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57 convalescent plasma COVID-19 controlled studies, 48 RCTs
-37% improvement
for early treatment, RR
1.37
[0.55-3.42]
Supplementary Data — Convalescent Plasma for COVID-19: real-time meta analysis of 57 studies
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
INFANT-COVID-19
Libster (DB RCT)
50%
0.50 [0.09-2.65]
death
2/80
4/80
Improvement, RR [CI]
Treatment
Control
INFANT-COVID-19
Libster (DB RCT)
50%
0.50 [0.09-2.65]
ventilation
2/80
4/80
INFANT-COVID-19
Libster (DB RCT)
67%
0.33 [0.07-1.60]
ICU
2/80
6/80
INFANT-COVID-19
Libster (DB RCT)
48%
0.52 [0.29-0.94]
progression
13/80
25/80
Balcells (RCT)
-247%
3.47 [0.35-11.9]
death
5/28
2/30
Balcells (RCT)
-163%
2.63 [0.43-9.10]
ventilation
5/28
2/30
Balcells (RCT)
-23%
1.23 [0.56-1.89]
progression
13/28
12/30
Van Hise (RCT)
-441%
5.41 [0.29-101]
hosp.
3/49
0/23
C3PO
Korley (RCT)
-396%
4.96 [0.58-42.2]
death
5/250
1/248
C3PO
Korley (RCT)
10%
0.90 [0.64-1.26]
hosp.
51/257
56/254
C3PO
Korley (RCT)
6%
0.94 [0.72-1.22]
progression
77/257
81/254
CONV-ERT
Alemany (DB RCT)
80%
0.20 [0.01-4.14]
death
0/188
2/188
CONV-ERT
Alemany (DB RCT)
-5%
1.05 [0.60-1.84]
hosp.
22/188
21/188
CONV-ERT
Alemany (DB RCT)
-5%
1.05 [0.85-1.30]
no recov.
188 (n)
188 (n)
CONV-ERT
Alemany (DB RCT)
-4%
1.04 [0.97-1.11]
viral load
188 (n)
188 (n)
CONV-ERT
Alemany (DB RCT)
4%
0.96 [0.88-1.05]
viral load
188 (n)
188 (n)
CoV-Early
Gharbharan (DB RCT)
-1%
1.01 [0.06-16.0]
death
1/207
1/209
CoV-Early
Gharbharan (DB RCT)
67%
0.33 [0.01-8.16]
ventilation
0/207
1/209
CoV-Early
Gharbharan (DB RCT)
14%
0.86 [0.59-1.22]
progression
207 (n)
209 (n)
CoV-Early
Gharbharan (DB RCT)
42%
0.58 [0.33-1.02]
progression
123 (n)
103 (n)
CoV-Early
Gharbharan (DB RCT)
39%
0.61 [0.28-1.34]
hosp.
10/207
18/209
CoV-Early
Gharbharan (DB RCT)
-50%
1.50 [0.40-5.64]
hosp. time
207 (n)
209 (n)
CoV-Early
Gharbharan (DB RCT)
-1%
1.01 [0.88-1.16]
no recov.
137/207
137/209
CoV-Early
Gharbharan (DB RCT)
-8%
1.1 [0.00-9e+04]
recov. time
207 (n)
209 (n)
COVIC-19
Hoffmann (RCT)
51%
0.49 [0.05-5.27]
death
1/59
2/58
COVIC-19
Hoffmann (RCT)
91%
0.09 [0.01-0.77]
death/hosp.
0/59
5/58
COVIC-19
Hoffmann (RCT)
89%
0.11 [0.01-2.00]
death/hosp.
0/59
4/58
COVIC-19
Hoffmann (RCT)
67%
0.33 [0.01-7.97]
ICU
0/59
1/58
Li (RCT)
35%
0.65 [0.27-1.39]
death
8/51
12/50
Li (RCT)
15%
0.85 [0.53-1.18]
no improv.
25/52
29/51
Li (RCT)
76%
0.24 [0.07-0.64]
viral+
4/26
15/23
ConPlas-19
Avendaño-Solà (RCT)
88%
0.12 [0.01-2.11]
death
0/38
4/43
ConPlas-19
Avendaño-Solà (RCT)
93%
0.07 [0.01-0.57]
progression
0/38
7/43
ConPlas-19
Avendaño-Solà (RCT)
92%
0.08 [0.01-0.76]
progression
0/38
6/43
PLACID
Agarwal (RCT)
-7%
1.07 [0.73-1.58]
death
34/235
31/229
PLACID
Agarwal (RCT)
-7%
1.07 [0.73-1.58]
progression
44/235
41/229
PLACID
Agarwal (RCT)
1%
0.99 [0.54-1.81]
ventilation
19/227
19/224
PLACID
Agarwal (RCT)
28%
0.72 [0.55-0.95]
viral+
56/173
76/169
ILBS-COVID-02
Bajpai (RCT)
-323%
4.23 [0.43-41.6]
death
3/14
1/15
ILBS-COVID-02
Bajpai (RCT)
-114%
2.14 [0.22-21.1]
death
2/14
1/15
ILBS-COVID-02
Bajpai (RCT)
-221%
3.21 [0.38-27.4]
ventilation
3/14
1/15
ILBS-COVID-02
Bajpai (RCT)
25%
0.75 [0.54-1.04]
hosp. time
14 (n)
15 (n)
ILBS-COVID-02
Bajpai (RCT)
33%
0.67 [0.41-1.10]
viral load
14 (n)
15 (n)
AlQahtani (RCT)
50%
0.50 [0.05-5.08]
death
1/20
2/20
AlQahtani (RCT)
33%
0.67 [0.22-2.01]
ventilation
4/20
6/20
AlQahtani (RCT)
22%
0.78 [0.57-1.07]
hosp. time
20 (n)
20 (n)
PlasmAr
Simonovich (RCT)
4%
0.96 [0.50-1.83]
death
25/228
12/105
PlasmAr
Simonovich (RCT)
19%
0.81 [0.50-1.31]
7-point status
228 (n)
105 (n)
Ray (RCT)
33%
0.67 [0.30-1.50]
death
10/40
14/40
RECOVERY
Recovery Co.. (RCT)
0%
1.00 [0.93-1.07]
death
1,399/5,795
1,408/5,763
RECOVERY
Recovery Co.. (RCT)
-1%
1.01 [0.97-1.06]
no disch.
1,963/5,795
1,941/5,763
Gonzalez
-7%
1.07 [0.76-1.50]
death
60/130
26/60
OT1
Gonzalez
-1%
1.01 [0.76-1.34]
death
70/130
32/60
OT1
Pouladza.. (SB RCT)
40%
0.60 [0.16-2.29]
death
3/30
5/30
Pouladza.. (SB RCT)
-30%
1.30 [0.99-1.71]
hosp. time
30 (n)
30 (n)
Bennett-.. (DB RCT)
19%
0.81 [0.36-1.86]
death
16/59
5/15
Bennett-.. (DB RCT)
11%
0.89 [0.34-2.31]
death
14/59
4/15
Bennett-.. (DB RCT)
0%
1.00 [0.75-1.32]
no improv.
47/59
12/15
Elhadi (ICU)
-16%
1.16 [0.88-1.54]
death
16/23
265/442
ICU patients
LIFESAVER
Teofili (RCT)
-100%
2.00 [0.16-24.3]
death
1/4
1/8
ConCoVid-19
Gharbharan (RCT)
4%
0.96 [0.25-2.41]
death
6/43
11/43
ConCoVid-19
Gharbharan (RCT)
12%
0.88 [0.49-1.60]
no disch.
43 (n)
43 (n)
Cho
-4%
1.04 [0.64-1.62]
death
402 (n)
4,642 (n)
PLACOVID
Sekine (RCT)
-38%
1.38 [0.73-2.63]
death
18/80
13/80
PLACOVID
Sekine (RCT)
-100%
2.00 [0.72-5.59]
death
10/80
5/80
PLACOVID
Sekine (RCT)
-11%
1.11 [0.74-1.66]
no improv.
31/80
28/80
PLACOVID
Sekine (RCT)
-67%
1.67 [0.01-470]
hosp. time
80 (n)
80 (n)
COVIDIT
Kirenga (RCT)
-21%
1.21 [0.51-2.89]
death
10/69
8/67
COVIDIT
Kirenga (RCT)
9%
0.91 [0.38-2.16]
progression
9/41
7/29
COVIDIT
Kirenga (RCT)
-50%
1.50 [0.81-2.77]
viral time
67 (n)
67 (n)
CAPRI
Hsue (DB RCT)
-212%
3.12 [0.14-71.7]
death
1/16
0/18
CAPRI
Hsue (DB RCT)
-12%
1.12 [0.08-16.6]
death
1/16
1/18
CAPRI
Hsue (DB RCT)
-425%
5.25 [0.27-102]
ventilation
2/16
0/18
CAPRI
Hsue (DB RCT)
-425%
5.25 [0.27-102]
progression
2/16
0/18
CAPRI
Hsue (DB RCT)
-425%
5.25 [0.27-102]
progression
2/16
0/18
DAWn-plasma
Devos (RCT)
1%
0.99 [0.52-1.88]
death
320 (n)
163 (n)
DAWn-plasma
Devos (RCT)
-8%
1.08 [0.65-1.80]
ventilation
320 (n)
163 (n)
DAWn-plasma
Devos (RCT)
0%
1.00 [0.74-1.34]
ICU
320 (n)
163 (n)
CONCOR-1
Bégin (RCT)
-13%
1.13 [0.88-1.45]
death
156/625
69/313
CONCOR-1
Bégin (RCT)
-12%
1.12 [0.86-1.46]
death
141/614
63/307
CONCOR-1
Bégin (RCT)
-16%
1.16 [0.94-1.43]
death/int.
199/614
86/307
CAPSID
Körper (RCT)
37%
0.63 [0.33-1.22]
death
11/53
17/52
CAPSID
Körper (RCT)
14%
0.86 [0.34-2.20]
death
7/53
8/52
CAPSID
Körper (RCT)
16%
0.84 [0.62-1.14]
no recov.
30/53
35/52
LACCPT
Abayomi (DB RCT)
-17%
1.17 [0.58-2.35]
death
7/11
6/11
TSUNAMI
Menichetti (RCT)
23%
0.77 [0.39-1.49]
death
14/231
19/240
TSUNAMI
Menichetti (RCT)
-4%
1.04 [0.62-1.75]
ventilation
25/231
25/240
TSUNAMI
Menichetti (RCT)
12%
0.88 [0.59-1.33]
progression
59/231
67/239
COP20
Holm (RCT)
45%
0.55 [0.11-2.84]
death
2/17
3/14
COP20
Holm (RCT)
69%
0.31 [0.01-7.09]
ventilation
0/17
1/14
COP20
Holm (RCT)
19%
0.81 [0.25-2.64]
progression
4/16
4/13
COP20
Holm (RCT)
-57%
1.57 [0.52-4.74]
oxygen time
17 (n)
14 (n)
COP20
Holm (RCT)
-62%
1.62 [0.76-3.46]
hosp. time
17 (n)
14 (n)
CONTAIN COVID-19
Ortigoza (DB RCT)
12%
0.88 [0.63-1.20]
death
59/462
71/462
CONTAIN COVID-19
Ortigoza (DB RCT)
1%
0.99 [0.66-1.47]
death
35/463
39/463
CONTAIN COVID-19
Ortigoza (DB RCT)
8%
0.92 [0.74-1.16]
WHO scale
468 (n)
473 (n)
CONTAIN COVID-19
Ortigoza (DB RCT)
6%
0.94 [0.75-1.18]
WHO scale
468 (n)
473 (n)
CONTAIN COVID-19
Ortigoza (DB RCT)
-2%
1.02 [0.77-1.37]
PASC
141 (n)
140 (n)
CONTAIN COVID-19
Ortigoza (DB RCT)
5%
0.95 [0.54-1.67]
PASC
141 (n)
140 (n)
CONTAIN COVID-19
Ortigoza (DB RCT)
-15%
1.15 [0.59-2.25]
PASC
141 (n)
140 (n)
CONTAIN COVID-19
Ortigoza (DB RCT)
18%
0.82 [0.44-1.51]
PASC
141 (n)
140 (n)
CONTAIN COVID-19
Ortigoza (DB RCT)
-18%
1.18 [0.71-1.95]
PASC
141 (n)
140 (n)
PennCCP2
Bar (RCT)
81%
0.19 [0.04-0.84]
death
40 (n)
39 (n)
PennCCP2
Bar (RCT)
44%
0.56 [0.24-1.29]
no improv.
40 (n)
39 (n)
PennCCP2
Bar (RCT)
51%
0.49 [0.18-1.30]
ventilation
5/40
10/39
CSSC-004
Sullivan (DB RCT)
86%
0.14 [0.01-2.75]
death
0/592
3/589
CSSC-004
Sullivan (DB RCT)
25%
0.75 [0.17-3.32]
ICU
3/592
4/589
CSSC-004
Sullivan (DB RCT)
54%
0.46 [0.26-0.80]
hosp.
17/592
37/589
Jalili (RCT)
-45%
1.45 [0.74-2.87]
death
16/60
11/60
Jalili (RCT)
-8%
1.08 [0.72-1.63]
ICU
27/60
25/60
Jalili (RCT)
-250%
3.50 [0.76-16.2]
ARDS
7/60
2/60
Jalili (RCT)
-10%
1.10 [0.89-1.36]
hosp. time
60 (n)
60 (n)
Baldeón (DB RCT)
12%
0.88 [0.37-2.11]
death
7/63
12/95
PROTECT-Patient
van den Berg (RCT)
17%
0.83 [0.41-1.68]
death
11/52
13/51
PROTECT-Patient
van den Berg (RCT)
67%
0.33 [0.04-3.04]
ventilation
1/52
3/51
PROTECT-Patient
van den Berg (RCT)
5%
0.95 [0.55-1.63]
no improv.
16/47
18/50
PROTECT-Patient
van den Berg (RCT)
-3%
1.03 [0.62-1.71]
no disch.
18/46
19/50
Mesina
-29%
1.29 [0.70-2.36]
death
18/65
14/65
Mesina
-60%
1.60 [0.96-2.65]
hosp. time
65 (n)
65 (n)
De Santis (RCT)
13%
0.87 [0.48-1.56]
death
11/36
25/71
De Santis (RCT)
12%
0.88 [0.42-1.82]
death
8/36
18/71
COPLA-II
Bajpai (RCT)
-14%
1.14 [0.76-1.69]
death
42/200
37/200
COPLA-II
Bajpai (RCT)
-19%
1.19 [0.69-2.06]
death
25/200
21/200
COPLA-II
Bajpai (RCT)
-12%
1.12 [0.67-1.88]
ventilation
27/200
24/200
COPLA-II
Bajpai (RCT)
-2%
1.02 [0.90-1.15]
ICU
200 (n)
200 (n)
COPLA-II
Bajpai (RCT)
0%
1.00 [0.91-1.09]
hosp. time
200 (n)
200 (n)
COPLA-II
Bajpai (RCT)
6%
0.94 [0.71-1.24]
no recov.
64/200
68/200
COPLA-II
Bajpai (RCT)
-1%
1.01 [0.98-1.05]
viral+
200 (n)
200 (n)
CP-COVID-19
Rojas (SB RCT)
-220%
3.20 [0.64-16.0]
death
46 (n)
45 (n)
CP-COVID-19
Rojas (SB RCT)
38%
0.62 [0.40-0.97]
no disch.
46 (n)
45 (n)
CP-COVID-19
Rojas (SB RCT)
-25%
1.25 [0.36-4.33]
viral+
46 (n)
45 (n)
CP-COVID-19
Rojas (SB RCT)
-16%
1.16 [0.33-4.08]
viral+
46 (n)
45 (n)
CP-COVID-19
Rojas (SB RCT)
-51%
1.51 [0.33-6.98]
viral+
46 (n)
45 (n)
CP-COVID-19
Rojas (SB RCT)
-12%
1.12 [0.16-7.84]
viral+
46 (n)
45 (n)
COOP-COVID-19-MCTI
Song (RCT)
-52%
1.52 [0.70-3.27]
death
22/87
7/42
CORIPLASM
Lacombe (RCT)
49%
0.51 [0.20-1.32]
death
7/60
12/60
CORIPLASM
Lacombe (RCT)
64%
0.36 [0.14-0.97]
death
4/22
11/27
CORIPLASM
Lacombe (RCT)
-68%
1.68 [0.74-3.35]
progression
13/60
8/60
CORIPLASM
Lacombe (RCT)
-4%
1.04 [0.61-1.78]
progression
19/60
20/60
CORIPLASM
Lacombe (RCT)
-7%
1.07 [0.00-9700]
hosp. time
60 (n)
60 (n)
CCAP-2
Thorlaci.. (DB RCT)
-76%
1.76 [0.62-5.01]
death
15/98
4/46
CCAP-2
Thorlaci.. (DB RCT)
-88%
1.88 [0.56-6.33]
death
12/98
3/46
CCAP-2
Thorlaci.. (DB RCT)
-72%
1.72 [0.50-5.87]
death
11/98
3/46
CCAP-2
Thorlaci.. (DB RCT)
-64%
1.64 [0.36-7.60]
death
7/98
2/46
CCAP-2
Thorlaci.. (DB RCT)
-735%
8.35 [0.47-148]
death
5/98
0/46
CCAP-2
Thorlaci.. (DB RCT)
-37%
1.37 [0.29-6.52]
ventilation
6/94
2/43
CCAP-2
Thorlaci.. (DB RCT)
-31%
1.31 [0.45-3.82]
ICU
12/89
4/39
CCAP-2
Thorlaci.. (DB RCT)
-41%
1.41 [0.72-2.09]
7-point status
98 (n)
46 (n)
PLACO COVID
Manzini (DB RCT)
-25%
1.25 [0.61-2.57]
death
14/60
12/60
PLACO COVID
Manzini (DB RCT)
-10%
1.10 [0.61-1.95]
death/int.
17/59
14/56
PLACO COVID
Manzini (DB RCT)
-6%
1.06 [0.70-1.61]
viral time
60 (n)
60 (n)
PassItOn
Self (DB RCT)
-3%
1.03 [0.73-1.44]
death
89/482
80/465
PassItOn
Self (DB RCT)
-26%
1.26 [0.81-1.90]
death
63/482
48/465
PassItOn
Self (DB RCT)
-4%
1.04 [0.82-1.33]
7-point status
487 (n)
473 (n)
REMAP-CAP
Higgins (RCT)
1%
0.99 [0.86-1.14]
death
370/944
324/790
ICU patients
Denkinger (RCT)
8%
0.92 [0.75-1.11]
death
68 (n)
66 (n)
Denkinger (RCT)
-2%
1.02 [0.59-1.77]
ventilation
19/68
18/66
Denkinger (RCT)
22%
0.78 [0.52-1.16]
7-point status
68 (n)
66 (n)
Baksh (DB RCT)
-1%
1.01 [0.94-1.09]
no recov.
381/538
381/532
Baksh (DB RCT)
-4%
1.04 [0.79-1.39]
PASC
533 (n)
528 (n)
Baksh (DB RCT)
9%
0.91 [0.60-1.37]
PASC
232 (n)
234 (n)
Baksh (DB RCT)
-18%
1.18 [0.80-1.74]
PASC
301 (n)
294 (n)
Alshamrani (PSM)
-14%
1.14 [0.79-1.45]
death
24/41
108/205
Alshamrani (PSM)
-17%
1.17 [0.93-1.28]
progression
34/41
154/205
Alshamrani (PSM)
-43%
1.43 [1.13-1.80]
ICU
37 (n)
166 (n)
Alshamrani (PSM)
-32%
1.32 [1.07-1.63]
hosp. time
41 (n)
205 (n)
Krishnan
-270%
3.70 [0.90-15.8]
death
case control
Kasten
-4%
1.04 [0.49-2.21]
death
7/19
11/31
Kasten
-17%
1.17 [0.43-3.15]
death
5/19
7/31
Co-CLARITY
Gauiran (RCT)
-400%
5.00 [0.25-98.5]
death
2/22
0/22
Co-CLARITY
Gauiran (RCT)
-100%
2.00 [0.20-20.5]
ICU
2/22
1/22
Co-CLARITY
Gauiran (RCT)
-7%
1.07 [0.77-1.50]
hosp. time
22 (n)
22 (n)
Lewandowski
-62%
1.62 [0.88-2.98]
death
430 (all patients)
CP_COVID-19
Khawaja (DB RCT)
-154%
2.54 [0.11-59.6]
death
1/37
0/20
CP_COVID-19
Khawaja (DB RCT)
73%
0.27 [0.03-2.80]
ventilation
1/37
2/20
CP_COVID-19
Khawaja (DB RCT)
46%
0.54 [0.12-2.43]
ICU
3/37
3/20
Iasella (PSM)
-26%
1.26 [0.93-1.71]
death
73/290
58/290
Iasella (PSM)
-1%
1.01 [0.86-1.17]
ventilation
155/290
154/290
Iasella (PSM)
0%
1.00 [0.82-1.22]
progression
118/290
118/290
Shaheen (RCT)
0%
1.00 [0.43-2.31]
death
8/30
8/30
Convalescent plasma COVID-19 outcomes
c19 early .org
June 2025
1 OT: comparison with other treatment
Favors conv. plasma
Favors control
Figure S2. Comparison of results for RCTs versus observational studies.
For COVID-19 treatments, there is no significant difference between the results of RCTs and observational studies. Observational studies do not systematically over or underestimate efficacy. For high-cost treatments, there is a non-significant trend towards RCTs showing greater efficacy.
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