CHAMGAP
APPROVEDReviewed and approved by the Chamgap Editorial Team (2026-07-24). The draft was written by AI, the existence of all 4 cited sources was verified at the original page, and the verdict passed blind grading and adversarial audit. Methodology v0.6.
Verdict No. 1870 · Search date 2026-07-24 · Methodology v0.6

Convalescent plasma,
does it really help with Reduced 28-day mortality in patients hospitalized with COVID-19?

30-Second Summary
F
Evidence Grade F · 10 · Safety caution
The antibodies are present, but convalescent plasma did not improve survival after hospitalization
Transfusion can cause allergic or febrile reactions, circulatory overload, acute lung injury, and rare severe events. Blood-group compatibility, blood-product screening, and monitoring are required.
What the
research shows
The grade is F. Publicly funded RECOVERY randomized and analyzed all 11,558 participants by intention to treat. Twenty-eight-day mortality was 24% in both groups, rate ratio 1.00 (95% CI 0.93 to 1.07), so the primary endpoint failed. REMAP-CAP also found a 99.4% probability of futility for organ support-free days in 2,011 randomized critically ill adults.
What the
ads claim
The true compositional fact that plasma contains anti-spike antibodies is joined to an unsupported survival benefit after hospitalization.
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Useful facts when choosing a product

  • RECOVERY selected plasma with a EUROIMMUN anti-spike IgG signal-to-cutoff ratio of at least 6.0. Two units of about 275 mL each, allowed range 200 to 350 mL, were given at least 12 hours apart and from different donors when possible.
  • The presence of measurable antibodies in plasma does not establish reduced mortality.
  • RECOVERY randomized 11,558 and included all 11,558 in the primary intention-to-treat analysis.
Gap Measurement · Verdict 1870 · F 10
What advertising claims
What independent, higher-quality research supports
△ GAP
01

What the research actually shows

RECOVERY randomized 11,558 people and analyzed all as assigned. Twenty-eight-day mortality was 1,399 of 5,795 versus 1,408 of 5,763, 24% versus 24%, rate ratio 1.00 (95% CI 0.93 to 1.07), P=0.95. Its prespecified design target was at least 90% power at a two-sided P=0.01 to detect a 20% proportional reduction in 28-day mortality. REMAP-CAP randomized 2,011 critically ill adults and found an adjusted odds ratio of 0.97 (95% credible interval 0.83 to 1.15) for organ-support-free days, with 99.4% probability of futility. A collaborative meta-analysis of 33 trials and 16,477 participants found mortality RR 0.97 (95% CI 0.92 to 1.02), with 0% heterogeneity. Cochrane found 28-day mortality RR 0.98 (95% CI 0.92 to 1.03) across 21 randomized trials and 19,021 participants with moderate or severe disease. Verdict 1861 is A with 88 points. In the same era, inpatient COVID-19 setting, and large public platform-trial context, tocilizumab trials consistently favored benefit with 3% heterogeneity, whereas convalescent-plasma trials were consistently null with 0% heterogeneity. The grades differ because the data differ, not because the topics do.

02

Why this is classified as F (10)

A large public trial and two major syntheses were consistently null for inpatient mortality, and their intervals exclude the 20% proportional reduction RECOVERY was prospectively designed to detect. Independent critical-care futility was also reproduced, yielding F with 10 points.

Counterpoint. Antibody content is real, and evidence for very early outpatient use or selected profoundly immunocompromised people is outside this verdict. A different timing or indication requires a separate assessment.

Rejudgment record. Cross-check applied — Repeated null large independent hard-endpoint trials with confidence intervals excluding clinically meaningful mortality benefit

Scoring profile behind this grade
EndpointHHard endpoint - actual events such as death
ReplicationRXRepeatedly refuted in the same indication
IndependenceI2Decisive evidence is publicly or non-profit funded
Effect sizeE0Null
PrecisionC1The confidence interval excludes meaningful benefit

The scoring table and the verdict agree (F).

Sub-claim grades by effect

This ingredient is marketed for several effects. A single overall grade blends strong and weak claims together, so each effect is graded separately here. The overall grade reflects the strongest disconfirming or core claim.

Effect (sub-claim)GradeBasis
Reduced 28-day mortality in hospitalized patientsFThe 11,558-person intention-to-treat result was RR 1.00, with the confidence interval excluding meaningful benefit.
More organ support-free days in critically ill patientsFREMAP-CAP reported a 99.4% probability of futility.
Faster discharge among hospitalized patientsFRECOVERY also found no improvement in discharge by day 28.

Cross-check — Codex and Claude

This verdict was drafted by Codex through literature review and source-existence checks, cross-checked through blind grading and adversarial audit, and settled by reapplying the methodology boundary rules. Cases with split grades were resolved through rejudgment.
03

Evidence Table

StudyDesignSampleFundingEndpointResultWeight
RECOVERY Collaborative Group 2021Large multicenter randomized open-label platform trial with intention-to-treat analysis1Public funding from UK Research and Innovation, the MRC, and NIHRAll-cause mortality at 28 days24% (1,399/5,795) versus 24% (1,408/5,763), RR 1.00 (95% CI 0.93 to 1.07), P=0.95; primary endpoint failed.Decisive large hard-endpoint refutation
REMAP-CAP Investigators 2021International multicenter Bayesian adaptive randomized trial1,979Multisource public and nonprofit funding including the EU, NHMRC, NIHR, CIHR, and WellcomeOrgan support-free days through day 21Adjusted OR 0.97 (95% credible interval 0.83 to 1.15), 99.4% probability of futility; primary endpoint null.Independent repeated refutation
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Receipt — 4 References

All 4 cited sources were verified for existence at the original page (as of 2026-07-24).

RECOVERY Collaborative Group. Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial. Lancet. 2021;397(10289):2049-2059. PMID: 34000257. DOI: 10.1016/S0140-6736(21)00897-7.
checked
Writing Committee for the REMAP-CAP Investigators. Effect of Convalescent Plasma on Organ Support-Free Days in Critically Ill Patients With COVID-19: A Randomized Clinical Trial. JAMA. 2021;326(17):1690-1702. PMID: 34606578. DOI: 10.1001/jama.2021.18178.
checked
Janiaud P, Axfors C, Schmitt AM, et al. Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials. BMC Infect Dis. 2021;21:1170. PMID: 34800996. DOI: 10.1186/s12879-021-06829-7.
checked
Piechotta V, Iannizzi C, Chai KL, et al. Convalescent plasma for people with COVID-19: a living systematic review. Cochrane Database Syst Rev. 2023;5:CD013600. PMID: 37162745. DOI: 10.1002/14651858.CD013600.pub6.
checked
Draft and rewrite: Codex (AI) · Verification: Codex blind grading and adversarial audit · Final adjudication: Claude
Reviewed and approved: Chamgap Editorial Team · Approval date: 2026-07-24 · Corrections: none

Cite this verdict

Convalescent plasma x reduced mortality in hospitalized COVID-19 Evidence Grade F card
[Chamgap] Convalescent plasma x reduced mortality in hospitalized COVID-19 — Evidence Grade F·10. 4 cited sources checked. Source: https://chamgap.com/en/verdicts/immunity/covid19-convalescent-plasma-hospital-mortality/ · CC BY 4.0

CC BY 4.0 — free to use with attribution; do not distort grades, numbers, or verdict meaning.

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