Early Convalescent Plasma Therapy and Mortality among US Veterans Hospitalized with Non-Severe COVID-19: An Observational Analysis Emulating a Target Trial

Link to article at PubMed

J Infect Dis. 2021 Jun 21:jiab330. doi: 10.1093/infdis/jiab330. Online ahead of print.

ABSTRACT

BACKGROUND: Early convalescent plasma transfusion may reduce mortality in patients with non-severe coronavirus disease 2019 (COVID-19).

METHODS: This study emulates a (hypothetical) target trial using observational data from a cohort of United States Veterans admitted to a Department of Veterans Affairs (VA) facility between May 1 and November 17, 2020 with non-severe COVID-19. The intervention was convalescent plasma initiated within 2 days of eligibility. Thirty-day mortality was compared using cumulative incidence curves, risk differences, and hazard ratios estimated from pooled logistic models with inverse probability weighting to adjust for confounding.

RESULTS: Of 11,269 eligible person-trials contributed by 4,755 patients, 402 trials were assigned to the convalescent plasma group. Forty and 671 deaths occurred within the plasma and non-plasma groups, respectively. The estimated 30-day mortality risk was 6.5% (95% CI: 4.0, 9.7) in the plasma group and 6.2% (95% CI: 5.6, 7.0) in the non-plasma group. The associated risk difference was 0.30% (95% CI -2.30, 3.60) and the hazard ratio was 1.04 (95% CI 0.64,1.62).

CONCLUSION: Our target trial emulation estimated no meaningful differences in 30-day mortality between non-severe COVID-19 patients treated and untreated with convalescent plasma.

PMID:34153099 | DOI:10.1093/infdis/jiab330

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