OBJECTIVE: No single therapy is proven effective yet in children with COVID-19. Although rare, critically ill patients with COVID-19 might need convalescent plasma therapy as an alternative for treatment. This systematic review aims to assess the use of CP from published studies and ongoing clinical trials in the pediatric population with COVID-19 infection.

MATERIALS AND METHODS: This systematic review is registered in the PROSPERO database (CRD42021265136). We searched PubMed, Science Direct, Medline, Scielo, and four different preprint databases, including Medrxiv, Research Square, SSRN, and Biorxiv. We also searched for clinical trials on Clinicaltrials.gov and the International Clinical Trials Registry Platform (ICTRP).

RESULTS: We include 11 studies with a total of 40 patients. Most of the patients are female (60%) with a mean age of 9.84 (SD±6.4) years old and present with severe or critical conditions. After CP transfusion, the time needed for a temperature drop, negative PCR results, clinical improvement, oxygen discontinuation, and hospital discharge is three days (SD±1.4), 8.6 days (SD±7.2), 8.4 days (SD±8.7), nine days (SD±5.95), and 9.05 (SD±5.05) days, respectively. Within 24-72 hours of transfusion, C-reactive protein, fibrinogen, brain natriuretic peptide, and liver function tests are normalized. There is one event of line-associated thrombus due to convalescent plasma transfusion.

CONCLUSIONS: Overall, further randomized controlled trials are needed to assess the efficacy and safety of CP. Until there is further evidence, the administration of convalescent plasma should be limited in clinical research settings.