Safety and efficacy of convalescent plasma as a therapy for SARS-CoV-2: A systematic review and meta-analysis.

Background and Aims: The safety and efficacy of convalescent plasma therapy (CPT) in SARS-CoV-2 is promising but intriguing due to heterogeneity of published studies. We conducted this systematic review and meta-analysis of convalescent plasma use in COVID-19 to identify its safety and efficacy. Material and Methods: We comprehensively searched the databases - PubMed, Web of Science, Embase, and the Cochrane Library for journal papers published between December 2019 and January 2021 about the use of CPT in SARS-CoV-2, and performed a meta-analysis using random effects models and assessed the quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Results: Of 1529 records, 11 studies were eligible (five RCTs, two nonrandomized intervention trials, three prospective observational, and one retrospective), and all were conducted in confirmed patients of SARS-CoV-2. Out of the 11 studies, four investigated the effect of CPT on mortality, three on symptom alleviation, five on duration of hospital stay, four on time to discharge, three on the effect on viral clearance, three on the improvement in antibody titers, two on oxygen requirement, and two on adverse events. The pooled estimate for relative risk of death from SARS-CoV-2 was no different after CPT than control (RR: 0.87, 95% CI: 0.69, 1.10), (p = 0.426) but the relative risk of clinical improvement of symptoms was better after CPT (RR: 1.61, 95% CI: 0.97. 2.70). There was earlier hospital discharge after CPT over control (RR: 1.49, 95% CI: 0.79, 2.80), improved viral clearance (RR: 1.95; 95% CI: 1.07, 3.53), and quicker detection of antibody titer (RR: 1.95; 95% CI: 1.07, 3.53). No difference was observed for adverse effects between CPT and control (RR: 0.92.; 95% CI: 0.63 1.35). Conclusion: CPT appears to be a safe and promising treatment in moderate to severe SARS-CoV-2 leading to faster clinical improvement, reduced oxygen requirement, early hospital discharge, and quicker emergence of protective antibodies despite having no mortality benefit.

Comparative study of the mental health impact of the COVID-19 pandemic on health care professionals in India.

Aims: This study aimed to investigate how the psychological health of health care professionals (HCP) on COVID duty was different from those who were not directly in contact. Methodology: Of 473 (76%) randomly selected respondents (doctors and nurses) to a WhatsApp request message, 450 subjects' data were finally analyzed. Result: The prevalence of stress, anxiety and depression among HCP was 33.8, 38.9 and 43.6%, respectively. Compared with nonexposed professionals, COVID-19-exposed professionals had roughly double the score of these morbidities (t = 6.3, p < 0.001; t = 6.9, p < 0.001; t = 6.0, p < 0.001). Most worry (71.11%) was about the health of their family, followed by themselves (35.55%). Conclusion: The level of exposure, feelings of uncertainty and fear of infection emerged in our study as possible risk factors for psychological morbidities among HCP.

The efficacy and safety of hydroxychloroquine (HCQ) in treatment of COVID19 -a systematic review and meta-analysis.

INTRODUCTION: The treatment of SARS CoV2 (Severe Acute Respiratory Syndrome corona virus 2) also known as COVID-19 (corona virus disease 2019) continues to remain an enigma even after six months of the pandemic. Hydroxychloroquine (HCQ) has been one of the most widely tested drugs for SARS CoV2 on account of its antiviral properties. However the results so far have been far from categorical. The meta-analyses conducted till date are also lacking in precision and appropriateness. This systematic review and meta-analysis addresses the efficacy and safety of HCQ in SARS CoV2 by overcoming the limitations of earlier meta-analysis. METHODS: A total of 5 prominent medical databases were searched and fourteen studies (n = 12455) were included in the systematic review and meta-analyses. The data on survival, alleviation of symptoms, conversion of RT PCR positivity to negativity, use and efficacy in presence of co-morbidities (Hypertension, diabetes and heart disease) and cardiac and gastrointestinal side effects were extracted. Meta-analysis was applied to calculate the pooled estimates. Fixed-effects model results were chosen since I2 was <25%.Meta-analysis was conducted using STATA version 13 (StataCorp LP, College Station, TX, USA). RESULTS: The pooled estimates showed that HCQ treatment did not significantly affect survival at 14 and 28 days in COVID-19 patients with respect to the control population (RR: 1.003, 95% CI: 0.983-1.022), alleviation of symptoms at day 10 (RR: 1.044, 95% CI: 0.911 1.196), success in presence of co-morbidities (RR: 1.058, 95% CI: 1.035-1.082) and conversion from RT PCR positive to RT PCR negative on day 6 (RR:1.123, 95% CI: 1.041 1.212). There was higher risk for cardiac side effects (RR: 2.012, 95% CI: 1.428 2.833) and gastrointestinal side effects (RR: 1.318, 95% CI: 0.730 2.380) in HCQ recipients. CONCLUSION: There is no evidence on the safety and efficacy of HCQ either alone or in combination with other drugs in SARS CoV2 infection.