Kanj Saly, Al-Omari Basem
College of Medicine and Health Sciences, Khalifa University of Science and Technology, Abu Dhabi 127788, United Arab Emirates.
Viruses. 2021 May 7;13(5):849. doi: 10.3390/v13050849.
More than one year into the novel coronavirus disease 2019 (COVID-19) pandemic, healthcare systems across the world continue to be overwhelmed with soaring daily cases. The treatment spectrum primarily includes ventilation support augmented with repurposed drugs and/or convalescent plasma transfusion (CPT) from recovered COVID-19 patients. Despite vaccine variants being recently developed and administered in several countries, challenges in global supply chain logistics limit their timely availability to the wider world population, particularly in developing countries. Given the measured success of conventional CPT in treating several infections over the past decade, recent studies have reported its effectiveness in decreasing the duration and severity of COVID-19 symptoms. In this review, we conduct a literature search of published studies investigating the use of CPT to treat COVID-19 patients from January 2020 to January 2021. The literature search identified 181 records of which 39 were included in this review. A random-effects model was used to aggregate data across studies, and mortality rates of 17 vs. 32% were estimated for the CPT and control patient groups, respectively, with an odds ratio (OR) of 0.49. The findings indicate that CPT shows potential in reducing the severity and duration of COVID-19 symptoms. However, early intervention (preferably within 3 days), recruitment of donors, and plasma potency introduce major challenges for its scaled-up implementation. Given the low number of existing randomized clinical trials (RCTs, four with a total of 319 patients), unanticipated risks to CPT recipients are highlighted and discussed. Nevertheless, CPT remains a promising COVID-19 therapeutic option that merits internationally coordinated RCTs to achieve a scientific risk-benefit consensus.
新型冠状病毒肺炎（COVID-19）大流行已持续一年多，全球医疗系统仍因每日新增病例激增而不堪重负。治疗方法主要包括使用重新利用的药物和/或从康复的COVID-19患者中采集的恢复期血浆输血（CPT）来加强通气支持。尽管最近在一些国家研发并接种了多种新冠疫苗，但全球供应链物流方面的挑战限制了这些疫苗及时供应给更广泛的全球人口，尤其是在发展中国家。鉴于过去十年传统CPT在治疗多种感染方面取得了一定成效，近期研究报告了其在缩短COVID-19症状持续时间和减轻症状严重程度方面的有效性。在本综述中，我们检索了2020年1月至2021年1月期间发表的关于使用CPT治疗COVID-19患者的研究文献。文献检索共识别出181条记录，其中39条纳入了本综述。采用随机效应模型对各项研究的数据进行汇总，CPT组和对照组患者的死亡率分别估计为17%和32%，优势比（OR）为0.49。研究结果表明，CPT在减轻COVID-19症状的严重程度和持续时间方面显示出潜力。然而，早期干预（最好在3天内）、供体招募和血浆效力等因素给其扩大应用带来了重大挑战。鉴于现有随机临床试验数量较少（四项，共319例患者），CPT接受者的意外风险得到了突出强调和讨论。尽管如此，CPT仍然是一种有前景的COVID-19治疗选择，值得开展国际协调的随机对照试验，以达成科学的风险效益共识。
