恢复期血浆治疗重症新型冠状病毒肺炎患者的Meta分析

A meta-analysis of convalescent plasma in the treatment of patients with severe coronavirus disease 2019

  • 摘要:
    目的  采用Meta分析评价恢复期血浆对重症新型冠状病毒肺炎(COVID-19)患者的有效性和安全性。
    方法  通过检索EMBASE、PubMed、Web of Science、Cochrane Library、中国知网(CNKI)、中国生物医学文献数据库等数据库,纳入恢复期血浆治疗重症COVID-19患者的临床随机对照实验(RCTs), 检索时限截至2021年12月1日。有效性评价指标为28 d或30 d病死率、出院率,安全性评价指标为不良事发生率。Meta分析采用RevMan 5.3软件进行分析。
    结果  本研究Meta分析共纳入了9项RCTs, 共3 461例患者。结果显示,常规方案与恢复期血浆在治疗重症COVID-19患者的28 d或30 d全因死亡率(RR=0.94, 95%CI: 0.84~1.05, P=0.27)、28 d或30 d出院率(RR=1.06, 95%CI: 0.95~1.19, P=0.28)及不良事件发生率(RR=1.16, 95%CI: 0.71~1.88, P=0.55)方面,差异均无统计学意义。
    结论  本研究Meta分析提示,恢复期血浆治疗重症COVID-19患者的安全性较好,但对短期死亡率及出院率无明显改善。

     

    Abstract:
    Objective  To evaluate the effectiveness and safety of convalescent plasma in treatment of patients with severe coronavirus disease 2019(COVID-19) by meta-analysis.
    Methods  Databases such as EMBASE, PubMed, Web of Science, Cochrane Library, China National Knowledge Infrastructure(CNKI) and Chinese Biomedical Literature Database were searched to collect randomized controlled trials (RCTs) about convalescent plasma therapy for severe COVID-19, and the search deadline was December 1, 2021. The efficacy evaluation indexes included 28 d or 30 d mortality and discharge rate, and the safety evaluation index was the incidence of adverse events. A meta-analysis was performed by using RevMan 5.3 software.
    Results  A total of 9 RCTs including 3 461 patients were enrolled in this meta-analysis, and the results showed that there were no significant differences in the 28 d or 30 d all-cause mortality (RR=0.94, 95%CI, 0.84 to 1.05, P=0.27), 28 d or 30 d discharge rate (RR=1.06, 95%CI, 0.95 to 1.19, P=0.28) and incidence of adverse events (RR=1.16, 95%CI, 0.71 to 1.88, P=0.55)between routine regimen and convalescent plasma.
    Conclusion  meta-analysis of this study suggests that the convalescent plasma is safe in the treatment of patients with severe COVID-19, but it has no significant improvement in short-term mortality and discharge rate.

     

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