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14 alkalinization COVID-19 controlled studies, 9 RCTs
75% improvement
for early treatment, RR
0.25
[0.12-0.51]
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Yilmaz (SB RCT)
86%
0.14 [0.01-2.65]
hosp.
0/30
3/30
alkaline solution
Improvement, RR [CI]
Treatment
Control
Yilmaz (SB RCT)
62%
0.4 [0.00-2e+04]
viral load
30 (n)
30 (n)
alkaline solution
Yilmaz (SB RCT)
43%
0.6 [0.00-2e+06]
viral load
30 (n)
30 (n)
alkaline solution
Baxter (RCT)
65%
0.35 [0.01-8.27]
hosp.
0/37
1/42
sodium bicarb. OT1
SeaCare
de Gabory (RCT)
75%
0.25 [0.12-0.54]
progression
7/82
31/91
alkaline seawater
SeaCare
de Gabory (RCT)
68%
0.32 [0.15-0.71]
progression
7/82
24/91
alkaline seawater
SeaCare
de Gabory (RCT)
35%
0.65 [0.27-1.57]
progression
7/82
12/91
alkaline seawater
SeaCare
de Gabory (RCT)
24%
0.76 [0.60-0.96]
recov. time
82 (n)
91 (n)
alkaline seawater
SeaCare
de Gabory (RCT)
17%
0.83 [0.76-0.91]
recov. time
82 (n)
91 (n)
alkaline seawater
SeaCare
de Gabory (RCT)
26%
0.74 [0.57-0.97]
recov. time
82 (n)
91 (n)
alkaline seawater
SeaCare
de Gabory (RCT)
29%
0.71 [0.57-0.87]
recov. time
82 (n)
91 (n)
alkaline seawater
SeaCare
de Gabory (RCT)
26%
0.74 [0.61-0.92]
recov. time
82 (n)
91 (n)
alkaline seawater
SeaCare
de Gabory (RCT)
14%
0.86 [0.68-1.09]
recov. time
82 (n)
91 (n)
alkaline seawater
SeaCare
de Gabory (RCT)
11%
0.89 [0.70-1.13]
recov. time
82 (n)
91 (n)
alkaline seawater
SeaCare
de Gabory (RCT)
-2%
1.02 [0.80-1.29]
recov. time
82 (n)
91 (n)
alkaline seawater
SeaCare
de Gabory (RCT)
25%
0.75 [0.56-0.99]
recov. time
82 (n)
91 (n)
alkaline seawater
SeaCare
de Gabory (RCT)
3%
0.97 [0.77-1.21]
recov. time
82 (n)
91 (n)
alkaline seawater
SeaCare
de Gabory (RCT)
14%
0.86 [0.68-1.09]
recov. time
82 (n)
91 (n)
alkaline seawater
SeaCare
de Gabory (RCT)
37%
0.63 [0.19-2.09]
viral+
4/82
7/91
alkaline seawater
Mody (RCT)
64%
0.36 [0.19-0.68]
no improv.
8/30
22/30
sodium bicarb.
Salva
45%
0.55 [0.35-0.85]
death
35/327
34/174
alkaline ibuprofen CT2
Salva
76%
0.24 [0.14-0.43]
death
11/56
17/21
alkaline ibuprofen CT2
Salva
14%
0.86 [0.83-0.90]
hosp. time
327 (n)
174 (n)
alkaline ibuprofen CT2
Salva
18%
0.82 [0.74-0.91]
hosp. time
56 (n)
21 (n)
alkaline ibuprofen CT2
Soares (ICU)
76%
0.24 [0.11-0.54]
death
6/44
18/32
ICU patients sodium bicarb.
Delić (RCT)
23%
0.77 [0.56-1.06]
death
23/42
37/52
Intubated patients sodium bicarb.
Delić (RCT)
20%
0.80 [0.54-1.18]
death
20/42
31/52
Intubated patients sodium bicarb.
Calonico
49%
0.51 [0.31-0.85]
death
1,019 (n)
3,303 (n)
alkaline ibuprofen CT2
El-Badrawy
57%
0.43 [0.09-2.08]
death
3/127
3/55
sodium bicarb.
El-Badrawy
39%
0.61 [0.20-1.83]
progression
7/127
5/55
sodium bicarb.
El-Badrawy
19%
0.81 [0.68-0.96]
no recov.
84/127
45/55
sodium bicarb.
El-Badrawy
73%
0.27 [0.14-0.52]
no recov.
127 (n)
55 (n)
sodium bicarb.
El-Badrawy
66%
0.34 [0.25-0.47]
recov. time
127 (n)
55 (n)
sodium bicarb.
El-Badrawy (RCT)
23%
0.77 [0.50-1.18]
death
32/272
42/274
sodium bicarb.
El-Badrawy (RCT)
55%
0.45 [0.23-0.87]
death
12/247
27/251
sodium bicarb.
El-Badrawy (RCT)
79%
0.21 [0.02-1.76]
death
1/125
5/130
sodium bicarb.
El-Badrawy (RCT)
53%
0.47 [0.25-0.88]
death
11/63
22/59
sodium bicarb.
El-Badrawy (RCT)
-23%
1.23 [0.86-1.75]
death
20/25
15/23
sodium bicarb.
El-Badrawy (RCT)
28%
0.72 [0.66-0.80]
recov. time
272 (n)
274 (n)
sodium bicarb.
El-Badrawy (RCT)
33%
0.67 [0.52-0.85]
no recov.
238 (n)
229 (n)
sodium bicarb.
Kalayan
79%
0.21 [0.07-0.65]
death
3/37
24/62
alkaline ibuprofen CT2
Wang (RCT)
39%
0.61 [0.46-0.82]
hosp. time
23 (n)
32 (n)
sodium bicarb.
Pantazop.. (SB RCT)
67%
0.33 [0.01-7.85]
death
0/28
1/28
alkaline seawater
Pantazop.. (SB RCT)
67%
0.33 [0.01-7.85]
ICU
0/28
1/28
alkaline seawater
Pantazop.. (SB RCT)
80%
0.20 [0.01-3.99]
oxygen
0/28
2/28
alkaline seawater
Pantazop.. (SB RCT)
42%
0.58 [0.34-0.98]
viral+
11/28
19/28
alkaline seawater
Karami (DB RCT)
45%
0.55 [0.24-1.22]
symptoms
40 (n)
40 (n)
sodium bicarb.
Karami (DB RCT)
43%
0.57 [0.17-1.99]
symptoms
36 (n)
40 (n)
sodium bicarb.
Karami (DB RCT)
42%
0.58 [0.22-1.51]
symptoms
36 (n)
40 (n)
sodium bicarb.
Karami (DB RCT)
79%
0.21 [0.04-0.97]
symptoms
36 (n)
40 (n)
sodium bicarb.
Karami (DB RCT)
18%
0.82 [0.22-2.96]
symptoms
36 (n)
40 (n)
sodium bicarb.
Karami (DB RCT)
39%
0.61 [0.33-1.12]
cases
11/40
18/40
sodium bicarb.
Alkalinization COVID-19 outcomes
c19 early .org
December 2024
1 OT: comparison with other treatment 2 CT: study uses combined treatment
Favors alkalinization
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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