27 February 2023

Convalescent plasma from patients who have recovered from COVID-19 can be an effective treatment to prevent hospitalisation if delivered rapidly, according to a new meta-analysis.

Antiviral treatments for COVID are largely unavailable in many countries, so Dr Adam Levine of Brown University, Rhode Island, USA, and colleagues carried out a meta-analysis of trials of convalescent plasma.

Trials in the UK of convalescent plasma for hospitalised COVID-19 patients were halted because of lack of effectiveness. However, the new meta-analysis suggests the treatment can reduce hospitalisation rates if given as an outpatient treatment.

The researchers looked at the reduction in hospitalisation risk in five studies based in four countries, covering 2,620 adult outpatients. Among the COVID patients, 69% had comorbidities.

The hospitalisation rate was 8.5% for patients who were given convalescent plasma versus 12.2% for those who were not. This translates as a 30.1% relative risk reduction, say the authors in the journal Clinical Infectious Diseases.

“The hospitalisation reduction was greatest in those with both early transfusion and high antibody titre,” they report.

No significant reduction in hospitalisation was seen if treatment was given more than five days after symptoms, or for those receiving convalescent plasma with a lower than average antibody component, they add.

Dr Levine said: “If the results of this meta-analysis had somehow been available in March of 2020, then I am certain that millions of lives would have been saved around the world.

“These findings will be helpful for this pandemic, especially in places like China, India and other parts of the world that lack access to antiviral medications like Paxlovid.

“And because it provides information on how to more effectively use convalescent plasma as a therapy, this will be even more helpful in the next pandemic. This study is essentially a roadmap for how to do this right the next time.”


Levine AC, Fukuta Y, Huaman MA, Ou J, Meisenberg BR, Patel B, Paxton JH, Hanley DF, Rijnders BJ, Gharbharan A, Rokx C, Zwaginga JJ, Alemany A, Mitjà O, Ouchi D, Millat-Martinez P, Durkalski-Mauldin V, Korley FK, Dumont LJ, Callaway CW, Libster R, Marc GP, Wappner D, Esteban I, Polack F, Sullivan DJ. (2023) “COVID-19 Convalescent Plasma Outpatient Therapy to Prevent Outpatient Hospitalization: A Meta-analysis of Individual Participant Data From Five Randomized Trials.” Clinical Infectious Diseases, doi: 10.1093/cid/ciad088

Link: https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciad088/7048396

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