Axfors, CathrineJaniaud, PerrineSchmitt, Andreas MVan't Hooft, JannekeSmith, Emily RHaber, Noah AAbayomi, AkinAbduljalil, ManalAbdulrahman, AbdulkarimAcosta-Ampudia, YenyAguilar-Guisado, ManuelaAl-Beidh, FarahAlejandria, Marissa MAlfonso, Rachelle NAli, MohammadAlQahtani, ManafAlZamrooni, AlaaAnaya, Juan-ManuelAng, Mark Angelo CAomar, Ismael FArgumanis, Luis EAveryanov, AlexanderBaklaushev, Vladimir PBalionis, OlgaBenfield, ThomasBerry, ScottBirocco, NadiaBonifacio, Lynn BBowen, Asha CBown, AbbieCabello-Gutierrez, CarlosCamacho, BernardoCamacho-Ortiz, AdrianCampbell-Lee, SallyCao, Damon HCardesa, AnaCarnate, Jose MCastillo, German Jr JCavallo, RossanaChowdhury, Fazle RChowdhury, Forhad U HCiccone, GiovanninoCingolani, AntonellaClimacosa, Fresthel Monica MCompernolle, VeerleCortez, Carlo Francisco NCosta Neto, AbelD'Antico, SergioDaly, JamesDanielle, FrancaDavis, Joshua SDe Rosa, Francesco GiuseppeDenholm, Justin TDenkinger, Claudia MDesmecht, DanielDiaz-Coronado, Juan CDiaz Ponce-Medrano, Juan ADonneau, Anne-FrançoiseDumagay, Teresita EDunachie, SusannaDungog, Cecile CErinoso, OlufemiEscasa, Ivy Mae SEstcourt, Lise JEvans, AmyEvasan, Agnes L MFareli, Christian JFernandez-Sanchez, VeronicaGalassi, ClaudiaGallo, Juan EGarcia, Patricia JGarcia, Patricia LGarcia, Jesus AGarigliany, MutienGarza-Gonzalez, ElviraGauiran, Deonne Thaddeus VGaviria García, Paula AGiron-Gonzalez, Jose-AntonioGomez-Almaguer, DavidGordon, Anthony CGothot, AndreGrass Guaqueta, Jeser SantiagoGreen, CameronGrimaldi, DavidHammond, Naomi EHarvala, HeliHeralde, Francisco MHerrick, JesicaHiggins, Alisa MHills, Thomas EHines, JenniferHolm, KarinHoque, AshrafulHoste, EricIgnacio, Jose MIvanov, Alexander VJanssen, MaikeJennings, Jeffrey HJha, VivekanandKing, Ruby Anne NKjeldsen-Kragh, JensKlenerman, PaulKotecha, AdityaKrapp, FiorellaLabanca, LucianaLaing, EmmaLandin-Olsson, MonaLaterre, Pierre-FrançoisLim, Lyn-LiLim, JodorLjungquist, OskarLlaca-Díaz, Jorge MLopez-Robles, ConcepcionLopez-Cardenas, SalvadorLopez-Plaza, IleanaLucero, Josephine Anne CLundgren, MariaMacias, JuanMaganito, Sandy CMalundo, Anna Flor GManrique, Ruben DManzini, Paola MMarcos, MiguelMarquez, IgnacioMartinez-Marcos, Francisco JavierMata, Ana MMcArthur, Colin JMcQuilten, Zoe KMcVerry, Bryan JMenon, David KMeyfroidt, GeertMirasol, Ma Angelina LMisset, BenoîtMolton, James SMondragon, Alric VMonsalve, Diana MMoradi Choghakabodi, ParastooMorpeth, Susan CMouncey, Paul RMoutschen, MichelMüller-Tidow, CarstenMurphy, ErinNajdovski, TomeNichol, Alistair DNielsen, HenrikNovak, Richard MO'Sullivan, Matthew V NOlalla, JulianOsibogun, AkinOsikomaiya, BodunrinOyonarte, SalvadorPardo-Oviedo, Juan MPatel, Mahesh CPaterson, David LPeña-Perez, Carlos APerez-Calatayud, Angel APerez-Alba, EduardoPerkina, AnastasiaPerry, NaomiPouladzadeh, MandanaPoyato, InmaculadaPrice, David JQuero, Anne Kristine HRahman, Md MRahman, Md SRamesh, MayurRamirez-Santana, CarolinaRasmussen, MagnusRees, Megan ARego, EduardoRoberts, Jason ARoberts, David JRodriguez, YhojanRodriguez-Baño, JesusRogers, Benjamin ARojas, ManuelRomero, AlbertoRowan, Kathryn MSaccona, FabioSafdarian, MehdiSantos, Maria Clariza MSasadeusz, JoeScozzari, GitanaShankar-Hari, ManuSharma, GoravSnelling, ThomasSoto, AlonsoTagayuna, Pedrito YTang, AmyTatem, GenevaTeofili, LucianaTong, Steven Y CTurgeon, Alexis FVeloso, Januario DVenkatesh, BalasubramanianVentura-Enriquez, YanetWebb, Steve AWiese, LotharWikén, ChristianWood, Erica MYusubalieva, Gaukhar MZacharowski, KaiZarychanski, RyanKhanna, NinaMoher, DavidGoodman, Steven NIoannidis, John P AHemkens, Lars G2025-01-072025-01-072021-11-20Axfors C, Janiaud P, Schmitt AM, Van't Hooft J, Smith ER, Haber NA, et al. Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials. BMC Infect Dis. 2021 Nov 20;21(1):1170https://hdl.handle.net/10668/24965Convalescent plasma has been widely used to treat COVID-19 and is under investigation in numerous randomized clinical trials, but results are publicly available only for a small number of trials. The objective of this study was to assess the benefits of convalescent plasma treatment compared to placebo or no treatment and all-cause mortality in patients with COVID-19, using data from all available randomized clinical trials, including unpublished and ongoing trials (Open Science Framework, https://doi.org/10.17605/OSF.IO/GEHFX ). In this collaborative systematic review and meta-analysis, clinical trial registries (ClinicalTrials.gov, WHO International Clinical Trials Registry Platform), the Cochrane COVID-19 register, the LOVE database, and PubMed were searched until April 8, 2021. Investigators of trials registered by March 1, 2021, without published results were contacted via email. Eligible were ongoing, discontinued and completed randomized clinical trials that compared convalescent plasma with placebo or no treatment in COVID-19 patients, regardless of setting or treatment schedule. Aggregated mortality data were extracted from publications or provided by investigators of unpublished trials and combined using the Hartung-Knapp-Sidik-Jonkman random effects model. We investigated the contribution of unpublished trials to the overall evidence. A total of 16,477 patients were included in 33 trials (20 unpublished with 3190 patients, 13 published with 13,287 patients). 32 trials enrolled only hospitalized patients (including 3 with only intensive care unit patients). Risk of bias was low for 29/33 trials. Of 8495 patients who received convalescent plasma, 1997 died (23%), and of 7982 control patients, 1952 died (24%). The combined risk ratio for all-cause mortality was 0.97 (95% confidence interval: 0.92; 1.02) with between-study heterogeneity not beyond chance (I2 = 0%). The RECOVERY trial had 69.8% and the unpublished evidence 25.3% of the weight in the meta-analysis. Convalescent plasma treatment of patients with COVID-19 did not reduce all-cause mortality. These results provide strong evidence that convalescent plasma treatment for patients with COVID-19 should not be used outside of randomized trials. Evidence synthesis from collaborations among trial investigators can inform both evidence generation and evidence application in patient care.enAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/COVID-19Convalescent plasmaMeta-analysisSARS-CoV-2Red Andaluza de Diseño y Traslacion de Terapias Avanzadas,Centro Transfusional Tejidos y Celulas de Sevilla, SevillaCOVID-19HumansImmunization, PassiveRandomized Controlled Trials as TopicSARS-CoV-2Treatment OutcomeCOVID-19 Serotherapyresearch article34800996open accessTerapéuticaMetaanálisisPlasmaMortalidadInvestigadoresSistema de registrosAtención al paciente10.1186/s12879-021-06829-71471-2334PMC8605464https://bmcinfectdis.biomedcentral.com/counter/pdf/10.1186/s12879-021-06829-7https://pmc.ncbi.nlm.nih.gov/articles/PMC8605464/pdf