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14 alkalinization COVID-19 controlled studies, 9 RCTs
Supplementary Data — Alkalinization reduces COVID-19 risk: real-time meta analysis of 14 studies
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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 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 CT​1 ​ Salva 76% 0.24 [0.14-0.43] death 11/56 17/21 alkaline ibuprofen CT​1 ​ Salva 14% 0.86 [0.83-0.90] hosp. time 327 (n) 174 (n) alkaline ibuprofen CT​1 ​ Salva 18% 0.82 [0.74-0.91] hosp. time 56 (n) 21 (n) alkaline ibuprofen CT​1 ​ 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 CT​1 ​ 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 CT​1 ​ 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 Lumlertgul (RCT) 67% 0.33 [0.04-2.56] death 1/8 3/8 ICU patients intravenous sodium bicarb. Lumlertgul (RCT) 40% 0.60 [0.21-1.70] misc. 3/8 5/8 ICU patients intravenous sodium bicarb. 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 earlyMay 2025 ​1 ​ 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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