Current best evidence for clinical care (more info)
Started in late 2019, coronavirus disease 2019 (COVID-19) has rapidly turned into a global pandemic. Considering there is no proven therapy for COVID-19 infection, there is a need to propose potential treatment options. The use of convalescent plasma is one such option as convalescent plasma has previously been used for treating outbreaks of Ebola, influenza, Middle East Respiratory Syndrome Coronavirus (MERS-CoV), and severe acute respiratory (SAR) viruses. Therefore, we carried out an early systematic review to evaluate the efficacy of convalescent plasma (CP) therapy and its effects on COVID-19 patient outcomes. A structured and rigorous systematic review was carried out that included all studies conducted on this topic between December 2019 and June 2020. A total of 10 studies containing a mix of case reports, case series, observational studies, and randomized control trials were identified. Most of the studies lacked randomization and included only small groups of patients. Considering the limitations in the design of current studies, it is difficult to draw a definitive conclusion. However, our results showed that plasma therapy produces notable improvements in patients' clinical symptoms and radiological and biochemical parameters associated with COVID-19 infection. Based on the available information, it is difficult to draw a tangible conclusion about whether plasma therapy improves patient mortality. Until we have concrete evidence to prove otherwise, convalescent plasma therapy may be used as adjuvant therapy for treating COVID-19 infection in critically ill patients.
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This systematic review of low-quality data comes before an RCT (PLACID trial) published in the BMJ 10/22/2020. I would resort to the conclusions of the PLACID trial only.
Intensivist caring for patients with COVID-19 will be interested by this preliminary report on the effects of transfusion of plasma on convalescent patients. These findings mostly stress the need for prospective and methodologically robust trials, which are currently recruiting patients worldwide.
These two statements are at odds (last lines of the abstract): (1) Based on the available information, it is difficult to draw a tangible conclusion about whether plasma therapy improves patient mortality. (2) Until we have concrete evidence to prove otherwise, convalescent plasma therapy may be used as adjuvant therapy for treating COVID-19 infection in critically ill patients. More up-to-date living systematic reviews are available: https://pubmed.ncbi.nlm.nih.gov/33044747/
This is another useless review.