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0 0.5 1 1.5 2+ Mortality 35% Improvement Relative Risk Improvement 15% Viral clearance 76% Li et al. Conv. Plasma for COVID-19 RCT LATE TREATMENT Is late treatment with convalescent plasma beneficial for COVID-19? RCT 103 patients in China Improved viral clearance with convalescent plasma (p=0.012) Li et al., JAMA, doi:10.1001/jama.2020.10044 Favors conv. plasma Favors control
Effect of Convalescent Plasma Therapy on Time to Clinical Improvement in Patients With Severe and Life-threatening COVID-19: A Randomized Clinical Trial
Li et al., Effect of Convalescent Plasma Therapy on Time to Clinical Improvement in Patients With Severe and.., JAMA, doi:10.1001/jama.2020.10044
Jun 2020   Source   PDF  
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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.
risk of death, 34.6% lower, RR 0.65, p = 0.30, treatment 8 of 51 (15.7%), control 12 of 50 (24.0%), NNT 12, odds ratio converted to relative risk, 28 days.
risk of no improvement, 15.3% lower, RR 0.85, p = 0.37, treatment 25 of 52 (48.1%), control 29 of 51 (56.9%), NNT 11, inverted to make RR<1 favor treatment, odds ratio converted to relative risk, 28 days.
risk of no viral clearance, 76.4% lower, RR 0.24, p = 0.01, treatment 4 of 26 (15.4%), control 15 of 23 (65.2%), NNT 2.0, inverted to make RR<1 favor treatment, odds ratio converted to relative risk.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Li et al., 3 Jun 2020, Randomized Controlled Trial, China, peer-reviewed, 34 authors.
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This PaperConv. PlasmaAll
Effect of Convalescent Plasma Therapy on Time to Clinical Improvement in Patients With Severe and Life-threatening COVID-19
MD Ling Li, PhD Wei Zhang, MD Yu Hu, PhD Xunliang Tong, PhD Shangen Zheng, MD Juntao Yang, PhD Yujie Kong, MD Lili Ren, PhD Qing Wei, MD Heng Mei, PhD Caiying Hu, MD Cuihua Tao, MD Ru Yang, MD Jue Wang, MD Yongpei Yu, PhD; Yong Guo, Xiaoxiong Wu, MD Zhihua Xu, MD Li Zeng, MD Nian Xiong, Lifeng Chen, MD Juan Wang, MD Ning Man, MD Yu Liu, PhD Haixia Xu, E Deng, MS Xuejun Zhang, MS Chenyue Li, MD Conghui Wang, PhD Shisheng Su, PhD Linqi Zhang, PhD Jianwei Wang, PhD Yanyun Wu, PhD Zhong Liu
JAMA, doi:10.1001/jama.2020.10044
IMPORTANCE Convalescent plasma is a potential therapeutic option for patients with coronavirus disease 2019 (COVID-19), but further data from randomized clinical trials are needed. OBJECTIVE To evaluate the efficacy and adverse effects of convalescent plasma therapy for patients with COVID-19.
Alt, median (IQR, U/L
Arabi, Hajeer, Luke, Feasibility of using convalescent plasma immunotherapy for MERS-CoV infection, Saudi Arabia, Emerg Infect Dis, doi:10.3201/eid2209.151164
Ast, median (IQR, U/L
Beigel, Aga, Mc, IRC005 Study Team. Anti-influenza immune plasma for the treatment of patients with severe influenza A: a randomised, double-blind, phase 3 trial, Lancet Respir Med, doi:10.1016/S2213-2600(19)30199-7
Cheng, Wong, Soo, Use of convalescent plasma therapy in SARS patients in Hong Kong, Eur J Clin Microbiol Infect Dis, doi:10.1007/s10096-004-1271-9
Duan, Liu, Li, Effectiveness of convalescent plasma therapy in severe COVID-19 patients, Proc Natl Acad Sci U S A, doi:10.1073/pnas.2004168117
Garraud, Heshmati, Pozzetto, Plasma therapy against infectious pathogens, as of yesterday, today and tomorrow, Transfus Clin Biol, doi:10.1016/j.tracli.2015.12.003
Kleinbaum, Evaluating the proportional hazards assumption
Kraft, Hewlett, Koepsell, Nebraska Biocontainment Unit and the Emory Serious Communicable Diseases Unit. The use of TKM-100802 and convalescent plasma in 2 patients with Ebola virus disease in the United States, Clin Infect Dis, doi:10.1093/cid/civ334
Shen, Wang, Zhao, Treatment of 5 critically ill patients with COVID-19 with convalescent plasma, JAMA, doi:10.1001/jama.2020.4783?utm_campaign=articlePDF%26utm_medium=articlePDFlink%26utm_source=articlePDF%26utm_content=jama.2020.10044
Soo, Cheng, Wong, Retrospective comparison of convalescent plasma with continuing high-dose methylprednisolone treatment in SARS patients, Clin Microbiol Infect, doi:10.1111/j.1469-0691.2004.00956.x
Urea Nitrogen, median (IQR
Wang, Hu, Hu, Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China, JAMA, doi:10.1001/jama.2020.1585?utm_campaign=articlePDF%26utm_medium=articlePDFlink%26utm_source=articlePDF%26utm_content=jama.2020.10044
Wang, Zhang, Du, Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial, Lancet, doi:10.1016/S0140-6736(20)31022-9
Wu, Mcgoogan, Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention, JAMA, doi:10.1001/jama.2020.2648?utm_campaign=articlePDF%26utm_medium=articlePDFlink%26utm_source=articlePDF%26utm_content=jama.2020.10044
Yeh, Chiueh, Siu, Experience of using convalescent plasma for severe acute respiratory syndrome among healthcare workers in a Taiwan hospital, J Antimicrob Chemother, doi:10.1093/jac/dki346
Zhang, Tong, Zheng, Yang, Wei et al., Critical revision of the manuscript for important intellectual content
Late treatment
is less effective
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