Department of Anaesthesia, Pain Medicine & Critical Care, AIIMS, New Delhi, India.
Department of Critical & Intensive Care, JPN Apex Trauma Centre, AIIMS, New Delhi, India.
J Med Virol. 2021 Feb;93(2):1111-1118. doi: 10.1002/jmv.26408. Epub 2020 Aug 21.
In the absence of definitive therapy for coronavirus disease (COVID-19), convalescent plasma therapy (CPT) may be a critical therapeutic option. This review was conducted to evaluate the impact of CPT in COVID-19 patients based on the publications reported to date. A robust screening of electronic databases was conducted up to 10th July 2020. Randomized controlled trials (RCTs), cohort studies, and case series with a control group evaluating the effectiveness and safety of CPT in patients with COVID-19 are included for the meta-analyses. Our search retrieved seven studies, including two RCTs and five cohort studies, with a total of 5444 patients. In patients with COVID-19, the use of CPT reduces mortality (odd's ratio [OR] 0.44; 95% CI, 0.25-0.77), increases viral clearance (OR, 11.29; 95% CI, 4.9-25.9) and improves clinically (OR, 2.06; 95% CI, 0.8 to 4.9). However, the evidence is of low quality (mortality reduction, and viral clearance), and very low quality (clinical improvement). CPT may be beneficial for reducing mortality, viral shedding and improving clinical conditions in COVID-19 patients. However, further randomized control trials (RCT) are required to substantiate the safety margin, initiation, optimal dosage, titre and duration of CPT.
在缺乏针对冠状病毒病（COVID-19）的明确疗法的情况下，恢复期血浆疗法（CPT）可能是一种重要的治疗选择。本综述旨在根据迄今为止报道的出版物评估 CPT 在 COVID-19 患者中的影响。对电子数据库进行了严格筛选，截止日期为 2020 年 7 月 10 日。纳入了随机对照试验（RCT）、队列研究和病例系列研究，这些研究均设有对照组，评估了 CPT 在 COVID-19 患者中的有效性和安全性。我们的检索共获取了 7 项研究，其中包括 2 项 RCT 和 5 项队列研究，共纳入了 5444 例患者。在 COVID-19 患者中，CPT 可降低死亡率（比值比 [OR] 0.44；95%可信区间，0.25-0.77）、提高病毒清除率（OR，11.29；95%可信区间，4.9-25.9）并改善临床状况（OR，2.06；95%可信区间，0.8-4.9）。但是，证据质量较低（死亡率降低和病毒清除），而临床改善的证据质量极低。CPT 可能有助于降低 COVID-19 患者的死亡率、病毒脱落和改善临床状况。但是，需要进一步的随机对照试验（RCT）来证实 CPT 的安全性、起始时间、最佳剂量、滴度和持续时间。
