Evidence map›Paper›PMID 35262370›Full record

ReviewClinical microbiology reviews2022

COVID-19 Convalescent Plasma and Clinical Trials: Understanding Conflicting Outcomes.

Daniele Focosi, Massimo Franchini, Liise-Anne Pirofski, Thierry Burnouf, Nigel Paneth, Michael J Joyner, Arturo Casadevall

Open access · greenAbstract readReview
In one paragraph

Review in Clinical microbiology reviews, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 60 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
60citing papers in PubMed, 4 pooled it
10.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

60 citing papers in PubMed, 4 syntheses or guidelines pooled it, 99 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Efficacy of convalescent plasma in hospitalized COVID-19 patients: findings from a controlled trial.Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologica · 2024
    Trial
  6. Trial
  7. A Randomized Controlled Study Assessing Convalescent Immunoglobulins vs Convalescent Plasma for Hospitalized Patients With Coronavirus 2019.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023
    Trial
  8. Trial
  9. Article
  10. Article
  11. Article
  12. Review
  13. The Importance of Geographic Proximity of Convalescent Plasma Donors.Current topics in microbiology and immunology · 2025
    Review
  14. Review
  15. Article
  16. Review
  17. Estimates of actual and potential lives saved in the United States from the use of COVID-19 convalescent plasma.Proceedings of the National Academy of Sciences of the United States of America · 2024
    Article
  18. Article
  19. COVID-19 therapeutics.Clinical microbiology reviews · 2024
    Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 6 institutions in 3 countries.

Daniele FocosiNorth-Western Tuscany Blood Bank, Pisa University Hospital, Pisa, Italy.ORCID 0000-0001-8811-195X
Massimo FranchiniDivision of Transfusion Medicine, Carlo Poma Hospital, Mantua, Italy.
Liise-Anne PirofskiDivision of Infectious Diseases, Albert Einstein College of Medicine and Montefiore Medical Center, New York, New York, USA.
Thierry BurnoufGraduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical Universitygrid.412896.0, Taipei, Taiwan.
Nigel PanethDepartment of Epidemiology & Biostatistics and Pediatrics & Human Development, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA.
Michael J JoynerDepartment of Anesthesiology and Perioperative Medicine, Mayo Clinicgrid.66875.3a, Rochester, Minnesota, USA.
Arturo CasadevallDepartment of Medicine, Johns Hopkins School of Public Health and School of Medicine, Baltimore, Maryland, USA.ORCID 0000-0002-9402-9167
Albert Einstein College of Medicine · USAzienda Ospedaliera Carlo Poma · ITJohns Hopkins University · USMayo Clinic · USMichigan State University · USTaipei Medical University · TW

Funding

CTSA Administrative Supplement for Informatics Core: A novel AI/ML system to predict respiratory failure and ARDS in Covid-19 patientsUL1TR002556 · NCATS · ALBERT EINSTEIN COLLEGE OF MEDICINE, INC · PI KELLER, MARLA J, KIM, MIMI Y · 2018 to 2022
$26.7M
NCATS NIH HHS UL1 TR002556
6 · The paper itself

Abstract

Convalescent plasma (CP) recurs as a frontline treatment in epidemics because it is available as soon as there are survivors. The COVID-19 pandemic represented the first large-scale opportunity to shed light on the mechanisms of action, safety, and efficacy of CP using modern evidence-based medicine approaches. Studies ranging from observational case series to randomized controlled trials (RCTs) have reported highly variable efficacy results for COVID-19 CP (CCP), resulting in uncertainty. We analyzed variables associated with efficacy, such as clinical settings, disease severity, CCP SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) antibody levels and function, dose, timing of administration (variously defined as time from onset of symptoms, molecular diagnosis, diagnosis of pneumonia, or hospitalization, or by serostatus), outcomes (defined as hospitalization, requirement for ventilation, clinical improvement, or mortality), CCP provenance and time for collection, and criteria for efficacy. The conflicting trial results, along with both recent WHO guidelines discouraging CCP usage and the recent expansion of the FDA emergency use authorization (EUA) to include outpatient use of CCP, create confusion for both clinicians and patients about the appropriate use of CCP. A review of 30 available RCTs demonstrated that signals of efficacy (including reductions in mortality) were more likely if the CCP neutralizing titer was >160 and the time to randomization was less than 9 days. The emergence of the Omicron variant also reminds us of the benefits of polyclonal antibody therapies, especially as a bridge to the development and availability of more specific therapies.

Indexed as

COVID-19COVID-19 SerotherapyHumansImmunization, PassiveObservational Studies as TopicRandomized Controlled Trials as Topicconvalescent plasmaCOVID-19neutralizing antibodiespropensity score-matchedrandomized clinical trialviral neutralization tests

Identifiers

PMID35262370
PMCPMC9491201
OpenAlexW4220678499

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.