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- Axfors, Cathrine, et al.
(author)
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Association between convalescent plasma treatment and mortality in COVID-19 : a collaborative systematic review and meta-analysis of randomized clinical trials
- 2021
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In: BMC Infectious Diseases. - : BioMed Central (BMC). - 1471-2334. ; 21:1
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Research review (peer-reviewed)abstract
- Background: Convalescent plasma has been widely used to treat COVID-19 and is under investigation in numerous randomized clinical trials, but results are publicly available only for a small number of trials. The objective of this study was to assess the benefits of convalescent plasma treatment compared to placebo or no treatment and all-cause mortality in patients with COVID-19, using data from all available randomized clinical trials, including unpublished and ongoing trials (Open Science Framework, ). Methods: In this collaborative systematic review and meta-analysis, clinical trial registries (ClinicalTrials.gov, WHO International Clinical Trials Registry Platform), the Cochrane COVID-19 register, the LOVE database, and PubMed were searched until April 8, 2021. Investigators of trials registered by March 1, 2021, without published results were contacted via email. Eligible were ongoing, discontinued and completed randomized clinical trials that compared convalescent plasma with placebo or no treatment in COVID-19 patients, regardless of setting or treatment schedule. Aggregated mortality data were extracted from publications or provided by investigators of unpublished trials and combined using the Hartung-Knapp-Sidik-Jonkman random effects model. We investigated the contribution of unpublished trials to the overall evidence. Results: A total of 16,477 patients were included in 33 trials (20 unpublished with 3190 patients, 13 published with 13,287 patients). 32 trials enrolled only hospitalized patients (including 3 with only intensive care unit patients). Risk of bias was low for 29/33 trials. Of 8495 patients who received convalescent plasma, 1997 died (23%), and of 7982 control patients, 1952 died (24%). The combined risk ratio for all-cause mortality was 0.97 (95% confidence interval: 0.92; 1.02) with between-study heterogeneity not beyond chance (I-2 = 0%). The RECOVERY trial had 69.8% and the unpublished evidence 25.3% of the weight in the meta-analysis. Conclusions: Convalescent plasma treatment of patients with COVID-19 did not reduce all-cause mortality. These results provide strong evidence that convalescent plasma treatment for patients with COVID-19 should not be used outside of randomized trials. Evidence synthesis from collaborations among trial investigators can inform both evidence generation and evidence application in patient care.
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- Manzini, G., et al.
(author)
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A Legendre-Fourier spectral method with exact conservation laws for the Vlasov-Poisson system
- 2016
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In: Journal of Computational Physics. - : Elsevier. - 0021-9991 .- 1090-2716. ; 317, s. 82-107
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Journal article (peer-reviewed)abstract
- We present the design and implementation of an L-2-stable spectral method for the discretization of the Vlasov-Poisson model of a collisionless plasma in one space and velocity dimension. The velocity and space dependence of the Vlasov equation are resolved through a truncated spectral expansion based on Legendre and Fourier basis functions, respectively. The Poisson equation, which is coupled to the Vlasov equation, is also resolved through a Fourier expansion. The resulting system of ordinary differential equation is discretized by the implicit second-order accurate Crank-Nicolson time discretization. The non-linear dependence between the Vlasov and Poisson equations is iteratively solved at any time cycle by a Jacobian-Free Newton-Krylov method. In this work we analyze the structure of the main conservation laws of the resulting Legendre-Fourier model, e.g., mass, momentum, and energy, and prove that they are exactly satisfied in the semi-discrete and discrete setting. The L-2-stability of the method is ensured by discretizing the boundary conditions of the distribution function at the boundaries of the velocity domain by a suitable penalty term. The impact of the penalty term on the conservation properties is investigated theoretically and numerically. An implementation of the penalty term that does not affect the conservation of mass, momentum and energy, is also proposed and studied. A collisional term is introduced in the discrete model to control the filamentation effect, but does not affect the conservation properties of the system. Numerical results on a set of standard test problems illustrate the performance of the method.
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- Vencels, J., et al.
(author)
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SpectralPlasmaSolver : A Spectral Code for Multiscale Simulations of Collisionless, Magnetized Plasmas
- 2016
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In: Journal of Physics, Conference Series. - : Institute of Physics Publishing (IOPP). - 1742-6588 .- 1742-6596. ; 719:1
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Journal article (peer-reviewed)abstract
- We present the design and implementation of a spectral code, called SpectralPlasmaSolver (SPS), for the solution of the multi-dimensional Vlasov-Maxwell equations. The method is based on a Hermite-Fourier decomposition of the particle distribution function. The code is written in Fortran and uses the PETSc library for solving the non-linear equations and preconditioning and the FFTW library for the convolutions. SPS is parallelized for shared- memory machines using OpenMP. As a verification example, we discuss simulations of the two-dimensional Orszag-Tang vortex problem and successfully compare them against a fully kinetic Particle-In-Cell simulation. An assessment of the performance of the code is presented, showing a significant improvement in the code running-time achieved by preconditioning, while strong scaling tests show a factor of 10 speed-up using 16 threads.
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