Li: Effect of Convalescent Plasma Therapy on Time to Clinical Improvement in Patients With Severe and Life-threatening COVID-19: A Randomized Clinical Trial

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., JAMA, doi:10.1001/jama.2020.10044

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

Twitter
Facebook

All Studies Meta

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.

Important missing comments or errors? Let us know.

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.

All Studies All Outcomes Submit Updates or Corrections

This Paper Conv. Plasma All

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.

References

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

Please send us corrections, updates, or comments. Vaccines and treatments are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment, vaccine, or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.

Submit