Meta-analysis Of Efficacy And Safety Of Convalescent Plasma Therapy For COVID-19

Background And Objective: Corona Virus Disease2019(COVID-19)has become a worldwide pandemic.But there is no effective treatment for COVID-19.It is controversial that the efficacy and safety of convalescent plasma(CP)therapy for COVID-19.This meta-analysis aimed to assess the efficacy and safety of convalescent plasma therapy for COVID-19.The purpose of this study is to provide evidence-based medical evidence for seeking effective and safe treatment for COVID-19.Methods: This meta-analysis is based on the retrieval strategy of PRISMA(Preferred reporting items for systematic reviews and meta-analyses).The literature search was conducted in the databases of China National Knowledge Infrastructure,Pubmed,Web of Science,Embase,and Cochrane Central Register of Controlling Trials(Central).The literature search was conducted from the database construction to August 5.2021.The retrieval approach was conducted in subject words +free words.The study method was selected randomized controlled trial(RCT).The five aspects,which included case fatality rate,clinical improvement rate,the incidence of adverse reactions,days to hospital discharge,and the improvement rate of virology indicators,are consisted of the result of this study.The extracted data was divided into dichotomous data and continuous data.STATA 16 and Review Manager5.4 were used for data analysis.Risk Ratio(RR)and 95%confidence intervals(CI)were pooled by using a fixed or random effect model in dichotomous data.Mean difference(MD)and 95% confidence intervals(CI)were pooled by using a fixed or random effect model in continuous data.Studies with missing or unusable data are reported in findings descriptively.Results: This meta-analysis included thirteen English RCTs.There were 13232 participants,and 254 research centers.After analyzing the data,we concluded that:1.Case fatality rate: RR=0.70,95% CI(0.55,0.89),P<0.05;2.Clinical improvement rate(1)The rate of improvement of shortness of breath: RR=1.48,95%CI(1.13,1.93),P<0.05;(2)The rate of taking off ventilator: RR=0.99,95%CI(0.90,1.08),P>0.05;(3)The improvement of imaging results: RR=1.77,95%CI(0.21,14.73),P>0.05;(4)Degree of improvement in inflammatory indicators(1)C-reactive protein(CRP): MD=-40.16,95%CI(-92.20,11.89),P>0.05;(2)Ferritin: MD=-447.68,95%CI(-501.75,-393.6),P<0.05;(3)Interleukin-6(IL-6): MD=-4.46,95%CI(-8.28,-0.63),P<0.05;(4)Tumor Necrosis Factor-alpha(TNF-α): MD=-8.98,95%CI(-16.35,0.17),P=0.05;(5)Degree of improvement of other indicators(1)Lymphocyte: MD=0,95%CI(-0.03,0.03),P>0.05;(2)D-Dimer: MD=-518.45,95%CI(-1754.24,717.34),P>0.05;(3)Lactate dehydrogenase(LDH): MD=9.13,95%CI(-6.95,25.21),P>0.05;3.The incidence of adverse reactions: RR=1.55,95%CI(1.00,2.39),P=0.05;4.Days to hospital discharge: MD=-0.06,95%CI(-2.78,2.65),P>0.05;5.Improvement rate of virology indicators(1)Viral nucleic acid negative conversion rate: RR=0.59,95%CI(0.32,1.11),P>0.05;(2)Neutralizing antibody positive conversion rate: RR=6.33,95%CI(1.00,40.1),P=0.05.Conclusions: 1.Convalescent plasma therapy for COVID-19 can reduce case fatality rate,improve shortness of breath,reduce inflammatory markers,and does not increase adverse reactions significantly;2.It does not affect days to hospital discharge,taking off ventilator,imaging results,D-Dimer,LDH,virology indicators;3.The safety and potential efficacy of convalescent plasma therapy offer a promising treatment strategy for patients.But the future will require carefully designed large,multicentre,high-quality clinical trials to verify the credibility of the conclusion.