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The Effectiveness of Convalescent Plasma and Hyperimmune Immunoglobulin for the Treatment of Severe Acute Respiratory Infections of Viral Etiology: A Systematic Review and Exploratory Meta-analysis

Convalescent Plasma Study Group; Mair-Jenkins, John; Saavedra-Campos, Maria; Baillie, J. Kenneth; Cleary, Paul; Khaw, Fu-Meng; Lim, Wei Shen; Makki, Sophia; Rooney, Kevin D; Beck, Charles R.; Nguyen-Van-Tam, Jonathan S.

Authors

Convalescent Plasma Study Group

John Mair-Jenkins

Maria Saavedra-Campos

J. Kenneth Baillie

Paul Cleary

Fu-Meng Khaw

Wei Shen Lim

Sophia Makki

Kevin D Rooney

Charles R. Beck

Jonathan S. Nguyen-Van-Tam jvt@nottingham.ac.uk



Abstract

Background: Administration of convalescent plasma, serum, or hyperimmune immunoglobulin may be of clinical benefit for treatment of severe acute respiratory infections (SARIs) of viral etiology. We conducted a systematic review and exploratory meta-analysis to assess the overall evidence.

Methods: Healthcare databases and sources of grey literature were searched in July 2013. All records were screened against the protocol eligibility criteria, using a 3-stage process. Data extraction and risk of bias assessments were undertaken.

Results: We identified 32 studies of SARS coronavirus infection and severe influenza. Narrative analyses revealed consistent evidence for a reduction in mortality, especially when convalescent plasma is administered early after symptom onset. Exploratory post hoc meta-analysis showed a statistically significant reduction in the pooled odds of mortality following treatment, compared with placebo or no therapy (odds ratio, 0.25; 95% confidence interval, .14–.45; I(2) = 0%). Studies were commonly of low or very low quality, lacked control groups, and at moderate or high risk of bias. Sources of clinical and methodological heterogeneity were identified.

Conclusions: Convalescent plasma may reduce mortality and appears safe. This therapy should be studied within the context of a well-designed clinical trial or other formal evaluation, including for treatment of Middle East respiratory syndrome coronavirus CoV infection.

Journal Article Type Article
Publication Date Jan 1, 2015
Journal Journal of Infectious Diseases
Print ISSN 0022-1899
Electronic ISSN 1537-6613
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Volume 211
Issue 1
Pages 80-90
APA6 Citation Convalescent Plasma Study Group, , Mair-Jenkins, J., Saavedra-Campos, M., Baillie, J. K., Cleary, P., Khaw, F., …Nguyen-Van-Tam, J. S. (2015). The Effectiveness of Convalescent Plasma and Hyperimmune Immunoglobulin for the Treatment of Severe Acute Respiratory Infections of Viral Etiology: A Systematic Review and Exploratory Meta-analysis. Journal of Infectious Diseases, 211(1), 80-90. https://doi.org/10.1093/infdis/jiu396
DOI https://doi.org/10.1093/infdis/jiu396
Keywords MERS coronavirus; convalescent plasma; severe acute respiratory infection; systematic review; meta-analysis
Publisher URL http://jid.oxfordjournals.org/content/211/1/80
Related Public URLs http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4264590/
Copyright Statement Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by-nc-nd/4.0

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by-nc-nd/4.0





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