Cochrane rapid review on the use of convalescent plasma as COVID-19 treatment

Rapid Review: Plasma from people who have recovered from COVID‐19 to treat individuals with COVID‐19

People who have recovered from COVID-19 develop natural defences to the disease in their blood (antibodies). Antibodies are found in part of the blood called plasma. Plasma from blood donated from recovered patients, which contains COVID-19 antibodies, can be used to make two preparations. Firstly, convalescent plasma, which is plasma that contains these antibodies. Secondly, hyperimmune immunoglobulin, which is more concentrated, and therefore contains more antibodies.

Convalescent plasma and hyperimmune immunoglobulin have been used successfully to treat other respiratory viruses. These treatments (given by a drip or injection) are generally well-tolerated, but unwanted effects can occur.

The review authors wanted to know whether plasma from people who have recovered from COVID-19 is an effective treatment for people with COVID-19, and whether this treatment causes any unwanted effects.

The authors searched major medical databases for clinical studies on treatment with convalescent plasma or hyperimmune immunoglobulin for people with COVID-19. Studies could be conducted anywhere in the world and include participants of any age, gender or ethnicity, with mild, moderate or severe COVID-19.

The review includes eight completed studies, with 32 participants who received convalescent plasma. None of the studies randomly allocated participants to different treatments (randomised trials produce the best evidence). None of the studies included a group of people who did not receive convalescent plasma, as a comparison group.

Certainty (confidence) in the evidence is very limited because the studies were not randomised and did not use reliable methods to measure their results. Furthermore, they had only a small number of participants, who received various treatments alongside convalescent plasma, and some had underlying health problems.

The authors are very uncertain whether plasma from people who have recovered from COVID-19 is an effective treatment for people with COVID-19. The completed studies the authors found were poor quality and their results could be related to the natural progression of the disease, other treatments that the participants received, or to convalescent plasma.