{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T14:57:50Z","timestamp":1790607470922,"version":"4.1.0"},"reference-count":55,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Reviews in Medical Virology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    The efficacy of convalescent plasma (CP) in COVID\u201019 has been contested, with large randomized trials producing conflicting results that led to recommendations against routine use. We performed a systematic review with design\u2010stratified narrative synthesis (PRISMA 2020; SWiM; OSF:\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/osf.io\/tjcuq\">https:\/\/osf.io\/tjcuq<\/jats:ext-link>\n                    ) to test whether these conflicting outcomes can be reconciled through three interacting determinants\u2014timing, antibody titre, and host characteristics\u2014using a standardized 91\u2010field extraction matrix applied to each study. PubMed, Web of Science, and Scopus were searched through May 2026. Thirty\u2010one studies (20,793 patients; 8 RCTs, 23 observational) were included. The synthesis indicates that CP is effective, but only under a specific convergence of conditions: when administered early in the disease course, with sufficient antibody titre, to seronegative or immunocompromised hosts who have not yet mounted an endogenous antibody response. Among RCTs analysing timing, 4 of 6 found benefit with earlier administration; for titre, 3 of 4 RCTs with explicit comparisons found benefit with higher\u2010titre CP; and two large RCTs (combined\n                    <jats:italic>n<\/jats:italic>\n                    \u00a0=\u00a012,522) demonstrated preferential benefit in seronegative recipients. This interpretation is consistent with modelling estimates that CP, deployed largely to hospitalised patients, nonetheless saved tens of thousands of lives in the United States during the first pandemic year, an effect attributed to the subset treated early enough to modify disease progression. A second, previously unquantified finding concerns antibody class: characterisation of non\u2010IgG immunoglobulins was nearly absent, with only 2 of 31 studies\u2014both from our group\u2014reporting IgA or IgM data, despite evidence that IgA and IgM are among the most potent neutralising classes against SARS\u2010CoV\u20102. This hypothesis\u2010generating observation identifies a systematic gap in CP product assessment. These findings reframe CP efficacy from a binary question to a conditional one and provide a template for the precision deployment of passive immunotherapy in future pandemics.\n                  <\/jats:p>","DOI":"10.1002\/rmv.70189","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T18:55:29Z","timestamp":1785524129000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Timing, Titre, and Host Determinants of Convalescent Plasma Efficacy in COVID\u201019: A Systematic Review With Design\u2010Stratified Narrative Synthesis"],"prefix":"10.1002","volume":"36","author":[{"given":"Agnieszka","family":"Ku\u015b","sequence":"first","affiliation":[{"name":"Department of Hematology and Cellular Transplantation Lower Silesian Oncology Center  Wroclaw Poland"},{"name":"Labplus R&amp;D  Wroclaw 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