'}]}, { 'given': 'Juan P', 'family': 'Casas', 'sequence': 'additional', 'affiliation': [ { 'name': 'Massachusetts Veterans Epidemiology Research and Information ' 'Center, Department of Veterans Affairs Office of Research and ' 'Development, Boston, Massachusetts, USA'}, { 'name': 'Department of Medicine, Brigham and Women’s Hospital, Harvard ' 'Medical School, Boston, Massachusetts, USA'}]}, { 'given': 'David R', 'family': 'Gagnon', 'sequence': 'additional', 'affiliation': [ { 'name': 'Massachusetts Veterans Epidemiology Research and Information ' 'Center, Department of Veterans Affairs Office of Research and ' 'Development, Boston, Massachusetts, USA'}, { 'name': 'Department of Biostatistics, Boston University School of Public ' 'Health, Boston, Massachusetts, USA'}]}, { 'given': 'Miguel A', 'family': 'Hernán', 'sequence': 'additional', 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