Summary The clinical benefit of convalescent plasma (CP) for patients with coronavirus disease (COVID)-19 is still debated. In this systematic review and meta-analysis, we selected 10 randomized clinical trials (RCTs) and 15 non-randomized studies (total number of patients = 22,591) of CP treatment and evaluated two different scenarios: (1) disease stage of plasma recipients and (2) donated plasma antibody titer, considering all-cause mortality at the latest follow-up. Our results show that, when provided at early stages of the disease, CP significantly reduced mortality: risk ratio (RR) 0.72 (0.68, 0.77), p < 0.00001, while provided in severe or critical conditions, it did not (RR: 0.94 [0.86, 1.04], p = 0.22). On the other hand, the benefit on mortality was not increased by using plasma with a high-antibody titer compared with unselected plasma. This meta-analysis might promote CP usage in patients with early-stage COVID-19 in further RCTs to maximize its benefit in decreasing mortality, especially in less affluent countries. Graphical abstract Highlights • The benefit of convalescent plasma (CP) for patients with COVID-19 is still debated • Only when provided at early disease stages, CP reduced COVID-19 mortality • CP benefit on mortality does not increase when selecting high-antibody titers • Early treatment with CP may maximize its clinical benefit Systems medicine; Virology.
【저자키워드】 Virology, systems medicine, 【초록키워드】 Treatment, convalescent plasma, Meta-analysis, randomized clinical trial, Mortality, systematic review, risk, RCT, Patient, plasma, Follow-up, Critical, early stage, RCTs, COVID-19 mortality, Coronavirus Disease (COVID)-19, Abstract, plasma antibody, all-cause mortality, disease stage, clinical benefit, disease stages, recipient, early-stage COVID-19, System, benefit, selected, significantly, the disease, evaluated, provided, reduced, less, promote, conditions, non-randomized study, patients with COVID-19, 【제목키워드】 COVID-19, Convalescent plasma therapy, Effect,