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Late |
Bégin et al., Nature Medicine, doi:10.1038/s41591-021-01488-2 (Peer Reviewed) |
death, ↑13.0%, p=0.33 |
Convalescent plasma for hospitalized patients with COVID-19: an open-label, randomized controlled trial |
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RCT 940 hospitalized patients, 614 assigned to convalescent plasma, showing no significant differences. NCT04348656. |
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Late treatment study
Late treatment study
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| Bégin et al., Nature Medicine, doi:10.1038/s41591-021-01488-2 (Peer Reviewed) |
| Convalescent plasma for hospitalized patients with COVID-19: an open-label, randomized controlled trial |
RCT 940 hospitalized patients, 614 assigned to convalescent plasma, showing no significant differences. NCT04348656.
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risk of death, 13.0% higher, RR 1.13, p = 0.33, treatment 156 of 625 (25.0%), control 69 of 313 (22.0%), day 90.
risk of death, 12.0% higher, RR 1.12, p = 0.40, treatment 141 of 614 (23.0%), control 63 of 307 (20.5%), day 30.
risk of combined intubation/death, 16.0% higher, RR 1.16, p = 0.18, treatment 199 of 614 (32.4%), control 86 of 307 (28.0%).
Bégin et al., 9/9/2021, Randomized Controlled Trial, multiple countries, multiple regions, peer-reviewed, 32 authors.
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Early |
Korley et al., NEJM, doi:10.1056/NEJMoa2103784 (Peer Reviewed) |
death, ↑396.0%, p=0.22 |
Early Convalescent Plasma for High-Risk Outpatients with Covid-19 |
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RCT 511 emergency department patients, 257 assigned to convalescent plasma, showing no significant difference in outcomes. |
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Early treatment study
Early treatment study
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| Korley et al., NEJM, doi:10.1056/NEJMoa2103784 (Peer Reviewed) |
| Early Convalescent Plasma for High-Risk Outpatients with Covid-19 |
RCT 511 emergency department patients, 257 assigned to convalescent plasma, showing no significant difference in outcomes.
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risk of death, 396.0% higher, RR 4.96, p = 0.22, treatment 5 of 250 (2.0%), control 1 of 248 (0.4%).
risk of hospitalization, 10.0% lower, RR 0.90, p = 0.59, treatment 51 of 257 (19.8%), control 56 of 254 (22.0%).
risk of disease progression, 6.0% lower, RR 0.94, p = 0.70, treatment 77 of 257 (30.0%), control 81 of 254 (31.9%).
Korley et al., 8/18/2021, Randomized Controlled Trial, USA, North America, peer-reviewed, 28 authors.
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Early |
Balcells et al., PLOS Medicine, doi:10.1371/journal.pmed.1003415 (Peer Reviewed) |
death, ↑247.4%, p=0.11 |
Early versus deferred anti-SARS-CoV-2 convalescent plasma in patients admitted for COVID-19: A randomized phase II clinical trial |
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Small RCT with 28 early and 30 deferred (treated according to prespecified deterioration criteria) convalescent plasma patients, not showing significant differences. "Early" is relative, with a median of 5 days from symptom onse.. |
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Early treatment study
Early treatment study
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| Balcells et al., PLOS Medicine, doi:10.1371/journal.pmed.1003415 (Peer Reviewed) |
| Early versus deferred anti-SARS-CoV-2 convalescent plasma in patients admitted for COVID-19: A randomized phase II clinical trial |
Small RCT with 28 early and 30 deferred (treated according to prespecified deterioration criteria) convalescent plasma patients, not showing significant differences. "Early" is relative, with a median of 5 days from symptom onset. 13 patients in the deferred group received plasma.
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risk of death, 247.4% higher, RR 3.47, p = 0.11, treatment 5 of 28 (17.9%), control 2 of 30 (6.7%), adjusted, OR converted to RR, logistic regression, early vs. deferred.
risk of mechanical ventilation, 163.3% higher, RR 2.63, p = 0.16, treatment 5 of 28 (17.9%), control 2 of 30 (6.7%), adjusted, OR converted to RR, logistic regression, early vs. deferred.
risk of disease progression, 23.3% higher, RR 1.23, p = 0.23, treatment 13 of 28 (46.4%), control 12 of 30 (40.0%), adjusted, OR converted to RR, logistic regression, early vs. deferred.
Balcells et al., 3/3/2021, Randomized Controlled Trial, Chile, South America, peer-reviewed, 32 authors.
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Late |
Recovery Collaborative Group, The Lancet, doi:10.1016/S0140-6736(21)00897-7 (press release 1/15/2021) (Peer Reviewed) |
death, 0.0%, p=0.95 |
Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial |
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RCT 16,287 hospitalized patients in the UK, showing no significant differences with convalescent plasma treatment. Subgroup analysis shows better results for those treated <= 7 days from symptom onset. NCT04381936. |
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Late treatment study
Late treatment study
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| Recovery Collaborative Group, The Lancet, doi:10.1016/S0140-6736(21)00897-7 (press release 1/15/2021) (Peer Reviewed) |
| Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial |
RCT 16,287 hospitalized patients in the UK, showing no significant differences with convalescent plasma treatment. Subgroup analysis shows better results for those treated <= 7 days from symptom onset. NCT04381936.
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risk of death, no change, RR 1.00, p = 0.95, treatment 1399 of 5795 (24.1%), control 1408 of 5763 (24.4%), day 28.
risk of no hospital discharge, 1.0% higher, RR 1.01, p = 0.57, treatment 1963 of 5795 (33.9%), control 1941 of 5763 (33.7%), day 28.
Recovery Collaborative Group et al., 1/15/2021, Randomized Controlled Trial, United Kingdom, Europe, peer-reviewed, 1 author.
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Early |
Libster et al., NEJM, doi:10.1056/NEJMoa2033700 (Peer Reviewed) |
death, ↓50.0%, p=0.43 |
Early High-Titer Plasma Therapy to Prevent Severe Covid-19 in Older Adults |
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RCT 160 patients >=65 with symptom onset <72 hours, 80 treated with convalescent plasma, showing lower progression to severe disease with treatment. NCT04479163. |
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Early treatment study
Early treatment study
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| Libster et al., NEJM, doi:10.1056/NEJMoa2033700 (Peer Reviewed) |
| Early High-Titer Plasma Therapy to Prevent Severe Covid-19 in Older Adults |
RCT 160 patients >=65 with symptom onset <72 hours, 80 treated with convalescent plasma, showing lower progression to severe disease with treatment. NCT04479163.
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risk of death, 50.0% lower, RR 0.50, p = 0.43, treatment 2 of 80 (2.5%), control 4 of 80 (5.0%).
risk of mechanical ventilation, 50.0% lower, RR 0.50, p = 0.43, treatment 2 of 80 (2.5%), control 4 of 80 (5.0%).
risk of ICU admission, 67.0% lower, RR 0.33, p = 0.17, treatment 2 of 80 (2.5%), control 6 of 80 (7.5%).
risk of disease progression, 48.0% lower, RR 0.52, p = 0.03, treatment 13 of 80 (16.2%), control 25 of 80 (31.2%).
Libster et al., 1/6/2021, Double Blind Randomized Controlled Trial, Argentina, South America, peer-reviewed, 56 authors.
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Late |
Ray et al., medRxiv, doi:10.1101/2020.11.25.20237883 (Peer Reviewed) |
death, ↓33.0%, p=0.34 |
Clinical and immunological benefits of convalescent plasma therapy in severe COVID-19: insights from a single center open label randomised control trial |
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Small RCT 80 hospitalized patients in India, 40 treated with convalescent plasma, not showing significant differences in primary analysis. Authors note that significant improvement in hypoxia, reduction in hospital stay, and survival bene.. |
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Late treatment study
Late treatment study
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| Ray et al., medRxiv, doi:10.1101/2020.11.25.20237883 (Peer Reviewed) |
| Clinical and immunological benefits of convalescent plasma therapy in severe COVID-19: insights from a single center open label randomised control trial |
Small RCT 80 hospitalized patients in India, 40 treated with convalescent plasma, not showing significant differences in primary analysis. Authors note that significant improvement in hypoxia, reduction in hospital stay, and survival benefit was seen in severe COVID-19 patients with ARDS aged <67. CTRI/2020/05/025209.
risk of death, 33.0% lower, RR 0.67, p = 0.34, treatment 10 of 40 (25.0%), control 14 of 40 (35.0%), adjusted, Mantel-Haenszel.
Ray et al., 11/29/2020, Randomized Controlled Trial, India, South Asia, peer-reviewed, 37 authors.
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Late |
Simonovich et al., NEJM, doi:0.1056/NEJMoa2031304 (Peer Reviewed) |
death, ↓4.1%, p=1.00 |
A Randomized Trial of Convalescent Plasma in Covid-19 Severe Pneumonia |
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RCT 333 hospitalized patients in Argentina, 228 treated with convalescent plasma, showing no significant differences in clinical status or mortality. NCT04383535. |
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Late treatment study
Late treatment study
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| Simonovich et al., NEJM, doi:0.1056/NEJMoa2031304 (Peer Reviewed) |
| A Randomized Trial of Convalescent Plasma in Covid-19 Severe Pneumonia |
RCT 333 hospitalized patients in Argentina, 228 treated with convalescent plasma, showing no significant differences in clinical status or mortality. NCT04383535.
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risk of death, 4.1% lower, RR 0.96, p = 1.00, treatment 25 of 228 (11.0%), control 12 of 105 (11.4%).
risk of 7-point scale status, 19.0% lower, RR 0.81, p = 0.40, treatment 228, control 105, RR approximated with OR.
Simonovich et al., 11/24/2020, Randomized Controlled Trial, Argentina, South America, peer-reviewed, 39 authors.
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Late |
AlQahtani et al., Scientific Reports, doi:10.1038/s41598-021-89444-5 (preprint 11/4/2020) (Peer Reviewed) |
death, ↓50.0%, p=0.55 |
Randomized controlled trial of convalescent plasma therapy against standard therapy in patients with severe COVID-19 disease |
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Small RCT with 40 hospitalized patients in Bahrain, 20 treated with convalescent plasma, not showing significant differences. NCT04356534. |
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Late treatment study
Late treatment study
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| AlQahtani et al., Scientific Reports, doi:10.1038/s41598-021-89444-5 (preprint 11/4/2020) (Peer Reviewed) |
| Randomized controlled trial of convalescent plasma therapy against standard therapy in patients with severe COVID-19 disease |
Small RCT with 40 hospitalized patients in Bahrain, 20 treated with convalescent plasma, not showing significant differences. NCT04356534.
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risk of death, 50.0% lower, RR 0.50, p = 0.55, treatment 1 of 20 (5.0%), control 2 of 20 (10.0%).
noninvasive or mechanical ventilation, 33.3% lower, RR 0.67, p = 0.47, treatment 4 of 20 (20.0%), control 6 of 20 (30.0%).
hospitalization time, 21.9% lower, relative time 0.78, p = 0.12, treatment 20, control 20.
AlQahtani et al., 11/4/2020, Randomized Controlled Trial, Bahrain, Middle East, peer-reviewed, 11 authors.
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Late |
Bajpai et al., medRxiv, doi:10.1101/2020.10.25.20219337 (Preprint) |
death, ↑323.0%, p=0.22 |
Efficacy of Convalescent Plasma Therapy compared to Fresh Frozen Plasma in Severely ill COVID-19 Patients: A Pilot Randomized Controlled Trial |
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Small RCT 29 patients in India, 14 treated with convalescent plasma, not showing significant differences with treatment. |
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Late treatment study
Late treatment study
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| Bajpai et al., medRxiv, doi:10.1101/2020.10.25.20219337 (Preprint) |
| Efficacy of Convalescent Plasma Therapy compared to Fresh Frozen Plasma in Severely ill COVID-19 Patients: A Pilot Randomized Controlled Trial |
Small RCT 29 patients in India, 14 treated with convalescent plasma, not showing significant differences with treatment.
risk of death, 323.0% higher, RR 4.23, p = 0.22, treatment 3 of 14 (21.4%), control 1 of 15 (6.7%), adjusted, 28 days, Cox proportional hazards.
risk of death, 114.3% higher, RR 2.14, p = 0.60, treatment 2 of 14 (14.3%), control 1 of 15 (6.7%), 7 days.
risk of mechanical ventilation, 221.4% higher, RR 3.21, p = 0.33, treatment 3 of 14 (21.4%), control 1 of 15 (6.7%), 7 days.
hospitalization time, 24.8% lower, relative time 0.75, p = 0.08, treatment 14, control 15.
relative improvement in Ct value, 32.5% lower, RR 0.68, p = 0.11, treatment 14, control 15.
Bajpai et al., 10/27/2020, Randomized Controlled Trial, India, South Asia, preprint, 20 authors.
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Late |
Agarwal et al., BMJ, doi:10.1136/bmj.m3939 (Peer Reviewed) |
death, ↑7.0%, p=0.74 |
Convalescent plasma in the management of moderate covid-19 in adults in India: open label phase II multicentre randomised controlled trial (PLACID Trial) |
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RCT 464 hospitalized patients in India, 235 treated with convalescent plasma, showing no improvement in combined death at 28 days or progression to severe disease. CTRI/2020/04/024775. |
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Late treatment study
Late treatment study
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| Agarwal et al., BMJ, doi:10.1136/bmj.m3939 (Peer Reviewed) |
| Convalescent plasma in the management of moderate covid-19 in adults in India: open label phase II multicentre randomised controlled trial (PLACID Trial) |
RCT 464 hospitalized patients in India, 235 treated with convalescent plasma, showing no improvement in combined death at 28 days or progression to severe disease. CTRI/2020/04/024775.
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risk of death, 7.0% higher, RR 1.07, p = 0.74, treatment 34 of 235 (14.5%), control 31 of 229 (13.5%).
combined death at 28 days or progression to severe disease, 7.0% higher, RR 1.07, p = 0.74, treatment 44 of 235 (18.7%), control 41 of 229 (17.9%).
risk of mechanical ventilation, 1.0% lower, RR 0.99, p = 0.98, treatment 19 of 227 (8.4%), control 19 of 224 (8.5%).
risk of no virological cure, 28.0% lower, RR 0.72, p = 0.02, treatment 56 of 173 (32.4%), control 76 of 169 (45.0%), day 7.
Agarwal et al., 10/22/2020, Randomized Controlled Trial, India, South Asia, peer-reviewed, 6 authors.
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Late |
Avendaño-Solà et al., medRxiv, doi:10.1101/2020.08.26.20182444 (Peer Reviewed) |
death, ↓88.3%, p=0.12 |
Convalescent Plasma for COVID-19: A multicenter, randomized clinical trial |
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Early terminated RCT with 81 hospitalized patients, 38 treated with convalescent plasma, showing lower progression with treatment. NCT04345523. |
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Late treatment study
Late treatment study
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| Avendaño-Solà et al., medRxiv, doi:10.1101/2020.08.26.20182444 (Peer Reviewed) |
| Convalescent Plasma for COVID-19: A multicenter, randomized clinical trial |
Early terminated RCT with 81 hospitalized patients, 38 treated with convalescent plasma, showing lower progression with treatment. NCT04345523.
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risk of death, 88.3% lower, RR 0.12, p = 0.12, treatment 0 of 38 (0.0%), control 4 of 43 (9.3%), continuity correction due to zero event, day 29.
risk of disease progression, 93.0% lower, RR 0.07, p = 0.01, treatment 0 of 38 (0.0%), control 7 of 43 (16.3%), continuity correction due to zero event, day 29, progression to categories 5-7.
risk of disease progression, 91.9% lower, RR 0.08, p = 0.03, treatment 0 of 38 (0.0%), control 6 of 43 (14.0%), continuity correction due to zero event, day 15, progression to categories 5-7.
Avendaño-Solà et al., 9/29/2020, Randomized Controlled Trial, Spain, Europe, peer-reviewed, 36 authors.
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Late |
Li et al., JAMA, doi:10.1001/jama.2020.10044 (Peer Reviewed) |
death, ↓34.6%, p=0.30 |
Effect of Convalescent Plasma Therapy on Time to Clinical Improvement in Patients With Severe and Life-threatening COVID-19: A Randomized Clinical Trial |
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Small RCT 103 severe condition patients, 52 treated with convalescent plasma, showing improved viral clearance but no statistically significant improvements in mortality or clinical improvement. ChiCTR2000029757. |
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Late treatment study
Late treatment study
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| Li et al., JAMA, doi:10.1001/jama.2020.10044 (Peer Reviewed) |
| Effect of Convalescent Plasma Therapy on Time to Clinical Improvement in Patients With Severe and Life-threatening COVID-19: A Randomized Clinical Trial |
Small RCT 103 severe condition patients, 52 treated with convalescent plasma, showing improved viral clearance but no statistically significant improvements in mortality or clinical improvement. ChiCTR2000029757.
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risk of death, 34.6% lower, RR 0.65, p = 0.30, treatment 8 of 51 (15.7%), control 12 of 50 (24.0%), OR converted to RR, 28 days.
risk of no improvement, 15.3% lower, RR 0.85, p = 0.37, treatment 25 of 52 (48.1%), control 29 of 51 (56.9%), OR converted to RR, 28 days.
risk of no virological cure, 76.4% lower, RR 0.24, p < 0.001, treatment 4 of 26 (15.4%), control 15 of 23 (65.2%), OR converted to RR.
Li et al., 6/3/2020, Randomized Controlled Trial, China, Asia, peer-reviewed, 34 authors.
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Late |
Gharbharan et al., Nature Communications, doi:10.1038/s41467-021-23469-2 (Peer Reviewed) |
death, ↓3.8%, p=0.95 |
Effects of potent neutralizing antibodies from convalescent plasma in patients hospitalized for severe SARS-CoV-2 infection |
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RCT 86 hospitalized patients, 43 treated with convalescent plasma, not showing significant differences with treatment. Authors conclude that the most likely explanation was already high antibody titers on the day of inclusion, and they re.. |
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Late treatment study
Late treatment study
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| Gharbharan et al., Nature Communications, doi:10.1038/s41467-021-23469-2 (Peer Reviewed) |
| Effects of potent neutralizing antibodies from convalescent plasma in patients hospitalized for severe SARS-CoV-2 infection |
RCT 86 hospitalized patients, 43 treated with convalescent plasma, not showing significant differences with treatment. Authors conclude that the most likely explanation was already high antibody titers on the day of inclusion, and they recommend treating patients early. NCT04342182.
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risk of death, 3.8% lower, RR 0.96, p = 0.95, treatment 6 of 43 (14.0%), control 11 of 43 (25.6%), adjusted, OR converted to RR, multivariable logistic regression.
time to discharge, 11.7% lower, relative time 0.88, p = 0.68, treatment 43, control 43, adjusted, multivariable Fine and Gray regression.
Gharbharan et al., 5/27/2020, Randomized Controlled Trial, Netherlands, Europe, peer-reviewed, 32 authors.
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