Convalescent Plasma Study Group
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.
J. Kenneth Baillie
Wei Shen Lim
Kevin D Rooney
Charles R. Beck
JONATHAN NGUYEN-VAN-TAM JONATHAN.VAN-TAM@NOTTINGHAM.AC.UK
Professor of Health Protection
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.
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
|Journal Article Type||Article|
|Acceptance Date||Jul 9, 2014|
|Online Publication Date||Jul 16, 2014|
|Publication Date||Jan 1, 2015|
|Deposit Date||Oct 19, 2016|
|Publicly Available Date||Oct 19, 2016|
|Journal||Journal of Infectious Diseases|
|Publisher||Oxford University Press|
|Peer Reviewed||Peer Reviewed|
|Keywords||MERS coronavirus; convalescent plasma; severe acute respiratory infection; systematic review; meta-analysis|
|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|
Mair-Jenkins 2015 J Infect Dis.pdf
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by-nc-nd/4.0