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恢复期血浆与 COVID-19 患者全因死亡率:系统评价和荟萃分析。

Convalescent plasma and all-cause mortality of COVID-19 patients: systematic review and meta-analysis.

机构信息

Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.

Department of Anaesthesiology, Intensive Therapy and Care, Oncology Institute of Vojvodina, Sremska Kamenica, Serbia.

出版信息

Sci Rep. 2023 Aug 9;13(1):12904. doi: 10.1038/s41598-023-40009-8.

Abstract

Insight into the clinical potential of convalescent plasma in patients with coronavirus disease (COVID-19) is important given the severe clinical courses in unvaccinated and seronegative individuals. The aim of the study was to investigate whether there is a survival benefit of convalescent plasma therapy in COVID-19 patients. The authors independently assessed randomized controlled trials (RCTs) identified by the search strategy for inclusion, extracted data, and assessed risk of bias. The binary primary outcome was all-cause mortality. Risk ratio (RR) of the convalescent plasma treatment (vs. best standard care) and its associated standard error (effect size) were calculated. A random-effects model was employed to statistically pool the effect sizes of the selected studies. We included 19 RCTs with 17,021 patients. The random-effects model resulted in an estimated pooled RR of 0.94 (95% CI 0.81-1.08, p = 0.33), showing no statistical evidence of the benefit of convalescent plasma therapy on all-cause mortality. Convalescent plasma therapy was not found to be effective in reducing all-cause mortality in COVID-19 patients. Further studies are needed to determine in which patients convalescent plasma therapy may lead to a reduction in mortality.

摘要

鉴于未接种疫苗和血清阴性个体的严重临床病程,了解恢复期血浆在冠状病毒病 (COVID-19) 患者中的临床潜力非常重要。本研究旨在探讨 COVID-19 患者接受恢复期血浆治疗是否有生存获益。作者独立评估了搜索策略确定的随机对照试验 (RCT),以纳入、提取数据和评估偏倚风险。主要的二元结局是全因死亡率。恢复期血浆治疗(与最佳标准治疗相比)的风险比 (RR) 及其相关标准误差(效应大小)进行了计算。采用随机效应模型对选定研究的效果大小进行统计学汇总。我们纳入了 19 项 RCT,共纳入了 17021 名患者。随机效应模型得出的估计合并 RR 为 0.94(95%CI 0.81-1.08,p=0.33),没有统计学证据表明恢复期血浆治疗对全因死亡率有获益。恢复期血浆治疗并未降低 COVID-19 患者的全因死亡率。需要进一步的研究来确定恢复期血浆治疗可能在哪些患者中导致死亡率降低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4f7/10412555/43c1f079f215/41598_2023_40009_Fig1_HTML.jpg

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