Evidence favouring the efficacy of convalescent plasma for COVID-19 therapy
bioinformatics clinical diagnostics therapeutics
Authors: Joyner et al.
Link to paper: https://doi.org/10.1101/2020.07.29.20162917
Journal/ Pre-Print: MedRxiv
Tags; Bioinformatics, Clinical/ Diagnostics, Therapeutics
Meta-analysis including 12 studies describing treatment with convalescent plasma (CP) to reduce mortality in severe COVID-19 patients found reduced mortality (13%) compared to controls (25%; odds ratio 0.43, P < 0.001).
Difference between median cohort age, proportion receiving mechanical ventilation, duration of study follow up were not found to affect the aggregate OR (coefficients P > 0.22).
Joyner et al. carried out a meta-analysis of 12 studies involving the treatment of severe COVID-19 patients with CP. 3 of these studies were randomised clinical trials, 5 were matched controls, and 4 case series, which amounts to a total of 804 COVID-19 patient outcomes. The aggregate of these studies found that CP treatment reduced mortality to 13% compared to 25% for non-transfused (adds ratio 0.43, P <0.001). The authors suggest that since CP was administered later in disease progression in these studies, their analysis may underestimate mortality reduction achievable in this approach.
Impact for SARS-CoV2/COVID19 research efforts
Treatment of SARS-CoV2/COVID19 positive individuals - Study aims to bring statistical clarity to the use of CP to reduce mortality in severe COVID-19
In silico study / bioinformatics study
Strengths and limitations of the paper
Novelty: Provides statistically relevant information on the reduction of mortality rates in COVID-19 after treatment with CP in the absence of a large scale Randomised Controlled Trial
Standing in the field: Uses existing papers/studies and provides statistics for the biologically sound rationale of the use of CP in COVID-19.
Appropriate statistics: Yes, statistics were appropriate and accurate.
Viral model used: N/A
Translatability: Provides a basis for further larger-scale RCTs to be carried out investigating the potential of CP to treat COVID-19 patients.
Lack of background describing the different studies, e.g. the dose of CP used, timing of CP administration.
Comparison of studies is only based on mortality; time between diagnosis and CP administration, and duration of follow-up after transfusion could have been compared.