TY - JOUR AU - Axfors, Cathrine AU - Janiaud, Perrine AU - Schmitt, Andreas M AU - Van't Hooft, Janneke AU - Smith, Emily R AU - Haber, Noah A. AU - Abayomi, Akin AU - Abduljalil, Manal AU - Abdulrahman, Abdulkarim AU - Acosta-Ampudia, Yeny AU - Aguilar-Guisado, Manuela AU - Al-Beidh, Farah AU - Alejandria, Marissa M AU - Alfonso, Rachelle N AU - Ali, Mohammad AU - AlQahtani, Manaf AU - AlZamrooni, Alaa AU - Anaya, Juan-Manuel AU - Ang, Mark Angelo C AU - Aomar, Ismael F AU - Argumanis, Luis E AU - Averyanov, Alexander AU - Baklaushev, Vladimir P AU - Balionis, Olga AU - Benfield, Thomas AU - Berry, Scott AU - Birocco, Nadia AU - Bonifacio, Lynn B AU - Bowen, Asha C AU - Bown, Abbie AU - Cabello-Gutierrez, Carlos AU - Camacho, Bernardo AU - Camacho-Ortiz, Adrian AU - Campbell-Lee, Sally AU - Cao, Damon H AU - Cardesa, Ana AU - Carnate, Jose M AU - Castillo, German Jr J AU - Cavallo, Rossana AU - Chowdhury, Fazle R AU - Chowdhury, Forhad U H AU - Ciccone, Giovannino AU - Cingolani, Antonella AU - Climacosa, Fresthel Monica M AU - Compernolle, Veerle AU - Cortez, Carlo Francisco N AU - Costa Neto, Abel AU - D'Antico, Sergio AU - Daly, James AU - Danielle, Franca AU - Davis, Joshua S AU - De Rosa, Francesco Giuseppe AU - Denholm, Justin T AU - Denkinger, Claudia M AU - Desmecht, Daniel AU - Díaz-Coronado, Juan C AU - Díaz Ponce-Medrano, Juan A AU - Donneau, Anne-Françoise AU - Dumagay, Teresita E AU - Dunachie, Susanna AU - Dungog, Cecile C AU - Erinoso, Olufemi AU - Escasa, Ivy Mae S AU - Estcourt, Lise J. AU - Evans, Amy AU - Evasan, Agnes L M AU - Fareli, Christian J AU - Fernandez-Sanchez, Veronica AU - Galassi, Claudia AU - Gallo, Juan E AU - Garcia, Patricia J AU - Garcia, Patricia L AU - Garcia, Jesus A AU - Garigliany, Mutien AU - Garza-Gonzalez, Elvira AU - Gauiran, Deonne Thaddeus V AU - Gaviria García, Paula A AU - Giron-Gonzalez, Jose-Antonio AU - Gómez-Almaguer, David AU - Gordon, Anthony C. AU - Gothot, André AU - Grass Guaqueta, Jeser Santiago AU - Green, Cameron AU - Grimaldi, David AU - Hammond, Naomi E AU - Harvala, Heli AU - Heralde, Francisco M AU - Herrick, Jesica AU - Higgins, Alisa M AU - Hills, Thomas E AU - Hines, Jennifer AU - Holm, Karin AU - Hoque, Ashraful AU - Hoste, Eric AU - Ignacio, Jose M AU - Ivanov, Alexander V AU - Janssen, Maike AU - Jennings, Jeffrey H AU - Jha, Vivekanand AU - King, Ruby Anne N AU - Kjeldsen-Kragh, Jens AU - Klenerman, Paul AU - Kotecha, Aditya AU - Krapp, Fiorella AU - Labanca, Luciana AU - Laing, Emma AU - Landin-Olsson, Mona AU - Laterre, Pierre-François AU - Lim, Lyn-Li AU - Lim, Jodor AU - Ljungquist, Oskar AU - Llaca-Díaz, Jorge M AU - López-Robles, Concepción AU - López-Cárdenas, Salvador AU - Lopez-Plaza, Ileana AU - Lucero, Josephine Anne C AU - Lundgren, Maria AU - Macías, Juan AU - Maganito, Sandy C AU - Malundo, Anna Flor G AU - Manrique, Rubén D AU - Manzini, Paola M AU - Marcos, Miguel AU - Marquez, Ignacio AU - Martínez-Marcos, Francisco Javier AU - Mata, Ana M AU - McArthur, Colin J AU - McQuilten, Zoe K AU - McVerry, Bryan J AU - Menon, David K. AU - Meyfroidt, Geert AU - Mirasol, Ma Angelina L AU - Misset, Benoît AU - Molton, James S AU - Mondragon, Alric V AU - Monsalve, Diana M AU - Moradi Choghakabodi, Parastoo AU - Morpeth, Susan C AU - Mouncey, Paul R. AU - Moutschen, Michel AU - Müller-Tidow, Carsten AU - Murphy, Erin AU - Najdovski, Tome AU - Nichol, Alistair D. AU - Nielsen, Henrik AU - Novak, Richard M AU - O'Sullivan, Matthew V N AU - Olalla, Julian AU - Osibogun, Akin AU - Osikomaiya, Bodunrin AU - Oyonarte, Salvador AU - Pardo-Oviedo, Juan M AU - Patel, Mahesh C AU - Paterson, David L AU - Peña-Perez, Carlos A AU - Perez-Calatayud, Angel A AU - Pérez-Alba, Eduardo AU - Perkina, Anastasia AU - Perry, Naomi AU - Pouladzadeh, Mandana AU - Poyato, Inmaculada AU - Price, David J. AU - Quero, Anne Kristine H AU - Rahman, Md M AU - Rahman, Md S AU - Ramesh, Mayur AU - Ramírez-Santana, Carolina AU - Rasmussen, Magnus AU - Rees, Megan A AU - Rego, Eduardo AU - Roberts, Jason A AU - Roberts, David J. AU - Rodríguez, Yhojan AU - Rodríguez-Baño, Jesús AU - Rogers, Benjamin A AU - Rojas, Manuel AU - Romero, Alberto AU - Rowan, Kathryn M. AU - Saccona, Fabio AU - Safdarian, Mehdi AU - Santos, Maria Clariza M AU - Sasadeusz, Joe AU - Scozzari, Gitana AU - Shankar-Hari, Manu AU - Sharma, Gorav AU - Snelling, Thomas AU - Soto, Alonso AU - Tagayuna, Pedrito Y AU - Tang, Amy AU - Tatem, Geneva AU - Teofili, Luciana AU - Tong, Steven Y C AU - Turgeon, Alexis F AU - Veloso, Januario D AU - Venkatesh, Balasubramanian AU - Ventura-Enriquez, Yanet AU - Webb, Steve A AU - Wiese, Lothar AU - Wikén, Christian AU - Wood, Erica M AU - Yusubalieva, Gaukhar M AU - Zacharowski, Kai AU - Zarychanski, Ryan AU - Khanna, Nina AU - Moher, David AU - Goodman, Steven N. AU - Ioannidis, John P.A. AU - Hemkens, Lars G. PY - 2021 DA - November TI - Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials JO - BMC Infectious Diseases VL - 21 DO - https://doi.org/10.1186/s12879-021-06829-7 AB - BACKGROUND: Convalescent plasma has been widely used to treat COVID-19 and is under investigation in numerous randomized clinical trials, but results are publicly available only for a small number of trials. The objective of this study was to assess the benefits of convalescent plasma treatment compared to placebo or no treatment and all-cause mortality in patients with COVID-19, using data from all available randomized clinical trials, including unpublished and ongoing trials (Open Science Framework, https://doi.org/10.17605/OSF.IO/GEHFX ). METHODS: In this collaborative systematic review and meta-analysis, clinical trial registries (ClinicalTrials.gov, WHO International Clinical Trials Registry Platform), the Cochrane COVID-19 register, the LOVE database, and PubMed were searched until April 8, 2021. Investigators of trials registered by March 1, 2021, without published results were contacted via email. Eligible were ongoing, discontinued and completed randomized clinical trials that compared convalescent plasma with placebo or no treatment in COVID-19 patients, regardless of setting or treatment schedule. Aggregated mortality data were extracted from publications or provided by investigators of unpublished trials and combined using the Hartung-Knapp-Sidik-Jonkman random effects model. We investigated the contribution of unpublished trials to the overall evidence. RESULTS: A total of 16,477 patients were included in 33 trials (20 unpublished with 3190 patients, 13 published with 13,287 patients). 32 trials enrolled only hospitalized patients (including 3 with only intensive care unit patients). Risk of bias was low for 29/33 trials. Of 8495 patients who received convalescent plasma, 1997 died (23%), and of 7982 control patients, 1952 died (24%). The combined risk ratio for all-cause mortality was 0.97 (95% confidence interval: 0.92; 1.02) with between-study heterogeneity not beyond chance (I2 = 0%). The RECOVERY trial had 69.8% and the unpublished evidence 25.3% of the weight in the meta-analysis. CONCLUSIONS: Convalescent plasma treatment of patients with COVID-19 did not reduce all-cause mortality. These results provide strong evidence that convalescent plasma treatment for patients with COVID-19 should not be used outside of randomized trials. Evidence synthesis from collaborations among trial investigators can inform both evidence generation and evidence application in patient care. PB - Springer Nature UR - https://www.research.ed.ac.uk/en/publications/31fffeec-cb4c-4cf9-a7c1-05e9bb1f9b87 KW - Coronavirus (COVID-19) ER