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Association of Conv...
Association of Convalescent Plasma Treatment With Clinical Outcomes in Patients With COVID-19 : A Systematic Review and Meta-analysis
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- Janiaud, Perrine (författare)
- Univ Basel, Univ Hosp Basel, Dept Clin Res, Basel, Switzerland.
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- Axfors, Cathrine (författare)
- Uppsala universitet,Obstetrisk och reproduktiv hälsoforskning,Stanford Univ, Meta Res Innovat Ctr Stanford, Stanford, CA 94305 USA.
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- Schmitt, Andreas M. (författare)
- Univ Basel, Univ Hosp Basel, Dept Clin Res, Basel, Switzerland.;Univ Basel, Dept Med Oncol, Basel, Switzerland.
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- Gloy, Viktoria (författare)
- Univ Basel, Univ Hosp Basel, Dept Clin Res, Basel, Switzerland.
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- Ebrahimi, Fahim (författare)
- Univ Ctr Gastrointestinal & Liver Dis, Dept Gastroenterol & Hepatol, Basel, Switzerland.
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- Hepprich, Matthias (författare)
- Univ Hosp Basel, Clin Endocrinol Diabet & Metab, Basel, Switzerland.;Cantonal Hosp Olten, Clin Endocrine & Metab Disorders, Olten, Switzerland.
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- Smith, Emily R. (författare)
- George Washington Univ, Dept Global Hlth, Milken Inst, Sch Publ Hlth, Washington, DC USA.
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- Haber, Noah A. (författare)
- Stanford Univ, Meta Res Innovat Ctr Stanford, Stanford, CA 94305 USA.
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- Khanna, Nina (författare)
- Univ Basel, Univ Hosp Basel, Div Infect Dis, Basel, Switzerland.;Univ Basel, Univ Hosp Basel, Hosp Hyg & Infect Biol Lab, Basel, Switzerland.
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- Moher, David (författare)
- Ottawa Hosp Res Inst, Ctr Journalol, Clin Epidemiol Program, Ottawa, ON, Canada.
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- Goodman, Steven N. (författare)
- Stanford Univ, Meta Res Innovat Ctr Stanford, Stanford, CA 94305 USA.;Stanford Univ, Sch Med, Dept Med, Stanford, CA 94305 USA.;Stanford Univ, Sch Med, Dept Epidemiol & Populat Hlth, Stanford, CA 94305 USA.
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- Ioannidis, John P. A. (författare)
- Stanford Univ, Meta Res Innovat Ctr Stanford, Stanford, CA 94305 USA.;Stanford Univ, Sch Med, Dept Med, Stanford, CA 94305 USA.;Stanford Univ, Sch Med, Dept Epidemiol & Populat Hlth, Stanford, CA 94305 USA.;Stanford Univ, Sch Med, Dept Biomed Data Sci, Stanford, CA 94305 USA.;Stanford Univ, Sch Humanities & Sci, Dept Stat, Stanford, CA 94305 USA.;Berlin Inst Hlth, Meta Res Innovat Ctr Berlin, Berlin, Germany.
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- Hemkens, Lars G. (författare)
- Univ Basel, Univ Hosp Basel, Dept Clin Res, Basel, Switzerland.;Stanford Univ, Meta Res Innovat Ctr Stanford, Stanford, CA 94305 USA.;Berlin Inst Hlth, Meta Res Innovat Ctr Berlin, Berlin, Germany.
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Univ Basel, Univ Hosp Basel, Dept Clin Res, Basel, Switzerland Obstetrisk och reproduktiv hälsoforskning (creator_code:org_t)
- American Medical Association (AMA), 2021
- 2021
- Engelska.
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Ingår i: Journal of the American Medical Association (JAMA). - : American Medical Association (AMA). - 0098-7484 .- 1538-3598. ; 325:12, s. 1185-1195
- Relaterad länk:
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https://jamanetwork....
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- IMPORTANCE Convalescent plasma is a proposed treatment for COVID-19. OBJECTIVE To assess clinical outcomes with convalescent plasma treatment vs placebo or standard of care in peer-reviewed and preprint publications or press releases of randomized clinical trials (RCTs). DATA SOURCES PubMed, the Cochrane COVID-19 trial registry, and the Living Overview of Evidence platform were searched until January 29, 2021. STUDY SELECTION The RCTs selected compared any type of convalescent plasma vs placebo or standard of care for patients with confirmed or suspected COVID-19 in any treatment setting. DATA EXTRACTION AND SYNTHESIS Two reviewers independently extracted data on relevant clinical outcomes, trial characteristics, and patient characteristics and used the Cochrane Risk of Bias Assessment Tool. The primary analysis included peer-reviewed publications of RCTs only, whereas the secondary analysis included all publicly available RCT data (peer-reviewed publications, preprints, and press releases). Inverse variance-weighted meta-analyses were conducted to summarize the treatment effects. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation. MAIN OUTCOMES AND MEASURES All-cause mortality, length of hospital stay, clinical improvement, clinical deterioration, mechanical ventilation use, and serious adverse events. RESULTS A total of 1060 patients from 4 peer-reviewed RCTs and 10 722 patients from 6 other publicly available RCTs were included. The summary risk ratio (RR) for all-cause mortality with convalescent plasma in the 4 peer-reviewed RCTs was 0.93 (95% CI, 0.63 to 1.38), the absolute risk difference was -1.21% (95% CI, -5.29% to 2.88%), and there was low certainty of the evidence due to imprecision. Across all 10 RCTs, the summary RR was 1.02 (95% CI, 0.92 to 1.12) and there was moderate certainty of the evidence due to inclusion of unpublished data. Among the peer-reviewed RCTs, the summary hazard ratio was 1.17 (95% CI, 0.07 to 20.34) for length of hospital stay, the summary RR was 0.76 (95% CI, 0.20 to 2.87) for mechanical ventilation use (the absolute risk difference for mechanical ventilation use was -2.56%[95% CI, -13.16% to 8.05%]), and there was low certainty of the evidence due to imprecision for both outcomes. Limited data on clinical improvement, clinical deterioration, and serious adverse events showed no significant differences. CONCLUSIONS AND RELEVANCE Treatment with convalescent plasma compared with placebo or standard of care was not significantly associated with a decrease in all-cause mortality or with any benefit for other clinical outcomes. The certainty of the evidence was low to moderate for all-cause mortality and low for other outcomes.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
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Janiaud, Perrine
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Axfors, Cathrine
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Schmitt, Andreas ...
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Gloy, Viktoria
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Ebrahimi, Fahim
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Hepprich, Matthi ...
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Smith, Emily R.
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Haber, Noah A.
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Khanna, Nina
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Moher, David
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Goodman, Steven ...
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Ioannidis, John ...
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Hemkens, Lars G.
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