LACK OF ASSOCIATION BETWEEN CONVALESCENT PLASMA ADMINISTRATION AND LENGTH OF HOSPITAL STAY: A HOSPITAL-DAY STRATIFIED MULTI-CENTER RETROSPECTIVE COHORT STUDY

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Abstract

Background

Effects of timing of Convalescent plasma (CP) administration on hospitalized COVID-19 patients are not established.

Methods

We used the National COVID Cohort Collaborative data to perform a retrospective cohort study of hospitalized COVID-19 patients in the United States between 07-01-2020 and 12-19-2020. We stratified patients based on day of CP administration (Day 0, 1, 2, 3 and 4) from COVID-19 diagnosis. We used 35 predictors to frame matched cohorts accounting for clinical and sociodemographic characteristics. We used competing risk survival models to examine the association between CP administration and length of hospital stay with in-hospital death as a competing risk performing Gray’s test on the cumulative incidence function and Cox’s regression on cause specific hazard ratios.

Results

In a cohort of 4,003 hospitalized COVID-19 patients, 197 (4.9%) received CP within the first 5 days following COVID-19 diagnosis. After adjusting for potential confounding variables, there were no statistically significant associations between day of CP administration and length of hospital stay. Day 0 CP administration signallled lower mortality but was not statistically significant (HR 0.45 [0.19-1.03]).

Conclusions

We found no association between the timing of CP administration and length of stay among hospitalized COVID-19 patients.

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  1. SciScore for 10.1101/2021.05.04.21256627: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    No key resources detected.


    Results from OddPub: Thank you for sharing your data.


    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Limitations: Administration of CP was not consistently coded in the N3C data. To restrict our analysis to patients who had received CP rather than other plasma products, we excluded all data from providers without specific codes or descriptions for CP data. That restriction reduced our potential population by over 90%. While we attempted to match patient severity using 9 day of CP predictors based on data available within N3C, there could be other predictors that better represent patient status for matching purposes. Furthermore, the study could be augmented, pending data availability, with information on the oxygen device that was used during the treatment period. Another limitation is that the N3C dataset did not track whether a patient was involved in a COVID-19 vaccination trial which may skew results. This, however, is unlikely as vaccinated individuals are unlikely to be hospitalized for COVID-19 given the timeframe this analysis considered is between 07/01/2020 and 12/19/2020. Finally, while the research team considered use of titer and blood type, the analyzed N3C dataset did not contain titer levels of CP that was administered and was sparse in blood type information. Future work: Our data do not demonstrate any clear benefit for CP administration in hospitalized patients with COVID-19 within the first 4 days of hospitalization. There was a trend towards reduced mortality for CP administered on Day 0 but a potential for increased mortality if administered on day 4. M...

    Results from TrialIdentifier: No clinical trial numbers were referenced.


    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.


    Results from JetFighter: We did not find any issues relating to colormaps.


    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.


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