The effectiveness of convalescent plasma and hyperimmune immunoglobulin for the treatment of severe acute respiratory infections of viral etiology: a systematic review

Background: Administration of convalescent plasma, serum, or hyperimmune immunoglobulin may be of clinical benefit for treatment of severe acute respiratory infections (SARIs) of viral etiology. We conducted a systematic review and exploratory meta-analysis to assess the overall evidence. Method...

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Main Authors: Mair-Jenkins, John, Saavedra-Campos, Maria, Baillie, J. Kenneth, Cleary, Paul, Khaw, Fu-Meng, Lim, Wei Shen, Makki, Sophia, Rooney, Kevin D, Beck, Charles R., Nguyen-Van-Tam, Jonathan S.
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Published: Oxford University Press 2014
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Online Access:https://eprints.nottingham.ac.uk/37680/
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author Mair-Jenkins, John
Saavedra-Campos, Maria
Baillie, J. Kenneth
Cleary, Paul
Khaw, Fu-Meng
Lim, Wei Shen
Makki, Sophia
Rooney, Kevin D
Beck, Charles R.
Nguyen-Van-Tam, Jonathan S.
author_facet Mair-Jenkins, John
Saavedra-Campos, Maria
Baillie, J. Kenneth
Cleary, Paul
Khaw, Fu-Meng
Lim, Wei Shen
Makki, Sophia
Rooney, Kevin D
Beck, Charles R.
Nguyen-Van-Tam, Jonathan S.
author_sort Mair-Jenkins, John
building Nottingham Research Data Repository
collection Online Access
description Background: Administration of convalescent plasma, serum, or hyperimmune immunoglobulin may be of clinical benefit for treatment of severe acute respiratory infections (SARIs) of viral etiology. We conducted a systematic review and exploratory meta-analysis to assess the overall evidence. Methods: Healthcare databases and sources of grey literature were searched in July 2013. All records were screened against the protocol eligibility criteria, using a 3-stage process. Data extraction and risk of bias assessments were undertaken. Results: We identified 32 studies of SARS coronavirus infection and severe influenza. Narrative analyses revealed consistent evidence for a reduction in mortality, especially when convalescent plasma is administered early after symptom onset. Exploratory post hoc meta-analysis showed a statistically significant reduction in the pooled odds of mortality following treatment, compared with placebo or no therapy (odds ratio, 0.25; 95% confidence interval, .14–.45; I(2) = 0%). Studies were commonly of low or very low quality, lacked control groups, and at moderate or high risk of bias. Sources of clinical and methodological heterogeneity were identified. Conclusions: Convalescent plasma may reduce mortality and appears safe. This therapy should be studied within the context of a well-designed clinical trial or other formal evaluation, including for treatment of Middle East respiratory syndrome coronavirus CoV infection.
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spelling nottingham-376802020-05-04T16:50:55Z https://eprints.nottingham.ac.uk/37680/ The effectiveness of convalescent plasma and hyperimmune immunoglobulin for the treatment of severe acute respiratory infections of viral etiology: a systematic review Mair-Jenkins, John Saavedra-Campos, Maria Baillie, J. Kenneth Cleary, Paul Khaw, Fu-Meng Lim, Wei Shen Makki, Sophia Rooney, Kevin D Beck, Charles R. Nguyen-Van-Tam, Jonathan S. Background: Administration of convalescent plasma, serum, or hyperimmune immunoglobulin may be of clinical benefit for treatment of severe acute respiratory infections (SARIs) of viral etiology. We conducted a systematic review and exploratory meta-analysis to assess the overall evidence. Methods: Healthcare databases and sources of grey literature were searched in July 2013. All records were screened against the protocol eligibility criteria, using a 3-stage process. Data extraction and risk of bias assessments were undertaken. Results: We identified 32 studies of SARS coronavirus infection and severe influenza. Narrative analyses revealed consistent evidence for a reduction in mortality, especially when convalescent plasma is administered early after symptom onset. Exploratory post hoc meta-analysis showed a statistically significant reduction in the pooled odds of mortality following treatment, compared with placebo or no therapy (odds ratio, 0.25; 95% confidence interval, .14–.45; I(2) = 0%). Studies were commonly of low or very low quality, lacked control groups, and at moderate or high risk of bias. Sources of clinical and methodological heterogeneity were identified. Conclusions: Convalescent plasma may reduce mortality and appears safe. This therapy should be studied within the context of a well-designed clinical trial or other formal evaluation, including for treatment of Middle East respiratory syndrome coronavirus CoV infection. Oxford University Press 2014-07-16 Article PeerReviewed Mair-Jenkins, John, Saavedra-Campos, Maria, Baillie, J. Kenneth, Cleary, Paul, Khaw, Fu-Meng, Lim, Wei Shen, Makki, Sophia, Rooney, Kevin D, Beck, Charles R. and Nguyen-Van-Tam, Jonathan S. (2014) The effectiveness of convalescent plasma and hyperimmune immunoglobulin for the treatment of severe acute respiratory infections of viral etiology: a systematic review. Journal of Infectious Diseases, 211 (1). pp. 80-90. ISSN 1537-6613 MERS coronavirus; convalescent plasma; severe acute respiratory infection; systematic review; meta-analysis http://jid.oxfordjournals.org/content/211/1/80 doi:10.1093/infdis/jiu396 doi:10.1093/infdis/jiu396
spellingShingle MERS coronavirus; convalescent plasma; severe acute respiratory infection; systematic review; meta-analysis
Mair-Jenkins, John
Saavedra-Campos, Maria
Baillie, J. Kenneth
Cleary, Paul
Khaw, Fu-Meng
Lim, Wei Shen
Makki, Sophia
Rooney, Kevin D
Beck, Charles R.
Nguyen-Van-Tam, Jonathan S.
The effectiveness of convalescent plasma and hyperimmune immunoglobulin for the treatment of severe acute respiratory infections of viral etiology: a systematic review
title The effectiveness of convalescent plasma and hyperimmune immunoglobulin for the treatment of severe acute respiratory infections of viral etiology: a systematic review
title_full The effectiveness of convalescent plasma and hyperimmune immunoglobulin for the treatment of severe acute respiratory infections of viral etiology: a systematic review
title_fullStr The effectiveness of convalescent plasma and hyperimmune immunoglobulin for the treatment of severe acute respiratory infections of viral etiology: a systematic review
title_full_unstemmed The effectiveness of convalescent plasma and hyperimmune immunoglobulin for the treatment of severe acute respiratory infections of viral etiology: a systematic review
title_short The effectiveness of convalescent plasma and hyperimmune immunoglobulin for the treatment of severe acute respiratory infections of viral etiology: a systematic review
title_sort effectiveness of convalescent plasma and hyperimmune immunoglobulin for the treatment of severe acute respiratory infections of viral etiology: a systematic review
topic MERS coronavirus; convalescent plasma; severe acute respiratory infection; systematic review; meta-analysis
url https://eprints.nottingham.ac.uk/37680/
https://eprints.nottingham.ac.uk/37680/
https://eprints.nottingham.ac.uk/37680/