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Supplementary Data — Casirivimab/imdevimab reduced COVID-19 risk: real-time meta analysis of 34 studies

@CovidAnalysis, October 2025, Version 51V51
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0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Regeneron (RCT) 38% 0.62 [0.29-1.33] recov. time 92 (n) 91 (n) Improvement, RR [CI] Treatment Control Regeneron (RCT) 54% 0.46 [0.19-1.13] recov. time 92 (n) 91 (n) Regeneron (RCT) 71% 0.29 [0.17-0.48] death/hosp. 18/1,355 62/1,341 Regeneron (RCT) 70% 0.30 [0.13-0.68] death/hosp. 7/736 24/748 Regeneron (RCT) 29% 0.71 [0.60-0.85] recov. time 1,355 (n) 1,341 (n) Regeneron (RCT) 29% 0.71 [0.60-0.85] recov. time 736 (n) 748 (n) Weinreich (RCT) 50% 0.50 [0.09-2.72] death 2/2,091 4/2,089 Weinreich (RCT) 67% 0.33 [0.03-3.17] death 1/1,355 3/1,341 Weinreich (RCT) -2% 1.02 [0.06-16.2] death 1/736 1/748 Weinreich (RCT) 71% 0.29 [0.17-0.48] death/hosp. 18/1,355 62/1,341 Weinreich (RCT) 70% 0.30 [0.13-0.68] death/hosp. 7/736 24/748 Weinreich (RCT) 29% 0.71 [0.58-0.87] recov. time 1,355 (n) 1,341 (n) Weinreich (RCT) 29% 0.71 [0.58-0.87] recov. time 736 (n) 748 (n) Webb 98% 0.0 [0.00-2e+05] death 0/115 57/5,536 Webb 91% 0.09 [0.01-0.63] hosp. 1/115 538/5,536 Cooper 77% 0.23 [0.03-1.65] death 1/1,148 33/8,534 Cooper 48% 0.52 [0.23-1.20] ICU 6/1,148 85/8,534 Cooper 52% 0.48 [0.35-0.64] hosp. 45/1,148 703/8,534 Kakinoki 58% 0.42 [0.17-0.92] progression 13/55 22/53 Komagamine 77% 0.23 [0.01-4.63] ventilation 0/53 2/75 Komagamine 92% 0.08 [0.01-0.90] ICU 0/53 7/75 Komagamine 68% 0.32 [0.13-0.68] progression 8/53 33/75 Komagamine 29% 0.71 [0.58-0.87] hosp. time 53 (n) 75 (n) Suzuki (PSM) -200% 3.00 [0.12-73.3] death 1/222 0/222 Suzuki 60% 0.40 [0.05-3.45] death 1/314 5/635 Suzuki (PSM) 45% 0.55 [0.31-0.96] progression 17/222 31/222 Suzuki 50% 0.50 [0.31-0.80] progression 34/314 70/365 O'Brien (DB RCT) 85% 0.15 [0.01-2.78] hosp. 0/100 3/104 O'Brien (DB RCT) 92% 0.08 [0.01-0.77] hosp./ER 0/100 6/104 O'Brien (DB RCT) 33% 0.67 [0.43-0.98] symp. case 29/100 44/104 O'Brien (DB RCT) 40% 0.60 [0.45-0.81] viral load 100 (n) 104 (n) Shopen -46% 1.46 [0.73-2.67] severe case 24/116 26/243 Osugi 24% 0.76 [0.23-2.49] hosp. 4/30 15/74 Wei 61% 0.39 [0.26-0.60] death/hosp. 23/1,116 27/5,291 Wei 61% 0.39 [0.30-0.51] hosp. 59/3,280 75/16,284 Wilden 82% 0.18 [0.05-0.50] hosp. n/a n/a Faraone 92% 0.08 [0.01-0.83] death 0/11 8/23 Faraone 94% 0.06 [0.00-0.76] oxygen 0/11 15/23 Miyashita 33% 0.67 [0.11-3.97] ventilation 2/461 3/461 Miyashita 46% 0.54 [0.35-0.82] oxygen 30/461 56/461 Levey 31% 0.69 [0.07-7.37] ICU 1/36 2/50 Levey 7% 0.93 [0.16-5.26] oxygen 2/36 3/50 Levey -108% 2.08 [0.81-5.33] hosp. 9/36 6/50 Kneidinger 97% 0.03 [0.00-264] severe case 0/3 34/215 Williams -21% 1.21 [0.14-9.86] oxygen 1/88 6/676 Williams -1% 1.01 [0.12-8.01] severe case 1/88 7/676 Williams 14% 0.86 [0.10-6.63] hosp. 1/88 8/676 Gershengorn -95% 1.95 [0.86-4.18] hosp. 369 (n) 5,915 (n) Gershengorn (PSM) -105% 2.05 [1.23-3.42] hosp. 21/369 41/1,476 Gershengorn (PSM) -100% 2.00 [0.99-4.06] hosp. 11/213 22/852 Gershengorn (PSM) -111% 2.11 [1.00-4.44] hosp. 10/156 19/624 Hussein (PSM) 60% 0.40 [0.38-0.42] death/hosp. population-based cohort Kip 46% 0.54 [0.41-0.71] death/hosp. 61/1,479 227/2,954 Shahnawaz 86% 0.14 [0.01-2.71] death 0/85 3/84 Shahnawaz 48% 0.52 [0.27-0.97] progression 12/85 23/84 Shahnawaz 31% 0.69 [0.56-0.86] viral time 85 (n) 84 (n) RECOVERY Horby (RCT) 3% 0.97 [0.90-1.06] death 1,124/4,839 1,203/4,946 RECOVERY Horby (RCT) 6% 0.94 [0.86-1.02] death 943/4,839 1,029/4,946 RECOVERY Horby (RCT) -1% 1.01 [0.90-1.14] ventilation 484/4,556 488/4,642 RECOVERY Horby (RCT) 21% 0.79 [0.69-0.91] death 396/1,633 452/1,520 RECOVERY Horby (RCT) 13% 0.87 [0.73-1.05] ventilation 190/1,599 202/1,484 Somersa.. (DB RCT) 3% 0.97 [0.56-1.69] death 804 (n) 393 (n) Somersa.. (DB RCT) 36% 0.64 [0.44-0.93] death 59/804 45/393 Somersa.. (DB RCT) -57% 1.57 [0.93-2.64] death 44/110 13/51 Somersa.. (DB RCT) 3% 0.97 [0.53-1.76] death 13/23 7/12 Somersa.. (DB RCT) 31% 0.69 [0.50-0.95] death/int. 82/804 58/393 Somersa.. (DB RCT) 30% 0.70 [0.52-0.94] no disch. 90/804 63/393 McCreary (PSM) 93% 0.07 [0.01-0.51] death 1/652 29/1,304 McCreary (PSM) 56% 0.44 [0.28-0.68] death/hosp. 22/652 101/1,304 McCreary (PSM) 48% 0.52 [0.33-0.82] hosp. 22/652 85/1,304 McCreary (PSM) 40% 0.60 [0.43-0.85] hosp./ER 40/652 133/1,304 Iustila-Maran (ICU) -16% 1.16 [0.53-2.54] death 14/50 7/29 ICU patients Shah -14% 1.14 [0.45-2.91] death 8/50 7/50 Shah 0% 1.00 [0.41-2.46] ventilation 8/50 8/50 Shah 14% 0.86 [0.54-1.39] ICU 19/50 22/50 Shah -43% 1.43 [0.00-1565] ICU 50 (n) 50 (n) Shah 4% 0.96 [0.63-1.45] oxygen 23/50 24/50 Shah 12% 0.88 [0.60-1.28] hosp. time 50 (n) 50 (n) Chua (PSM) 80% 0.20 [0.01-3.77] ventilation 0/32 3/96 Chua (PSM) 84% 0.16 [0.01-2.86] ICU 0/32 4/96 Chua (PSM) 31% 0.69 [0.31-1.53] oxygen 6/32 26/96 Regeneron (RCT) 94% 0.06 [0.01-0.50] symp. case 0/186 8/223 Regeneron (RCT) 48% 0.52 [0.25-1.07] cases 10/186 23/223 Regeneron (DB RCT) 92% 0.08 [0.01-0.79] hosp. 0/841 6/842 Regeneron (DB RCT) 81% 0.19 [0.12-0.30] cases 20/841 108/842 Regeneron (DB RCT) 82% 0.18 [0.08-0.41] cases 7/841 38/842 Regeneron (DB RCT) 89% 0.11 [0.01-2.06] hosp./ER 0/753 4/752 Regeneron (DB RCT) 81% 0.19 [0.10-0.35] symp. case 11/753 59/752 Regeneron (DB RCT) 62% 0.38 [0.23-0.61] recov. time 753 (n) 752 (n) Regeneron (DB RCT) 69% 0.31 [0.17-0.55] viral time 753 (n) 752 (n) Isa (DB RCT) 93% 0.07 [0.01-0.28] symp. case 3/729 13/240 Isa (DB RCT) 93% 0.07 [0.01-0.28] cases 0/729 10/240 Bes-Berlandier -67% 1.67 [0.69-4.06] progression 5/17 13/74 Isa (RCT) -37% 1.37 [0.57-3.32] symp. case 35/245 5/48 Ohtani 88% 0.12 [0.02-0.71] cases 14 (n) 38 (n) Casirivimab/imdevimab COVID-19 outcomes c19early.org October 2025 Favors casirivimab/im.. Favors control
Fig. S1. All outcomes.
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Fig. 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.
Please send us corrections, updates, or comments. c19early involves the extraction of 200,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. IMA and WCH provide treatment protocols.
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