• Zhiheng Xu, Jianmeng Zhou, Yongbo Huang, Xuesong Liu, Yonghao Xu, Sibei Chen, Dongdong Liu, Zhimin Lin, Xiaoqing Liu, and Yimin Li.
• State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Department of Critical Care Medicine, 151 Yanjiang Street, West Guangzhou, 510120, Guangdong, China.
• Crit Care. 2020 Jul 29; 24 (1): 469.

BackgroundConvalescent plasma administration may be of clinical benefit in patients with severe influenza, but reports on the efficacy of this therapy vary.MethodsWe conducted a systematic review and meta-analysis assessing randomized controlled trials (RCTs) involving the administration of convalescent plasma to treat severe influenza. Healthcare databases were searched in February 2020. All records were screened against eligibility criteria, and the risks of bias were assessed. The primary outcome was the fatality rate.ResultsA total of 2861 studies were retrieved and screened. Five eligible RCTs were identified. Pooled analyses yielded no evidence that using convalescent plasma to treat severe influenza resulted in significant reductions in mortality (odds ratio, 1.06; 95% CI, 0.51-2·23; P = 0.87; I2 = 35%), number of days in the intensive care unit, or number of days on mechanical ventilation. This treatment may have the possible benefits of increasing hemagglutination inhibition titers and reducing influenza B viral loads and cytokine levels. No serious adverse events were reported. The included studies were generally of high quality with a low risk of bias.ConclusionsThe administration of convalescent plasma appears safe but may not reduce the mortality, number of days in the intensive care unit, or number of days on mechanical ventilation in patients with severe influenza.

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