{"doi":"10.1093/infdis/jiab330","title":"Early Convalescent Plasma Therapy and Mortality Among US Veterans Hospitalized With Nonsevere COVID-19: An Observational Analysis Emulating a Target Trial","abstract":"<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Early convalescent plasma transfusion may reduce mortality in patients with nonsevere coronavirus disease 2019 (COVID-19).</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>This study emulates a (hypothetical) target trial using observational data from a cohort of US veterans admitted to a Department of Veterans Affairs (VA) facility between 1 May and 17 November 2020 with nonsevere 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.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Of 11 269 eligible person-trials contributed by 4755 patients, 402 trials were assigned to the convalescent plasma group. Forty and 671 deaths occurred within the plasma and nonplasma groups, respectively. The estimated 30-day mortality risk was 6.5% (95% confidence interval [CI], 4.0%–9.7%) in the plasma group and 6.2% (95% CI, 5.6%–7.0%) in the nonplasma group. The associated risk difference was 0.30% (95% CI, −2.30% to 3.60%) and the hazard ratio was 1.04 (95% CI, .64–1.62).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Our target trial emulation estimated no meaningful differences in 30-day mortality between nonsevere COVID-19 patients treated and untreated with convalescent plasma.</jats:p><jats:p>Clinical Trials Registration. NCT04545047.</jats:p></jats:sec>","journal":"The Journal of Infectious Diseases","year":2021,"id":639344,"datarank":0.9109210015833848,"base_score":3.044522437723423,"endowment":3.044522437723423,"self_citation_contribution":0.4566783656585135,"citation_network_contribution":0.4542426359248713,"self_endowment_contribution":0.4566783656585135,"citer_contribution":0.4542426359248713,"corpus_percentile":null,"corpus_rank":null,"citation_count":20,"citer_count":19,"citers_with_citation_signal":17,"citers_with_endowment":17,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1661021,"name":"Sarah C Keithly","orcid":null,"position":1,"is_corresponding":false},{"id":1661023,"name":"Katherine E Kurgansky","orcid":null,"position":2,"is_corresponding":false},{"id":388729,"name":"Arin L. Madenci","orcid":"0000-0003-1258-7278","position":3,"is_corresponding":false},{"id":424321,"name":"Hanna Gerlovin","orcid":"0000-0002-6700-2129","position":4,"is_corresponding":false},{"id":1661025,"name":"Helen Marucci-Wellman","orcid":null,"position":5,"is_corresponding":false},{"id":1038222,"name":"Annie Doubleday","orcid":"0000-0002-6600-8668","position":6,"is_corresponding":false},{"id":1661026,"name":"Eva R Thomas","orcid":null,"position":7,"is_corresponding":false},{"id":1661027,"name":"Yojin Park","orcid":null,"position":8,"is_corresponding":false},{"id":1661028,"name":"Yuk-Lam Ho","orcid":null,"position":9,"is_corresponding":false},{"id":637197,"name":"Jonathan D Sugimoto","orcid":null,"position":10,"is_corresponding":false},{"id":1661029,"name":"Kathryn P Moore","orcid":null,"position":11,"is_corresponding":false},{"id":1661030,"name":"Alexander C Peterson","orcid":null,"position":12,"is_corresponding":false},{"id":1661031,"name":"Constance Hoag","orcid":null,"position":13,"is_corresponding":false},{"id":291042,"name":"Kalpana Gupta","orcid":"0000-0002-6766-3576","position":14,"is_corresponding":false},{"id":1661032,"name":"Karen Jeans","orcid":null,"position":15,"is_corresponding":false},{"id":1661033,"name":"Molly Klote","orcid":null,"position":16,"is_corresponding":false},{"id":89914,"name":"Rachel Ramoni","orcid":"0000-0002-1459-9638","position":17,"is_corresponding":false},{"id":1661034,"name":"Grant D Huang","orcid":null,"position":18,"is_corresponding":false},{"id":1661035,"name":"Juan P Casas","orcid":null,"position":19,"is_corresponding":false},{"id":1661036,"name":"David R Gagnon","orcid":null,"position":20,"is_corresponding":false},{"id":128411,"name":"Miguel A Hernán","orcid":null,"position":21,"is_corresponding":false},{"id":1358614,"name":"Nicholas L Smith","orcid":null,"position":22,"is_corresponding":false},{"id":1236417,"name":"J Michael Gaziano","orcid":null,"position":23,"is_corresponding":false},{"id":11349,"name":"Kelly Cho","orcid":"0000-0003-1727-7076","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Early Convalescent Plasma Therapy and Mortality Among US Veterans Hospitalized With Nonsevere COVID-19: An Observational Analysis Emulating a Target Trial","abstract":"<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Early convalescent plasma transfusion may reduce mortality in patients with nonsevere coronavirus disease 2019 (COVID-19).</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>This study emulates a (hypothetical) target trial using observational data from a cohort of US veterans admitted to a Department of Veterans Affairs (VA) facility between 1 May and 17 November 2020 with nonsevere 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.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Of 11 269 eligible person-trials contributed by 4755 patients, 402 trials were assigned to the convalescent plasma group. Forty and 671 deaths occurred within the plasma and nonplasma groups, respectively. The estimated 30-day mortality risk was 6.5% (95% confidence interval [CI], 4.0%–9.7%) in the plasma group and 6.2% (95% CI, 5.6%–7.0%) in the nonplasma group. The associated risk difference was 0.30% (95% CI, −2.30% to 3.60%) and the hazard ratio was 1.04 (95% CI, .64–1.62).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Our target trial emulation estimated no meaningful differences in 30-day mortality between nonsevere COVID-19 patients treated and untreated with convalescent plasma.</jats:p><jats:p>Clinical Trials Registration. NCT04545047.</jats:p></jats:sec>","is_dataset_classified":null,"base_score":3.044522437723423,"endowment":3.044522437723423,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"34153099","pmcid":"PMC8411382","openalex_id":"https://openalex.org/W3176783047","authors":[],"funders":[{"funder_name":"VA Informatics and Computing Infrastructure","grant_id":"VA HSR RES 13–457","title":null},{"funder_name":"VA Informatics and Computing Infrastructure","grant_id":"VA HSR RES 13-457","title":null},{"funder_name":"VA-CAUSAL Methods Core","grant_id":"","title":null},{"funder_name":"Department of Veterans Affairs","grant_id":"","title":null},{"funder_name":"VA","grant_id":"","title":null},{"funder_name":"VA Boston Healthcare System","grant_id":"","title":null},{"funder_name":"VA Puget Sound Healthcare System","grant_id":"","title":null},{"funder_name":"Department of Veterans Affairs (VA) Office of Research and Development","grant_id":"","title":null},{"funder_name":"Department of Veterans Affairs (VA) Office of Research and Development","grant_id":"","title":null},{"funder_name":"VA-CAUSAL Methods Core","grant_id":"","title":null},{"funder_name":"VA Boston Healthcare System","grant_id":"","title":null},{"funder_name":"VA Puget Sound Healthcare System","grant_id":"","title":null},{"funder_name":"VA","grant_id":"","title":null}],"total_grants":13,"fwci":1.0952,"citation_percentile":0.80724013,"influential_citations":0,"citation_trend":[{"year":2021,"count":1},{"year":2022,"count":7},{"year":2023,"count":6},{"year":2024,"count":3},{"year":2025,"count":1},{"year":2026,"count":2}],"oa_status":"green","license":"public-domain","oa_locations":[{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/8411382","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/8411382","host_type":"repository"},{"url":"http://academic.oup.com/jid/advance-article-pdf/doi/10.1093/infdis/jiab330/39354334/jiab330.pdf","host_type":"publisher"},{"url":"http://academic.oup.com/jid/article-pdf/224/6/967/40406164/jiab330.pdf","host_type":"publisher"},{"url":"https://doi.org/10.1093/infdis/jiab330","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/34153099","host_type":"repository"},{"url":"https://academic.oup.com/jid/article-pdf/224/6/967/40406164/jiab330.pdf","host_type":"Unpaywall"}],"fields_of_study":["COVID-19 Clinical Research Studies","SARS-CoV-2 and COVID-19 Research","Sepsis Diagnosis and Treatment","Adult","Aged","Aged, 80 and over","Blood Component Transfusion","COVID-19","Female","Hospitalization","Humans","Immunization, Passive","Male","Middle Aged","Plasma","Treatment Outcome","United States","Veterans","Young Adult","COVID-19 Serotherapy"],"mesh_terms":["COVID-19","COVID-19 Serotherapy","Adult","Aged","Aged, 80 and over","Female","Hospitalization","Humans","Immunization, Passive","Male","Middle Aged","Plasma","United States","Veterans","Treatment Outcome","Blood Component Transfusion","Young Adult"],"keywords":["Convalescent plasma","Observational study","Coronavirus disease 2019 (COVID-19)","Medicine","2019-20 coronavirus outbreak","Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)","Betacoronavirus","Rescue therapy","Emergency medicine","Randomized controlled trial","Intensive care medicine","Internal medicine","Virology","Outbreak","Coronavirus","Covid-19","Sars-cov-2"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[{"name":"nct"}],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-07T00:04:32.379689Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}