Intravenous immunoglobulin as adjuvant therapy for COVID-19: A case report and literature review

Abstract

Severe acute respiratory syndrome coronavirus 2 has infected and caused the death of an alarming number of individuals worldwide. No specific treatment has been internationally standardized for coronavirus disease 2019 (COVID-19); however, in some cases, intravenous immunoglobulin (IVIG) has been used as adjuvant treatment in critically ill patients with COVID-19 pneumonia. We report a case of a 50-year-old man with severe COVID-19 pneumonia who received 5 days course of IVIG as adjuvant therapy. Invasive respiratory support was avoided. The patient had a successful recovery and was discharged without supplemental oxygen. A high dose of IVIG may improve survival in patients with severe COVID-19 pneumonia. In the current report, we reviewed literature on how IVIG use may improve the early stages of the disease.

Restraint Stress-Induced Immunosuppression Is Associated with Concurrent Macrophage Pyroptosis Cell Death in Mice

“…IVIg is a therapeutic preparation of pooled human IgG antibodies derived from thousands of healthy donors and has been widely used in various clinical settings for its immunomodulatory properties [ 18 , 19 ]. Apart from its well-established efficacy in treating immune-mediated disorders, accumulating evidence suggests that IVIg can also induce immunosuppressive effects under certain conditions [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ]. IVIg-induced immunosuppression has garnered considerable interest, given its potential implications in regulating immune responses and controlling autoimmune and inflammatory diseases [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ].…”

“…Apart from its well-established efficacy in treating immune-mediated disorders, accumulating evidence suggests that IVIg can also induce immunosuppressive effects under certain conditions [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ]. IVIg-induced immunosuppression has garnered considerable interest, given its potential implications in regulating immune responses and controlling autoimmune and inflammatory diseases [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ]. The underlying mechanisms responsible for this immunomodulatory effect are complex and multifaceted, involving interactions with various immune cell populations and immunoregulatory pathways.…”

“…In this study, we aim to compare restraint-stress-induced immunosuppression with two other established models: intravenous immunoglobulin (IVIg) administration and ambient cold exposure [ 18 , 19 ]. IVIg is a mixture of human antibodies and a clinically used drug in immunoglobulin therapy to treat inflammatory and autoimmune diseases, such as immune thrombocytopenia (ITP), Kawasaki disease, systemic lupus erythematosus, dermatomyositis, neurologic disorders, and even COVID-19 infections [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ]. IVIg-induced immunosuppression refers to the suppression of the immune system following the administration of IVIg, which contains high levels of antibodies; however, its mechanism is still not fully understood [ 14 ].…”

COVID-19 in a mosaic trisomy 13 patient with polycystic kidney disease

“…Interestingly, the rapidly expanding COVID-19 literature now includes several reports on successful use of IVIG as an adjuvant therapy, with favorable outcomes in severe COVID-19 pneumonia. 12 This should perhaps also be considered as an adjuvant agent in COVID-19 patients with chromosomal abnormalities and trisomy syndromes, particularly in cases with documented immunoglobulin deficiency.…”