www.nature.com/scientificreports/ definitive conclusions, absence of a major safety signal is somewhat reassuring. In line with experience in other settings 11 , CCP use was safe in our overall cohort, supporting future evaluation for different indications in high HIV burden populations. The premature termination of the PROTECT trial illustrates the complexity of undertaking clinical research in a rapidly evolving global pandemic. Inconsistent case numbers, viral evolution, and rapidly changing evidence during the trial period contributed to this challenge. Despite this, our trial demonstrated the feasibility of deploying CCP in a resource-limited setting and contributed knowledge on the use of this therapeutic strategy for COVID-19 pneumonia. Our experience highlights the necessity of globally networked clinical trial sites and harmonised study protocols to more efficiently evaluate interventions among diverse populations during a pandemic. Competing interests The authors declare no competing interests.