Cancer Center, The First Hospital of Jilin University, 71 Xinmin Street, Changchun, Jilin 130021, China.
Radiology, The First Hospital of Jilin University, 71 Xinmin Street, Changchun, Jilin 130021, China.
Int J Infect Dis. 2020 Sep;98:334-346. doi: 10.1016/j.ijid.2020.06.107. Epub 2020 Jul 4.
Convalescent plasma (CP) has been used successfully to treat many types of infectious disease, and has shown initial effects in the treatment of the emerging 2019 coronavirus disease (COVID-19). However, its curative effects and feasibility have yet to be confirmed by formal evaluation and well-designed clinical trials. To explore the effectiveness of treatment and predict the potential effects of CP with COVID-19, studies of different types of infectious disease treated with CP were included in this systematic review and meta-analysis.
Related studies were obtained from databases and screened according to the inclusion criteria. The data quality was assessed, and the data were extracted and pooled for analysis.
40 studies on CP treatment for infectious diseases were included. Our study found that CP treatment could reduce the risk of mortality, with a low incidence of adverse events, promote the production of antibodies, lead to a decline in viral load, and shorten the disease course. A meta-analysis of 15 controlled studies showed that there was a significantly lower mortality rate in the group treated with CP (pooled OR=0.32; 95% CI=0.19-0.52; p<0.001, I=54%) compared with the control groups. Studies were mostly of low or very low quality, with a moderate or high risk of bias. The sources of clinical and methodological heterogeneity were identified. The exclusion of heterogeneity indicated that the results were stable.
CP therapy has some curative effect and is well tolerated in treating infectious diseases. It is a potentially effective treatment for COVID-19.
恢复期血浆（CP）已成功用于治疗多种类型的传染病，并在治疗新出现的 2019 年冠状病毒病（COVID-19）方面显示出初步效果。然而，其疗效和可行性尚未通过正式评估和精心设计的临床试验得到证实。为了探讨治疗效果并预测 CP 对 COVID-19 的潜在影响，本系统评价和荟萃分析纳入了使用 CP 治疗不同类型传染病的研究。
从数据库中获取相关研究，并根据纳入标准进行筛选。评估数据质量，并提取和汇总数据进行分析。
纳入了 40 项 CP 治疗传染病的研究。我们的研究发现，CP 治疗可降低死亡率，不良事件发生率低，促进抗体产生，导致病毒载量下降，缩短病程。对 15 项对照研究的荟萃分析表明，CP 治疗组的死亡率明显低于对照组（合并 OR=0.32；95%CI=0.19-0.52；p<0.001，I=54%）。这些研究大多质量较低或极低，存在中度或高度偏倚风险。确定了临床和方法学异质性的来源。排除异质性表明结果稳定。
CP 治疗在治疗传染病方面具有一定疗效且耐受性良好。它是 COVID-19 的一种潜在有效治疗方法。
