tetano
Editor, Senior Moderator
J Infect Dis
. 2021 Jun 21;jiab330.
doi: 10.1093/infdis/jiab330. Online ahead of print.
Early Convalescent Plasma Therapy and Mortality among US Veterans Hospitalized with Non-Severe COVID-19: An Observational Analysis Emulating a Target Trial
Kelly Cho[SUP] 1 2 [/SUP], Sarah C Keithly[SUP] 3 [/SUP], Katherine E Kurgansky[SUP] 1 [/SUP], Arin L Madenci[SUP] 4 [/SUP], Hanna Gerlovin[SUP] 1 [/SUP], Helen M Wellman[SUP] 1 [/SUP], Annie Doubleday[SUP] 3 [/SUP], Eva R Thomas[SUP] 3 [/SUP], Yojin Park[SUP] 1 [/SUP], Yuk-Lam Anne Ho[SUP] 1 [/SUP], Jonathan D Sugimoto[SUP] 3 5 6 [/SUP], Kathryn P Moore[SUP] 3 [/SUP], Alexander C Peterson[SUP] 3 [/SUP], Constance Hoag[SUP] 1 [/SUP], Kalpana Gupta[SUP] 7 8 [/SUP], Karen Jeans[SUP] 9 [/SUP], Molly Klote[SUP] 9 [/SUP], Rachel Ramoni[SUP] 9 [/SUP], Grant D Huang[SUP] 9 [/SUP], Juan P Casas[SUP] 1 2 [/SUP], David R Gagnon[SUP] 1 10 [/SUP], Miguel A Hernán[SUP] 4 [/SUP], Nicholas L Smith[SUP] 3 5 [/SUP], J Michael Gaziano[SUP] 1 2 [/SUP]
Affiliations
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.
Keywords: COVID-19; Convalescent Plasma; Coronavirus; SARS-CoV-2.
. 2021 Jun 21;jiab330.
doi: 10.1093/infdis/jiab330. Online ahead of print.
Early Convalescent Plasma Therapy and Mortality among US Veterans Hospitalized with Non-Severe COVID-19: An Observational Analysis Emulating a Target Trial
Kelly Cho[SUP] 1 2 [/SUP], Sarah C Keithly[SUP] 3 [/SUP], Katherine E Kurgansky[SUP] 1 [/SUP], Arin L Madenci[SUP] 4 [/SUP], Hanna Gerlovin[SUP] 1 [/SUP], Helen M Wellman[SUP] 1 [/SUP], Annie Doubleday[SUP] 3 [/SUP], Eva R Thomas[SUP] 3 [/SUP], Yojin Park[SUP] 1 [/SUP], Yuk-Lam Anne Ho[SUP] 1 [/SUP], Jonathan D Sugimoto[SUP] 3 5 6 [/SUP], Kathryn P Moore[SUP] 3 [/SUP], Alexander C Peterson[SUP] 3 [/SUP], Constance Hoag[SUP] 1 [/SUP], Kalpana Gupta[SUP] 7 8 [/SUP], Karen Jeans[SUP] 9 [/SUP], Molly Klote[SUP] 9 [/SUP], Rachel Ramoni[SUP] 9 [/SUP], Grant D Huang[SUP] 9 [/SUP], Juan P Casas[SUP] 1 2 [/SUP], David R Gagnon[SUP] 1 10 [/SUP], Miguel A Hernán[SUP] 4 [/SUP], Nicholas L Smith[SUP] 3 5 [/SUP], J Michael Gaziano[SUP] 1 2 [/SUP]
Affiliations
- PMID: 34153099
- DOI: 10.1093/infdis/jiab330
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.
Keywords: COVID-19; Convalescent Plasma; Coronavirus; SARS-CoV-2.