Convalescent plasma is not recommended for patients with nonsevere, severe, or critical COVID-19, according to a living World Health Organization guideline published online Dec. 7 in The BMJ.

Arnav Agarwal, M.D., from McMaster University in Hamilton, Ontario, Canada, and colleagues developed a living guideline to replace earlier versions regarding the role of drugs in the treatment of patients with COVID-19. Recommendations on convalescent plasma were included based on pooled data from 16 randomized controlled trials with 16,236 patients.

The researchers note that the Guideline Development Group (GDG) strongly recommends against use of convalescent plasma for patients with nonsevere illness and recommends against its use in patients with severe and critical illness, unless in the context of a trial. These recommendations were based on evidence indicating no clear benefit for critical outcomes, such as mortality and mechanical ventilation for patients with nonsevere, severe, or critical illness, and significant resource requirements for plasma administration.

"Given there was no benefit demonstrated in any of the critical or important outcomes for nonsevere covid-19, the GDG did not see any justification for the resources (including time and cost) that would be associated with administration of convalescent plasma," the authors write.