The Value of Convalescent Plasma Therapy as a Strategy to Decrease Hospitalization in COVID-19 Patients: A Randomized Clinical Trial
et al., Acta Medica Philippina, doi:10.47895/amp.vi0.13454, Apr 2026
RCT 30 hospitalized COVID-19 patients in Indonesia showing significantly shorter length of hospital stay with convalescent plasma, however there are multiple major issues:
Table 1 fails to sum to N: the age-group counts in Table 1 total 28, not 30, and the 18-25 row "total" of 4 does not match the component cells (5 + 1).
Near-duplicate primary outcomes: the ER and HCU results are almost identical across every parameter. Two supposedly distinct LOS measures tracking each other this closely across 30 patients is unlikely, suggesting they are not independent measurements.
Secondary outcomes (fever resolution, SpO₂, symptom scores) are described in the methods but are not reported.
Control ER mean is mathematically impossible: the reported control ER LOS of 97.70 hours cannot be produced from integer-hour data summed over 15 patients (1465/15 = 97.67, 1466/15 = 97.73).
No prospective trial registration: this randomized interventional trial recruiting in 2022 was never prospectively registered - a significant GCP/CONSORT deviation.
Effect exceeds the powered design with unusually low p-values: the study was powered to detect a 24-hour difference, yet reports ~33 hours at p<0.001 for both outcomes.
Inconsistent and contradictory reporting: the text swaps the control group's male/female counts versus Table 1 and contains a self-contradictory sentence ("more males... than female (53.3%)"), and a broken age sentence that conflates group counts with column totals.
Unblinded care providers + subjective primary outcome: authors acknowledge that care providers were not blinded. Because the primary outcome is LOS, the unblinded physician is the one deciding when a patient goes home. This introduces uncontrolled bias, as the provider may consciously or subconsciously discharge the CPT patients earlier. Secondary outcomes with lower bias were not reported.
Severe baseline comorbidity imbalance: the control group was fundamentally sicker. 20% of the control group had 3 or more comorbidities, compared to only 7% in the CPT group. Overall, 67% of the control group had comorbidities versus 53% in the treatment group.
Improbable age math: the study reports the control group's mean age is 40.9 years. However, looking at the brackets in Table 1, the control group is skewed older. If we assume every single patient was the absolute youngest possible age in their bracket (18, 26, 36, 46, 56, 66), the sum is 612. Divided by 15, the absolute minimum mathematical mean is 40.8. The reported mean of 40.9 is barely above the mathematical floor of 40.8, implying the control group clustered at the bottom of every age bracket, which is statistically unlikely.
Rahardjo et al., 14 Apr 2026, Single Blind Randomized Controlled Trial, Indonesia, peer-reviewed, mean age 40.0, 4 authors, study period 2 February, 2022 - 31 May, 2022.
Contact: theresiarahardjo@gmail.com.
Abstract: ORIGINAL ARTICLE
The Value of Convalescent Plasma Therapy
as a Strategy to Decrease Hospitalization
in COVID-19 Patients: A Randomized Clinical Trial
Theresia Monica Rahardjo, PhD,1 Hendra Subroto,2 Christian Adiutama3 and Aloysius Suryawan, PhD1
2
1
Faculty of Medicine, Maranatha Christian University, Bandung, Indonesia
Department of Clinical Pathology, Faculty of Medicine, Maranatha Christian University, Bandung, Indonesia
3
Medical Faculty Universitas Pendidikan Indonesia, Bandung, Indonesia
ABSTRACT
Background. Convalescent plasma therapy (CPT) has been utilized as an emergency and last-resort treatment for
viral infections, particularly in the absence of vaccine. During the COVID-19 pandemic, CPT was implemented
worldwide based on its potential to provide passive immunity through SARS-CoV-2 antibodies. While numerous
studies explored the effectiveness of CPT to cure COVID-19 patients, there has no research specifically focused on
superiority of CPT impact on the length of hospitalization.
Objective. This study aimed to evaluate the effect of CPT on the length of hospital stay among patients with moderate
COVID-19.
Methods. This is a single blind randomized controlled trial (RCT) study involved 30 moderate-grade COVID-19
patients age 18-75 years with positive PCR result treated at Unggul Karsa Medika Hospital Bandung from February
2 to May 31, 2022. Moderate-grade COVID-19 defined by clinical pneumonia symptoms based on World Health
Organization (WHO) criteria. Eligible patients were randomly assigned (1:1 ratio) and outcome assessors were
blinded, while care providers and patients were not due to the intervention nature. The intervention arm (n=15)
received 200 ml of high-titer CPT within 24 hours of admission with standard care and the control arm (n=15)
received standard care only. The primary outcome measured was the length of stay (LOS) in both the Emergency
Room (ER) and COVID-19 High Care Unit (HCU). Data were analyzed using independent T-tests.
Results. Thirty (30) eligible patients (mean age 40 years;
53% female) were analyzed for the primary outcome
and all completed follow-ups. The CPT group had
significantly shorter LOS than controls (mean difference
for ER:-32.7 hours [95% CI:-45.0,-20.4]; HCU:-33.3
hours [95% CI:-45.8,-20.8]; p<0.001 for both). This
result attributed to the neutralizing antibodies present in
convalescent plasma, which could inhibit viral replication
and accelerate recovery. No adverse events were
observed in either group.
eISSN 2094-9278 (Online)
Published: April 30, 2026
https://doi.org/10.47895/amp.vi0.13454
Copyright: The Author(s) 2026
Corresponding author: Theresia Monica Rahardjo, PhD
Faculty of Medicine
Maranatha Christian University
Jl. Suria Sumantri No. 65,
Bandung, West Java, 40164 Indonesia
Email: theresiarahardjo@gmail.com
ORCiD: https://orcid.org/0000-0001-9280-023X
VOL. 60 NO. 8 2026
Conclusion. The administration of CPT may reduce
the LOS in moderate COVID-19 patients. However,
the small sample size can limit the generalizability
of this result and larger sample studies are needed to
strengthen this finding. Early CPT implementation may
improve patient management and optimize healthcare
resource utilization during the pandemic.
Keywords: convalescent plasma therapy, COVID-19, length
of stay, antibodies, hospitalization
51
Convalescent Plasma Therapy as a Strategy to Decrease Hospitalization in COVID-19 Patients
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"abstract": "<jats:p>Background. Convalescent plasma therapy (CPT) has been utilized as an emergency and last-resort treatment for viral infections, particularly in the absence of vaccine. During the COVID-19 pandemic, CPT was implemented worldwide based on its potential to provide passive immunity through SARS-CoV-2 antibodies. While numerous studies explored the effectiveness of CPT to cure COVID-19 patients, there has no research specifically focused on superiority of CPT impact on the length of hospitalization.\nObjective. This study aimed to evaluate the effect of CPT on the length of hospital stay among patients with moderate COVID-19.\nMethods. This is a single blind randomized controlled trial (RCT) study involved 30 moderate-grade COVID-19 patients age 18-75 years with positive PCR result treated at Unggul Karsa Medika Hospital Bandung from February 2 to May 31, 2022. Moderate-grade COVID-19 defined by clinical pneumonia symptoms based on World Health Organization (WHO) criteria. Eligible patients were randomly assigned (1:1 ratio) and outcome assessors were blinded, while care providers and patients were not due to the intervention nature. The intervention arm (n=15) received 200 ml of high-titer CPT within 24 hours of admission with standard care and the control arm (n=15) received standard care only. The primary outcome measured was the length of stay (LOS) in both the Emergency Room (ER) and COVID-19 High Care Unit (HCU). Data were analyzed using independent T-tests.\nResults. Thirty (30) eligible patients (mean age 40 years; 53% female) were analyzed for the primary outcome and all completed follow-ups. The CPT group had significantly shorter LOS than controls (mean difference for ER:-32.7 hours [95% CI:-45.0,-20.4]; HCU:-33.3 hours [95% CI:- 45.8,-20.8]; p<0.001 for both). This result attributed to the neutralizing antibodies present in convalescent plasma, which could inhibit viral replication and accelerate recovery. No adverse events were observed in either group.\nConclusion. The administration of CPT may reduce the LOS in moderate COVID-19 patients. However, the small sample size can limit the generalizability of this result and larger sample studies are needed to strengthen this finding. Early CPT implementation may improve patient management and optimize healthcare resource utilization during the pandemic.</jats:p>",
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Late treatment
is less effective
is less effective
