Early Convalescent Plasma Therapy and Mortality among US Veterans Hospitalized with Non-Severe COVID-19: An Observational Analysis Emulating a Target Trial.

<bold>Background: </bold>Early convalescent plasma transfusion may reduce mortality in patients with non-severe coronavirus disease 2019 (COVID-19).<bold>Methods: </bold>This study emulates a (hypothetical) target trial using observational data from a cohort of United States Veterans admitted to a Department of Veterans Affairs (VA) facility between May 1 and November 17, 2020 with non-severe 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.<bold>Results: </bold>Of 11,269 eligible person-trials contributed by 4,755 patients, 402 trials were assigned to the convalescent plasma group. Forty and 671 deaths occurred within the plasma and non-plasma groups, respectively. The estimated 30-day mortality risk was 6.5% (95% CI: 4.0, 9.7) in the plasma group and 6.2% (95% CI: 5.6, 7.0) in the non-plasma group. The associated risk difference was 0.30% (95% CI -2.30, 3.60) and the hazard ratio was 1.04 (95% CI 0.64,1.62).<bold>Conclusion: </bold>Our target trial emulation estimated no meaningful differences in 30-day mortality between non-severe COVID-19 patients treated and untreated with convalescent plasma. [ABSTRACT FROM AUTHOR]