Department of BioNano Technology, Gachon University, 1342 Seongnam-Daero, Sujeong-Gu, Seongnam-si 13120, Gyeonggi-Do, Korea.
Department of Industrial and Environmental Engineering, Graduate School of Environment, Gachon University, 1342 Seongnam-Daero, Sujeong-Gu, Seongnam-si 13120, Gyeonggi-Do, Korea.
Int J Environ Res Public Health. 2022 Aug 25;19(17):10622. doi: 10.3390/ijerph191710622.
This study investigated the efficacy and safety of convalescent plasma (CP) transfusion against the coronavirus disease 2019 (COVID-19) via a systematic review and meta-analysis of randomized controlled trials (RCTs). A total of 5467 articles obtained from electronic databases were assessed; however, only 34 RCTs were eligible after manually screening and eliminating unnecessary studies. The beneficial effect was addressed by assessing the risk ratio (RR) and standardized mean differences (SMDs) of the meta-analysis. It was demonstrated that CP therapy is not effective in improving clinical outcomes, including reducing mortality with an RR of 0.88 [0.76; 1.03] (I = 68% and = 0.10) and length of hospitalization with SMD of -0.47 [-0.95; 0.00] (I = 99% and = 0.05). Subgroup analysis provided strong evidence that CP transfusion does not significantly reduce all-cause mortality compared to standard of care (SOC) with an RR of 1.01 [0.99; 1.03] (I = 70% and = 0.33). In addition, CP was found to be safe for and well-tolerated by COVID-19 patients as was the SOC in healthcare settings. Overall, the results suggest that CP should not be applied outside of randomized trials because of less benefit in improving clinical outcomes for COVID-19 treatment.
本研究通过对随机对照试验（RCT）的系统评价和荟萃分析，调查了恢复期血浆（CP）输注治疗 2019 年冠状病毒病（COVID-19）的疗效和安全性。从电子数据库中评估了总共 5467 篇文章，但经过手动筛选和排除不必要的研究后，只有 34 项 RCT 符合入选标准。通过评估荟萃分析的风险比（RR）和标准化均数差（SMD）来评估有益效果。结果表明，CP 治疗并不能有效改善临床结局，包括降低死亡率的 RR 为 0.88 [0.76；1.03]（I = 68%， = 0.10）和住院时间的 SMD 为-0.47 [-0.95；0.00]（I = 99%， = 0.05）。亚组分析提供了强有力的证据，表明与标准治疗（SOC）相比，CP 输注并不能显著降低全因死亡率，RR 为 1.01 [0.99；1.03]（I = 70%， = 0.33）。此外，CP 在医疗保健环境中对 COVID-19 患者是安全且耐受良好的，与 SOC 一样。总体而言，结果表明 CP 不应该在 RCT 之外使用，因为它对改善 COVID-19 治疗的临床结局没有更多益处。
