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c19early.org COVID-19 treatment researchConvalescent PlasmaConv. Plasma (more..)
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Summary of COVID-19 convalescent plasma studies

Studies   Meta Analysis   Hide extended summaries

58 patient convalescent plasma early treatment RCT: 247% higher mortality (p=0.17), 163% higher ventilation (p=0.22), and 23% higher progression (p=0.51).
Small RCT with 28 early and 30 deferred (treated according to prespecified deterioration criteria) convalescent plasma patients, not showing significant differences. "Early" is relative, with a median of 5 days from symptom onset. 13 patients in the deferred group received plasma.

Mar 2021, PLOS Medicine, https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003415, https://c19p.org/balcells

144 patient convalescent plasma late treatment RCT: 76% higher mortality (p=0.43), 31% higher ICU admission (p=0.77), and 41% worse 7-point scale results (p=0.32).
RCT 147 patients in Denmark, showing no significant difference in outcomes with convalescent plasma. The trial was terminated due to futility.

Sep 2022, Scientific Reports, https://www.nature.com/articles/s41598-022-19629-z, https://c19p.org/thorlaciusussing

34 patient convalescent plasma late treatment RCT: 425% higher ventilation (p=0.21) and 425% higher progression (p=0.21).
RCT 34 hospitalized patients in the USA, showing no significant difference with convalescent plasma treatment.

Aug 2021, NCT04421404, https://clinicaltrials.gov/ct2/show/results/NCT04421404, https://c19p.org/hsue

129 patient convalescent plasma late treatment RCT: 52% higher mortality (p=0.37).
RCT 129 severe COVID-19 patients in Brazil, showing no significant difference in outcomes with convalescent plasma.

Jun 2022, The Lancet Regional Health - Americas, https://www.sciencedirect.com/science/article/pii/S2667193X22000333, https://c19p.org/song4

160 patient convalescent plasma late treatment RCT: 38% higher mortality (p=0.42), 11% worse improvement (p=0.74), and 67% longer hospitalization (p=0.87).
RCT 160 hospitalized patients in Brazil, showing no significant difference in outcomes with convalescent plasma.

Jul 2021, European Respiratory J., http://erj.ersjournals.com/lookup/doi/10.1183/13993003.01471-2021, https://c19p.org/sekine

511 patient convalescent plasma early treatment RCT: 396% higher mortality (p=0.22), 10% lower hospitalization (p=0.59), and 6% lower progression (p=0.7).
RCT 511 emergency department patients, 257 assigned to convalescent plasma, showing no significant difference in outcomes.

Aug 2021, NEJM, https://www.nejm.org/doi/full/10.1056/NEJMoa2103784, https://c19p.org/korley

29 patient convalescent plasma late treatment RCT: 323% higher mortality (p=0.22), 221% higher ventilation (p=0.33), 25% shorter hospitalization (p=0.08), and 32% improved viral clearance (p=0.11).
Small RCT 29 patients in India, 14 treated with convalescent plasma, not showing significant differences with treatment.

Oct 2020, medRxiv, https://www.medrxiv.org/content/10.1101/2020.10.25.20219337v1, https://c19p.org/bajpai

960 patient convalescent plasma late treatment RCT: 3% higher mortality (p=0.86) and 4% worse 7-point scale results (p=0.76).
RCT 947 hospitalized patients in the USA, showing no signficant difference with convalescent plasma treatment.

Nov 2022, Chest, https://www.sciencedirect.com/science/article/pii/S0012369222012016, https://c19p.org/self4

938 patient convalescent plasma late treatment RCT: 13% higher mortality (p=0.33) and 16% higher combined mortality/intubation (p=0.18).
RCT 940 hospitalized patients, 614 assigned to convalescent plasma, showing no significant differences.

Sep 2021, Nature Medicine, https://www.nature.com/articles/s41591-021-01488-2, https://c19p.org/begin

120 patient convalescent plasma late treatment RCT: 45% higher mortality (p=0.38), 8% higher ICU admission (p=0.85), 250% higher ARDS (p=0.16), and 10% longer hospitalization (p=0.39).
RCT 120 hospitalized patients in Iran, showing no significant differences with convalescent plasma treatment.

Dec 2021, Tanaffos 21:1, https://europepmc.org/article/med/36258918, https://c19p.org/jalili

430 patient convalescent plasma late treatment study: 62% higher mortality (p=0.12).
Retrospective 430 hospitalized COVID-19 patients with type 2 diabetes in Poland showing lower mortality with metformin and higher mortality with remdesivir, convalescent plasma, and aspirin in univariable analysis. These results were not statistically significant except for aspirin, and no baseline information per treatment is provided to assess confounding.

Mar 2024, Biomedicines, https://www.mdpi.com/2227-9059/12/3/605, https://c19p.org/lewandowski2cp

convalescent plasma late treatment study: 270% higher mortality (p=0.07).
Case control study with 2,431 hospitalized COVID-19 patients in India, showing higher mortality with convalescent plasma treatment, without statistical significance.

Apr 2023, The American J. Tropical Medicine and Hygiene, https://www.ajtmh.org/view/journals/tpmd/108/4/article-p727.xml, https://c19p.org/krishnan2cp

1,070 patient convalescent plasma late treatment RCT: 1% worse recovery (p=0.62).
RCT 1,070 outpatients in the USA, showing no significant difference in recovery with convalescent plasma treatment.

Jan 2023, The J. Infectious Diseases, https://academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiad023/7017764, https://c19p.org/baksh

91 patient convalescent plasma late treatment RCT: 220% higher mortality (p=0.16), 38% higher hospital discharge (p=0.04), and 25% worse viral clearance (p=0.72).
RCT 91 hospitalized patients in Colombia showing shorter time to discharge with convalescent plasma, but higher mortality (without statistical significance).

Jun 2022, BMC Infectious Diseases, https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-022-07560-7, https://c19p.org/rojas

136 patient convalescent plasma late treatment RCT: 21% higher mortality (p=0.8), 9% lower progression (p=1), no change in recovery (p=0.77), and 50% slower viral clearance (p=0.2).
RCT 136 hospitalized COVID-19 patients in Uganda, showing no significant benefit with convalescent plasma treatment.

Aug 2021, BMJ Open Respiratory Research, https://bmjopenrespres.bmj.com/lookup/doi/10.1136/bmjresp-2021-001017, https://c19p.org/kirenga3

246 patient convalescent plasma late treatment PSM study: 14% higher mortality (p=0.39), 17% higher progression (p=0.05), 43% longer ICU admission (p=0.003), and 32% longer hospitalization (p=0.01).
PSM retrospective 29 hospitals in Saudi Arabia, showing longer ICU and hospitalization time with convalescent plasma, but no significant difference in mortality.

Feb 2023, Saudi Pharmaceutical J., https://www.sciencedirect.com/science/article/pii/S1319016423000348, https://c19p.org/alshamranicp

130 patient convalescent plasma late treatment study: 29% higher mortality (p=0.54) and 60% longer hospitalization (p=0.07).
Prospective study of 65 hospitalized COVID-19 patients in the Philippines treated with convalescent plasma and 65 matched controls showing no significant difference in mortality and longer hospitalization with treatment.

Feb 2022, medRxiv, https://www.medrxiv.org/content/10.1101/2022.02.23.22271424, https://c19p.org/mesina

57 patient convalescent plasma late treatment RCT: 73% lower ventilation (p=0.28).
RCT 57 hospitalized COVID-19 patients showing no significant difference in outcomes with convalescent plasma treatment.

Mar 2024, Infectious Diseases, https://www.tandfonline.com/doi/full/10.1080/23744235.2024.2329957, https://c19p.org/khawaja

50 patient convalescent plasma late treatment study: 4% higher mortality (p=1).
Retrospective 144 immunocompromised patients treated with anti-CD20 therapy prior to contracting COVID-19. Among 50 patients hospitalized within 14 days, administration of high-titer convalescent plasma in the first 14 days was not associated with improved outcomes.

Nov 2023, Scientific Reports, https://www.nature.com/articles/s41598-023-48145-x, https://c19p.org/kasten

5,044 patient convalescent plasma late treatment study: 4% higher mortality (p=0.88).
Target trial emulation with 4,755 patients showing no significant difference in 30-day mortality with convalescent plasma.

Jun 2021, The J. Infectious Diseases, https://academic.oup.com/jid/article/224/6/967/6307367, https://c19p.org/cho2

464 patient convalescent plasma late treatment RCT: 7% higher mortality (p=0.74), 7% higher progression (p=0.74), 1% lower ventilation (p=0.98), and 28% improved viral clearance (p=0.02).
RCT 464 hospitalized patients in India, 235 treated with convalescent plasma, showing no improvement in combined death at 28 days or progression to severe disease.

Oct 2020, BMJ, https://www.bmj.com/content/371/bmj.m3939, https://c19p.org/agarwal

190 patient convalescent plasma late treatment study: 7% higher mortality (p=0.76).
RCT 190 hospitalized severe condition patients in Mexico, showing no significant difference between convalescent plasma and human immunoglobulin treatment.

Mar 2021, medRxiv, https://www.medrxiv.org/content/10.1101/2021.03.28.21254507, https://c19p.org/gonzalez

11,558 patient convalescent plasma late treatment RCT: no change in mortality (p=0.95) and 1% lower hospital discharge (p=0.57).
RCT 16,287 hospitalized patients in the UK, showing no significant differences with convalescent plasma treatment. Subgroup analysis shows better results for those treated <= 7 days from symptom onset.

Jan 2021, Recovery Collaborative Group, The Lancet, https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00897-7/fulltext, https://c19p.org/recoverycp

483 patient convalescent plasma late treatment RCT: 1% lower mortality (p=0.98), 8% higher ventilation (p=0.78), and no change in ICU admission (p=1).
RCT 489 hospitalized COVID-19 patients in Belgium, showing no significant difference in outcomes with convalescent plasma.

Aug 2021, European Respiratory J., http://erj.ersjournals.com/lookup/doi/10.1183/13993003.01724-2021, https://c19p.org/devos

120 patient convalescent plasma late treatment RCT: 49% lower mortality (p=0.16), 68% higher progression (p=0.18), and 7% longer hospitalization (p=0.99).
RCT 120 hospitalized patients in France, showing no significant difference in outcomes with convalescent plasma treatment, with the exception of lower mortality in the subgroup of immunosuppressed patients.

Aug 2022, medRxiv, https://www.medrxiv.org/content/10.1101/2022.08.09.22278329, https://c19p.org/lacombe

134 patient convalescent plasma late treatment RCT: 8% lower mortality (p=0.39), 2% higher ventilation (p=1), and 22% improved 7-point scale results (p=0.22).
RCT 134 hospitalized patients showing no significant difference in outcomes with convalescent plasma for all patients, however significantly improved mortality and time to improvement was seen for patients with cancer.

Dec 2022, Nature Cancer, https://www.nature.com/articles/s43018-022-00503-w, https://c19p.org/denkinger

1,734 patient convalescent plasma ICU RCT: 1% lower mortality (p=0.9).
Long-term followup for the REMAP-CAP very late stage ICU trial, showing no significant difference with convalescent plasma treatment.

Dec 2022, JAMA, https://jamanetwork.com/journals/jama/fullarticle/2799870, https://c19p.org/higginscp

416 patient convalescent plasma early treatment RCT: 14% lower progression (p=0.42), 39% lower hospitalization (p=0.22), and 1% worse recovery (p=0.92).
RCT 416 outpatients in the Netherlands, showing no significant difference with convalesent plasma treatment. Hospitalization was lower, and improved results were seen with ≤5 days of symptoms, without statistical significance.

Aug 2022, Clinical Microbiology and Infection, https://www.sciencedirect.com/science/article/pii/S1198743X22004219, https://c19p.org/gharbharan2

941 patient convalescent plasma late treatment RCT: 12% lower mortality (p=0.45), 8% improved 7-point scale results (p=0.5), and 2% higher PASC (p=0.88).
RCT 941 hospitalized patients in the USA, showing no significant difference with convalescent plasma treatment. PASC results are from

Dec 2021, JAMA Internal Medicine, https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2787090, https://c19p.org/ortigoza

107 patient convalescent plasma late treatment RCT: 13% lower mortality (p=0.67).
RCT 110 hospitalized patients in Brazil, showing no significant difference in outcomes with high-dose convalescent plasma.

Mar 2022, Emerging Infectious Diseases, https://wwwnc.cdc.gov/eid/article/28/3/21-2299_article.htm, https://c19p.org/desantis

158 patient convalescent plasma late treatment RCT: 12% lower mortality (p=1).
RCT 158 patients in Ecuador, showing no significant difference in mortality with convalescent plasma. Authors note indications of improved results for earlier treatment.

Jan 2022, Transfusion Medicine, https://onlinelibrary.wiley.com/doi/10.1111/tme.12851, https://c19p.org/baldeon

86 patient convalescent plasma late treatment RCT: 4% lower mortality (p=0.95) and 12% higher hospital discharge (p=0.68).
RCT 86 hospitalized patients, 43 treated with convalescent plasma, showing no significant differences with treatment. Authors conclude that the most likely explanation was already high antibody titers on the day of inclusion, and they recommend treating patients early. NCT04342182.

May 2021, Nature Communications, https://www.nature.com/articles/s41467-021-23469-2, https://c19p.org/gharbharan

60 patient convalescent plasma late treatment RCT: 30% longer hospitalization (p=0.06).
RCT 62 hospitalized patients in Iran, showing no significant difference in mortality and length of stay with convalescent plasma.

Apr 2021, Internal and Emergency Medicine, https://link.springer.com/10.1007/s11739-021-02734-8, https://c19p.org/pouladzadeh

333 patient convalescent plasma late treatment RCT: 4% lower mortality (p=1) and 19% improved 7-point scale results (p=0.4).
RCT 333 hospitalized patients in Argentina, 228 treated with convalescent plasma, showing no significant differences in clinical status or mortality.

Nov 2020, NEJM, https://www.nejm.org/doi/full/10.1056/nejmoa2031304, https://c19p.org/simonovich

74 patient convalescent plasma late treatment RCT: 19% lower mortality (p=0.75) and no change in improvement (p=1).
RCT 74 hospitalized patients in the USA, showing no significant difference with convalescent plasma treatment.

Apr 2021, Critical Care Medicine, https://journals.lww.com/10.1097/CCM.0000000000005066, https://c19p.org/bennettguerrero

471 patient convalescent plasma late treatment RCT: 23% lower mortality (p=0.47), 4% higher ventilation (p=1), and 12% lower progression (p=0.54).
RCT 487 patients in Italy, showing no significant difference in outcomes with convalescent plasma.

Nov 2021, JAMA Network Open, https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2786680, https://c19p.org/menichetti

376 patient convalescent plasma early treatment RCT: 80% lower mortality (p=0.5), 5% higher hospitalization (p=1), 5% worse recovery (p=0.67), and 4% worse viral clearance (p=0.33).
RCT 188 convalescent plasma and 188 control patients, showing no significant difference in outcomes.

Feb 2022, The Lancet Respiratory Medicine, https://www.sciencedirect.com/science/article/pii/S2213260021005452, https://c19p.org/alemany

80 patient convalescent plasma late treatment RCT: 33% lower mortality (p=0.34).
Small RCT 80 hospitalized patients in India, 40 treated with convalescent plasma, not showing significant differences in primary analysis. Authors note that significant improvement in hypoxia, reduction in hospital stay, and survival benefit was seen in severe COVID-19 patients with ARDS aged <67. CTRI/2020/05/025209.

Nov 2020, medRxiv, https://www.medrxiv.org/content/10.1101/2020.11.25.20237883v1, https://c19p.org/ray

105 patient convalescent plasma late treatment RCT: 37% lower mortality (p=0.19) and 16% improved recovery (p=0.32).
RCT 105 hospitalized patients in Germany, 53 treated with convalescent plasma, showing no significant difference in mortality or the primary composite outcome of survival and no longer fulfilling criteria for severe COVID-19 on day 21.

Oct 2021, J. Clinical Investigation, https://www.jci.org/articles/view/152264, https://c19p.org/korper

103 patient convalescent plasma late treatment RCT: 17% lower mortality (p=0.65), 67% lower ventilation (p=0.36), 5% greater improvement (p=1), and 3% lower hospital discharge (p=1).
RCT 103 hospitalized patients in South Africa, showing no significant difference in outcomes with convalescent plasma.

Feb 2022, Scientific Reports, https://www.nature.com/articles/s41598-022-06221-8https://www.nature.com/articles/s41598-022-06221-8.pdf, https://c19p.org/vandenberg

31 patient convalescent plasma late treatment RCT: 19% lower progression (p=1), 57% higher need for oxygen therapy (p=0.43), and 62% longer hospitalization (p=0.21).
RCT 31 hospitalized patients requiring supplemental oxygen in Sweden, showing no significant difference in outcomes with convalescent plasma.

Dec 2021, BMC Research Notes, https://bmcresnotes.biomedcentral.com/articles/10.1186/s13104-021-05847-7, https://c19p.org/holm

40 patient convalescent plasma late treatment RCT: 33% lower ventilation (p=0.47) and 22% shorter hospitalization (p=0.12).
Small RCT with 40 hospitalized patients in Bahrain, 20 treated with convalescent plasma, not showing significant differences. NCT04356534.

Nov 2020, Scientific Reports, https://www.nature.com/articles/s41598-021-89444-5, https://c19p.org/alqahtani

103 patient convalescent plasma late treatment RCT: 35% lower mortality (p=0.3), 15% greater improvement (p=0.37), and 76% improved viral clearance (p=0.01).
Small RCT 103 severe condition patients, 52 treated with convalescent plasma, showing improved viral clearance but no statistically significant improvements in mortality or clinical improvement. ChiCTR2000029757.

Jun 2020, JAMA, https://jamanetwork.com/journals/jama/fullarticle/2766943, https://c19p.org/li8

81 patient convalescent plasma late treatment RCT: 88% lower mortality (p=0.12) and 93% lower progression (p=0.01).
Early terminated RCT with 81 hospitalized patients, 38 treated with convalescent plasma, showing lower progression with treatment. NCT04345523.

Sep 2020, medRxiv, https://www.medrxiv.org/content/10.1101/2020.08.26.20182444v3, https://c19p.org/avendanosola

1,181 patient convalescent plasma late treatment RCT: 86% lower mortality (p=0.12) and 54% lower hospitalization (p=0.005).
RCT 1,181 outpatients in the USA, mean 6 days from symptom onset, showing lower hospitalization with treatment. NCT04373460.

Dec 2021, New England J. Medicine, https://www.nejm.org/doi/10.1056/NEJMoa2119657, https://c19p.org/sullivan

160 patient convalescent plasma early treatment RCT: 67% lower ICU admission (p=0.17) and 48% lower progression (p=0.03).
RCT 160 patients >=65 with symptom onset <72 hours, 80 treated with convalescent plasma, showing lower progression to severe disease with treatment.

Jan 2021, NEJM, https://www.nejm.org/doi/10.1056/NEJMoa2033700, https://c19p.org/libster

79 patient convalescent plasma late treatment RCT: 81% lower mortality (p=0.03), 44% greater improvement (p=0.18), and 51% lower ventilation (p=0.16).
RCT 79 hospitalized patients in the USA, showing significant benefit in clinical severity score and 28-day mortality with convalescent plasma treatment.

Dec 2021, J. Clinical Investigation, https://www.jci.org/articles/view/155114, https://c19p.org/bar
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