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恢复期血浆疗法治疗 COVID-19 的疗效:系统评价和荟萃分析。

Efficacy of convalescent plasma therapy for COVID-19: A systematic review and meta-analysis.

机构信息

Department of General Medicine, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India.

Nested Knowledge, St. Paul, Minnesota, USA.

出版信息

J Clin Apher. 2021 Jun;36(3):470-482. doi: 10.1002/jca.21881. Epub 2021 Feb 5.

Abstract

The purpose of this systematic review and meta-analysis was to examine clinical outcomes associated with convalescent plasma therapy in COVID-19 patients. We performed a literature search on PubMed, medRxiv, Web of Science, and Scopus to identify studies published up to December 10th, 2020 that examined the efficacy of convalescent plasma treatment for COVID-19. The primary endpoints were mortality, clinical improvement, and hospital length of stay. We screened 859 studies that met the search criteria, performed full-text reviews of 56 articles, and identified 15 articles that fulfilled inclusion criteria for meta-analysis. The odds of mortality were significantly lower in the convalescent plasma group compared to the control group (OR = 0.59 [95% CI = 0.44; 0.78], P < .001), although results from two key randomized controlled trials did not support the mortality benefit. The odds of clinical improvement were significantly higher in the convalescent plasma group compared to the control group (OR = 2.02 [95% CI = 1.54; 2.65], P < .001). There was no difference in hospital length of stay between the convalescent plasma group and the control group (MD = -0.49 days [95% CI = -3.11; 2.12], P = .713). In all, these data indicate that a mortality benefit with convalescent plasma is unclear, although there remain benefits with convalescent plasma therapy for COVID-19.

摘要

本系统评价和荟萃分析的目的是研究恢复期血浆疗法在 COVID-19 患者中的临床结局。我们在 PubMed、medRxiv、Web of Science 和 Scopus 上进行了文献检索,以确定截至 2020 年 12 月 10 日发表的研究,这些研究检查了恢复期血浆治疗 COVID-19 的疗效。主要终点是死亡率、临床改善和住院时间。我们筛选了符合搜索标准的 859 项研究,对 56 篇文章进行了全文审查,并确定了 15 篇符合荟萃分析纳入标准的文章。与对照组相比,恢复期血浆组的死亡率明显降低(OR=0.59 [95%CI=0.44;0.78],P<.001),尽管两项关键的随机对照试验的结果并不支持死亡率的获益。与对照组相比,恢复期血浆组的临床改善几率明显更高(OR=2.02 [95%CI=1.54;2.65],P<.001)。恢复期血浆组和对照组之间的住院时间没有差异(MD=-0.49 天 [95%CI=-3.11;2.12],P=0.713)。总之,这些数据表明,恢复期血浆治疗 COVID-19 可能具有死亡率获益,但目前仍存在获益。

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