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0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ INFANT-COVID-19 Libster (DB RCT) 50% 0.50 [0.09-2.65] death 2/80 4/80 Improvement, RR [CI] Treatment Control Balcells (RCT) -247% 3.47 [0.35-11.9] death 5/28 2/30 Korley (RCT) -396% 4.96 [0.58-42.2] death 5/250 1/248 Alemany (DB RCT) 80% 0.20 [0.01-4.14] death 0/188 2/188 Gharbharan (DB RCT) -1% 1.01 [0.06-16.0] death 1/207 1/209 Tau​2 = 0.49, I​2 = 30.4%, p = 0.6 Early treatment -36% 1.36 [0.44-4.17] 13/753 10/755 -36% improvement Gharbharan (RCT) 4% 0.96 [0.25-2.41] death 6/43 11/43 Improvement, RR [CI] Treatment Control Li (RCT) 35% 0.65 [0.27-1.39] death 8/51 12/50 Avendaño-Solà (RCT) 88% 0.12 [0.01-2.11] death 0/38 4/43 PLACID Agarwal (RCT) -7% 1.07 [0.73-1.58] death 34/235 31/229 Bajpai (RCT) -323% 4.23 [0.43-41.6] death 3/14 1/15 AlQahtani (RCT) 50% 0.50 [0.05-5.08] death 1/20 2/20 PlasmAr Simonovich (RCT) 4% 0.96 [0.50-1.83] death 25/228 12/105 Ray (RCT) 33% 0.67 [0.30-1.50] death 10/40 14/40 RECOVERY Recovery Co.. (RCT) 0% 1.00 [0.93-1.07] death 1,399/5,795 1,408/5,763 Gonzalez -7% 1.07 [0.76-1.50] death 60/130 26/60 OT​1 Pouladza.. (SB RCT) 40% 0.60 [0.16-2.29] death 3/30 5/30 Bennett-.. (DB RCT) 19% 0.81 [0.36-1.86] death 16/59 5/15 PLACOVID Sekine (RCT) -38% 1.38 [0.73-2.63] death 18/80 13/80 CAPRI Hsue (DB RCT) -212% 3.12 [0.14-71.7] death 1/16 0/18 DAWn-plasma Devos (RCT) 1% 0.99 [0.52-1.88] death 320 (n) 163 (n) CONCOR-1 Bégin (RCT) -13% 1.13 [0.88-1.45] death 156/625 69/313 CAPSID Körper (RCT) 37% 0.63 [0.33-1.22] death 11/53 17/52 TSUNAMI Menichetti (RCT) 23% 0.77 [0.39-1.49] death 14/231 19/240 Holm (RCT) 45% 0.55 [0.11-2.84] death 2/17 3/14 CONTAIN COVID-19 Ortigoza (DB RCT) 12% 0.88 [0.63-1.20] death 59/462 71/462 PennCCP2 Bar (RCT) 81% 0.19 [0.04-0.84] death 40 (n) 39 (n) Sullivan (DB RCT) 86% 0.14 [0.01-2.75] death 0/592 3/589 Jalili (RCT) -45% 1.45 [0.74-2.87] death 16/60 11/60 Baldeón (DB RCT) 12% 0.88 [0.37-2.11] death 7/63 12/95 PROTECT-Patient van den Berg (RCT) 17% 0.83 [0.41-1.68] death 11/52 13/51 De Santis (RCT) 13% 0.87 [0.48-1.56] death 11/36 25/71 Rojas (SB RCT) -220% 3.20 [0.64-16.0] death 46 (n) 45 (n) COOP-COVID-19-MCTI Song (RCT) -52% 1.52 [0.70-3.27] death 22/87 7/42 CORIPLASM Lacombe (RCT) 49% 0.51 [0.20-1.32] death 7/60 12/60 Raad -240% 3.40 [2.29-5.02] death 284 (n) 3,682 (n) CCAP-2 Thorlaci.. (DB RCT) -76% 1.76 [0.62-5.01] death 15/98 4/46 REMAP-CAP Higgins (RCT) 1% 0.99 [0.86-1.14] death 370/944 324/790 ICU patients Denkinger (RCT) 8% 0.92 [0.75-1.11] death 68 (n) 66 (n) CSSC-004 Baksh (DB RCT) -1% 1.01 [0.94-1.09] no recov. 381/538 381/532 Tau​2 = 0.02, I​2 = 49.5%, p = 0.46 Late treatment -4% 1.04 [0.94-1.15] 2,666/11,455 2,515/13,923 -4% improvement All studies -4% 1.04 [0.94-1.16] 2,679/12,208 2,525/14,678 -4% improvement 39 convalescent plasma COVID-19 studies c19early.org/cp Feb 2023 Tau​2 = 0.02, I​2 = 47.0%, p = 0.41 Effect extraction pre-specified(most serious outcome) 1 OT: comparison with other treatment Favors conv. plasma Favors control
Convalescent Plasma COVID-19 studies. Recent:
Baksh
Holm
Gonzalez
Körper
Pouladzadeh
Sekine
Denkinger.
Convalescent Plasma has been officially adopted for early treatment in 1 country. Submit updates/corrections.
Jan 31
Baksh et al., The Journal of Infectious Diseases, doi:10.1093/infdis/jiad023 Symptom duration and resolution with early outpatient treatment of convalescent plasma for COVID- 19: a randomized trial
1% worse recovery [p=0.62]. RCT 1,070 outpatients in the USA, showing no significant difference in recovery with convalescent plasma treatment.
Dec 29
Denkinger et al., Nature Cancer, doi:10.1038/s43018-022-00503-w Anti-SARS-CoV-2 antibody-containing plasma improves outcome in patients with hematologic or solid cancer and severe COVID-19: a randomized clinical trial
8% lower mortality [p=0.39], 2% higher ventilation [p=1], and 22% improved 7-point scale results [p=0.22]. RCT 134 hospitalized patients showing no significant difference in outcomes with convalescent plasma for all patients, however significantly improved mortality and time to improvement was seen for patients with cancer.
Dec 16
Higgins et al., JAMA, doi:10.1001/jama.2022.23257 Long-term (180-Day) Outcomes in Critically Ill Patients With COVID-19 in the REMAP-CAP Randomized Clinical Trial
1% lower mortality [p=0.9]. Long-term followup for the REMAP-CAP very late stage ICU trial, showing no significant difference with convalescent plasma treatment.
Sep 30
Thorlacius-Ussing et al., Scientific Reports, doi:10.1038/s41598-022-19629-z A randomized placebo-controlled trial of convalescent plasma for adults hospitalized with COVID-19 pneumonia
76% higher mortality [p=0.43], 31% higher ICU admission [p=0.77], and 41% worse 7-point scale results [p=0.32]. RCT 147 patients in Denmark, showing no significant difference in outcomes with convalescent plasma. The trial was terminated due to futility.
Aug 26
Raad et al., medRxiv, doi:10.1101/2022.08.25.22279181 (Preprint) International Multicenter Study Comparing Cancer to Non-Cancer Patients with COVID-19: Impact of Risk Factors and Treatment Modalities on Survivorship
240% higher mortality [p<0.0001]. Retrospective 3,966 COVID-19 patients, 1,115 with cancer, showing lower mortality with remdesivir and higher mortality with convalescent plasma.
Aug 23
Gharbharan et al., Clinical Microbiology and Infection, doi:10.1016/j.cmi.2022.08.005 Outpatient convalescent plasma therapy for high-risk patients with early COVID-19. A randomized placebo-controlled trial
14% lower progression [p=0.42], 39% lower hospitalization [p=0.22], and 1% worse recovery [p=0.92]. RCT 416 outpatients in the Netherlands, showing no significant difference with convalesent plasma treatment. Hospitalization was lower, and improved results were seen with ≤5 days of symptoms, without statistical significance.
Aug 10
Lacombe et al., medRxiv, doi:10.1101/2022.08.09.22278329 (Preprint) COVID-19 convalescent plasma to treat hospitalised COVID-19 patients with or without underlying immunodeficiency
49% lower mortality [p=0.16], 68% higher progression [p=0.18], and 7% longer hospitalization [p=0.99]. RCT 120 hospitalized patients in France, showing no significant difference in outcomes with convalescent plasma treatment, with the exception of lower mortality in the subgroup of immunosuppressed patients.
Jun 30
Song et al., The Lancet Regional Health - Americas, doi:10.1016/j.lana.2022.100216 Treatment of severe COVID-19 patients with either low- or high-volume of convalescent plasma versus standard of care: A multicenter Bayesian randomized open-label clinical trial (COOP-COVID-19-MCTI)
52% higher mortality [p=0.37]. RCT 129 severe COVID-19 patients in Brazil, showing no significant difference in outcomes with convalescent plasma.
Jun 27
Rojas et al., BMC Infectious Diseases, doi:10.1186/s12879-022-07560-7 Safety and efficacy of convalescent plasma for severe COVID-19: a randomized, single blinded, parallel, controlled clinical study
220% higher mortality [p=0.16], 38% higher hospital discharge [p=0.04], and 25% worse viral clearance [p=0.72]. RCT 91 hospitalized patients in Colombia showing shorter time to discharge with convalescent plasma, but higher mortality (without statistical significance).
Mar 31
De Santis et al., Emerging Infectious Diseases, doi:10.3201/eid2803.212299 High-Dose Convalescent Plasma for Treatment of Severe COVID-19
13% lower mortality [p=0.67]. RCT 110 hospitalized patients in Brazil, showing no significant difference in outcomes with high-dose convalescent plasma.
Feb 15
van den Berg et al., Scientific Reports, doi:10.1038/s41598-022-06221-8 Convalescent plasma in the treatment of moderate to severe COVID-19 pneumonia: a randomized controlled trial (PROTECT-Patient Trial)
17% lower mortality [p=0.65], 67% lower ventilation [p=0.36], 5% better improvement [p=1], and 3% lower hospital discharge [p=1]. RCT 103 hospitalized patients in South Africa, showing no significant difference in outcomes with convalescent plasma.
Feb 9
Alemany et al., The Lancet Respiratory Medicine, doi:10.1016/S2213-2600(21)00545-2 High-titre methylene blue-treated convalescent plasma as an early treatment for outpatients with COVID-19: a randomised, placebo-controlled trial
80% lower mortality [p=0.5], 5% higher hospitalization [p=1], 5% worse recovery [p=0.67], and 4% worse viral clearance [p=0.33]. RCT 188 convalescent plasma and 188 control patients, showing no significant difference in outcomes.
Jan 9
Baldeón et al., Transfusion Medicine, doi:10.1111/tme.12851 Effect of convalescent plasma as complementary treatment in patients with moderate COVID-19 infection
12% lower mortality [p=1]. RCT 158 patients in Ecuador, showing no significant difference in mortality with convalescent plasma. Authors note indications of improved results for earlier treatment.
Jan 1
Jalili et al., Tanaffos 21:1 Effect of Convalescent Plasma Therapy on Clinical Improvement of COVID-19 Patients: A Randomized Clinical Trial
45% higher mortality [p=0.38], 8% higher ICU admission [p=0.85], 250% higher ARDS [p=0.16], and 10% longer hospitalization [p=0.39]. RCT 120 hospitalized patients in Iran, showing no significant differences with convalescent plasma treatment.
Dec 21
2021
Sullivan et al., New England Journal of Medicine, doi:10.1056/NEJMoa2119657 (date from earlier preprint) Early Outpatient Treatment for Covid-19 with Convalescent Plasma
86% lower mortality [p=0.12] and 54% lower hospitalization [p=0.005]. RCT 1,181 outpatients in the USA, mean 6 days from symptom onset, showing lower hospitalization with treatment. NCT04373460.
Dec 15
2021
Bar et al., Journal of Clinical Investigation, doi:10.1172/JCI155114 A randomized controlled study of convalescent plasma for individuals hospitalized with COVID-19 pneumonia
81% lower mortality [p=0.03], 44% better improvement [p=0.18], and 51% lower ventilation [p=0.16]. RCT 79 hospitalized patients in the USA, showing significant benefit in clinical severity score and 28-day mortality with convalescent plasma treatment.
Dec 13
2021
Ortigoza et al., JAMA Internal Medicine, doi:10.1001/jamainternmed.2021.6850 Efficacy and Safety of COVID-19 Convalescent Plasma in Hospitalized Patients
12% lower mortality [p=0.45] and 8% improved 7-point scale results [p=0.5]. RCT 941 hospitalized patients in the USA, showing no significant difference with convalescent plasma treatment.
Dec 4
2021
Holm et al., BMC Research Notes, doi:10.1186/s13104-021-05847-7 Convalescence plasma treatment of COVID-19: results from a prematurely terminated randomized controlled open-label study in Southern Sweden
19% lower progression [p=1], 57% higher need for oxygen therapy [p=0.43], and 62% longer hospitalization [p=0.21]. RCT 31 hospitalized patients requiring supplemental oxygen in Sweden, showing no significant difference in outcomes with convalescent plasma.
Nov 29
2021
Menichetti et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2021.36246 Effect of High-Titer Convalescent Plasma on Progression to Severe Respiratory Failure or Death in Hospitalized Patients With COVID-19 Pneumonia
23% lower mortality [p=0.47], 4% higher ventilation [p=1], and 12% lower progression [p=0.54]. RCT 487 patients in Italy, showing no significant difference in outcomes with convalescent plasma.
Oct 15
2021
Körper et al., Journal of Clinical Investigation, doi:10.1172/JCI152264 Results of the CAPSID randomized trial for high-dose convalescent plasma in patients with severe COVID-19
37% lower mortality [p=0.19] and 16% improved recovery [p=0.32]. RCT 105 hospitalized patients in Germany, 53 treated with convalescent plasma, showing no significant difference in mortality or the primary composite outcome of survival and no longer fulfilling criteria for severe COVID-19 on day 21.
Sep 9
2021
Bégin et al., Nature Medicine, doi:10.1038/s41591-021-01488-2 Convalescent plasma for hospitalized patients with COVID-19: an open-label, randomized controlled trial
13% higher mortality [p=0.33] and 16% higher combined mortality/intubation [p=0.18]. RCT 940 hospitalized patients, 614 assigned to convalescent plasma, showing no significant differences.
Aug 26
2021
Devos et al., European Respiratory Journal, doi:10.1183/13993003.01724-2021 Early high antibody titre convalescent plasma for hospitalised COVID-19 patients: DAWn-plasma
1% lower mortality [p=0.98], 8% higher ventilation [p=0.78], and no change in ICU admission [p=1]. RCT 489 hospitalized COVID-19 patients in Belgium, showing no significant difference in outcomes with convalescent plasma.
Aug 23
2021
Hsue et al., NCT04421404 (Preprint) Effects of COVID-19 Convalescent Plasma (CCP) on Coronavirus-associated Complications in Hospitalized Patients (CAPRI)
425% higher ventilation [p=0.21] and 425% higher progression [p=0.21]. RCT 34 hospitalized patients in the USA, showing no significant difference with convalescent plasma treatment.
Aug 18
2021
Korley et al., NEJM, doi:10.1056/NEJMoa2103784 Early Convalescent Plasma for High-Risk Outpatients with Covid-19
396% higher mortality [p=0.22], 10% lower hospitalization [p=0.59], and 6% lower progression [p=0.7]. RCT 511 emergency department patients, 257 assigned to convalescent plasma, showing no significant difference in outcomes.
Jul 8
2021
Sekine et al., European Respiratory Journal, doi:10.1183/13993003.01471-2021 Convalescent plasma for COVID-19 in hospitalised patients: an open-label, randomised clinical trial
38% higher mortality [p=0.42], 11% worse improvement [p=0.74], and 67% longer hospitalization [p=0.87]. RCT 160 hospitalized patients in Brazil, showing no significant difference in outcomes with convalescent plasma.
Apr 16
2021
Bennett-Guerrero et al., Critical Care Medicine, doi:10.1097/CCM.0000000000005066 Severe Acute Respiratory Syndrome Coronavirus 2 Convalescent Plasma Versus Standard Plasma in Coronavirus Disease 2019 Infected Hospitalized Patients in New York
19% lower mortality [p=0.75] and no change in improvement [p=1]. RCT 74 hospitalized patients in the USA, showing no significant difference with convalescent plasma treatment.
Apr 10
2021
Pouladzadeh et al., Internal and Emergency Medicine, doi:10.1007/s11739-021-02734-8 A randomized clinical trial evaluating the immunomodulatory effect of convalescent plasma on COVID-19-related cytokine storm
30% longer hospitalization [p=0.06]. RCT 62 hospitalized patients in Iran, showing no significant difference in mortality and length of stay with convalescent plasma.
Mar 31
2021
Gonzalez et al., medRxiv, doi:10.1101/2021.03.28.21254507 (Preprint) Efficacy and safety of convalescent plasma and intravenous immunoglobulin in critically ill COVID-19 patients. A controlled clinical trial
7% higher mortality [p=0.76]. RCT 190 hospitalized severe condition patients in Mexico, showing no significant difference between convalescent plasma and human immunoglobulin treatment.
Mar 3
2021
Balcells et al., PLOS Medicine, doi:10.1371/journal.pmed.1003415 Early versus deferred anti-SARS-CoV-2 convalescent plasma in patients admitted for COVID-19: A randomized phase II clinical trial
247% higher mortality [p=0.17], 163% higher ventilation [p=0.22], and 23% higher progression [p=0.51]. Small RCT with 28 early and 30 deferred (treated according to prespecified deterioration criteria) convalescent plasma patients, not showing significant differences. "Early" is relative, with a median of 5 days from symptom onse..
Jan 15
2021
Recovery Collaborative Group, The Lancet, doi:10.1016/S0140-6736(21)00897-7 (press release 1/15/2021) Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial
no change in mortality [p=0.95] and 1% lower hospital discharge [p=0.57]. RCT 16,287 hospitalized patients in the UK, showing no significant differences with convalescent plasma treatment. Subgroup analysis shows better results for those treated <= 7 days from symptom onset.
Jan 6
2021
Libster et al., NEJM, doi:10.1056/NEJMoa2033700 Early High-Titer Plasma Therapy to Prevent Severe Covid-19 in Older Adults
67% lower ICU admission [p=0.17] and 48% lower progression [p=0.03]. RCT 160 patients >=65 with symptom onset <72 hours, 80 treated with convalescent plasma, showing lower progression to severe disease with treatment.
Nov 29
2020
Ray et al., medRxiv, doi:10.1101/2020.11.25.20237883 Clinical and immunological benefits of convalescent plasma therapy in severe COVID-19: insights from a single center open label randomised control trial
33% lower mortality [p=0.34]. Small RCT 80 hospitalized patients in India, 40 treated with convalescent plasma, not showing significant differences in primary analysis. Authors note that significant improvement in hypoxia, reduction in hospital stay, and survival bene..
Nov 24
2020
Simonovich et al., NEJM, doi:0.1056/NEJMoa2031304 A Randomized Trial of Convalescent Plasma in Covid-19 Severe Pneumonia
4% lower mortality [p=1] and 19% improved 7-point scale results [p=0.4]. RCT 333 hospitalized patients in Argentina, 228 treated with convalescent plasma, showing no significant differences in clinical status or mortality.
Nov 4
2020
AlQahtani et al., Scientific Reports, doi:10.1038/s41598-021-89444-5 (date from earlier preprint) Randomized controlled trial of convalescent plasma therapy against standard therapy in patients with severe COVID-19 disease
33% lower ventilation [p=0.47] and 22% shorter hospitalization [p=0.12]. Small RCT with 40 hospitalized patients in Bahrain, 20 treated with convalescent plasma, not showing significant differences. NCT04356534.
Oct 27
2020
Bajpai et al., medRxiv, doi:10.1101/2020.10.25.20219337 (Preprint) Efficacy of Convalescent Plasma Therapy compared to Fresh Frozen Plasma in Severely ill COVID-19 Patients: A Pilot Randomized Controlled Trial
323% higher mortality [p=0.22], 221% higher ventilation [p=0.33], 25% shorter hospitalization [p=0.08], and 32% improved viral clearance [p=0.11]. Small RCT 29 patients in India, 14 treated with convalescent plasma, not showing significant differences with treatment.
Oct 22
2020
Agarwal et al., BMJ, doi:10.1136/bmj.m3939 Convalescent plasma in the management of moderate covid-19 in adults in India: open label phase II multicentre randomised controlled trial (PLACID Trial)
7% higher mortality [p=0.74], 7% higher progression [p=0.74], 1% lower ventilation [p=0.98], and 28% improved viral clearance [p=0.02]. RCT 464 hospitalized patients in India, 235 treated with convalescent plasma, showing no improvement in combined death at 28 days or progression to severe disease.
Sep 29
2020
Avendaño-Solà et al., medRxiv, doi:10.1101/2020.08.26.20182444 Convalescent Plasma for COVID-19: A multicenter, randomized clinical trial
88% lower mortality [p=0.12] and 93% lower progression [p=0.01]. Early terminated RCT with 81 hospitalized patients, 38 treated with convalescent plasma, showing lower progression with treatment. NCT04345523.
Jun 3
2020
Li et al., JAMA, doi:10.1001/jama.2020.10044 Effect of Convalescent Plasma Therapy on Time to Clinical Improvement in Patients With Severe and Life-threatening COVID-19: A Randomized Clinical Trial
35% lower mortality [p=0.3], 15% better improvement [p=0.37], and 76% improved viral clearance [p=0.01]. Small RCT 103 severe condition patients, 52 treated with convalescent plasma, showing improved viral clearance but no statistically significant improvements in mortality or clinical improvement. ChiCTR2000029757.
May 27
2020
Gharbharan et al., Nature Communications, doi:10.1038/s41467-021-23469-2 Effects of potent neutralizing antibodies from convalescent plasma in patients hospitalized for severe SARS-CoV-2 infection
4% lower mortality [p=0.95] and 12% higher hospital discharge [p=0.68]. RCT 86 hospitalized patients, 43 treated with convalescent plasma, showing no significant differences with treatment. Authors conclude that the most likely explanation was already high antibody titers on the day of inclusion, and they rec..
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