Intravenous immunoglobulin treatment for patients with severe COVID-19: a retrospective multicentre study

Liu, Jiao; Chen, Yizhu; Li, Ranran; Wu, Zijian; Xu, Qianghong; Li, Zhongyi; Annane, Djillali; Feng, Hao; Huang, Sisi; Guo, Jun; Zhang, Lidi; Ye, Xiaofei; Zhu, Wei; Du, Hangxiang; Liu, Yong'An; Wang, Tao; Chen, Limin; Wen, Zhenliang; Teboul, Jean Louis; Chen, Dechang

doi:10.1016/j.cmi.2021.05.012

Cited by 17 publications

(23 citation statements)

References 41 publications

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“…However, a weakness of the study was the heterogeneity of the severity of illness among participants, even though the researchers used subgroup analysis of critical and severe patient types. In another retrospective cohort study, Liu et al did not find any significant difference in mortality of patients who received IVIG compared with non-IVIG patients (12).…”

Section: Introductionmentioning

confidence: 89%

“…However, the effectiveness of IVIG use for COVID-19 patients is controversial. A survival benefit from the administration of IVIG was reported in one single randomized clinical trial (6) and in some observational studies (7)(8)(9) but not in others (10)(11)(12). The results of a few small trials of IVIG treatment of COVID-19 have not been sufficiently powered to assess differences in mortality (10,13,14).…”

Section: Introductionmentioning

confidence: 99%

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Intravenous Immunoglobulin Therapy for Critically Ill COVID-19 Patients With Different Inflammatory Phenotypes: A Multicenter, Retrospective Study

Chen

Xie

Wu³

et al. 2022

Front. Immunol.

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BackgroundThe benefits of intravenous immunoglobulin administration are controversial for critically ill COVID-19 patients.MethodsWe analyzed retrospectively the effects of immunoglobulin administration for critically ill COVID-19 patients. The primary outcome was 28-day mortality. Inverse probability of treatment weighting (IPTW) with propensity score was used to account for baseline confounders. Cluster analysis was used to perform phenotype analysis.ResultsBetween January 1 and February 29, 2020, 754 patients with complete data from 19 hospitals were enrolled. Death at 28 days occurred for 408 (54.1%) patients. There were 392 (52.0%) patients who received intravenous immunoglobulin, at 11 (interquartile range (IQR) 8, 16) days after illness onset; 30% of these patients received intravenous immunoglobulin prior to intensive care unit (ICU) admission. By unadjusted analysis, no difference was observed for 28-day mortality between the immunoglobulin and non-immunoglobulin groups. Similar results were found by propensity score matching (n = 506) and by IPTW analysis (n = 731). Also, IPTW analysis did not reveal any significant difference between hyperinflammation and hypoinflammation phenotypes.ConclusionNo significant association was observed for use of intravenous immunoglobulin and decreased mortality of severe COVID-19 patients. Phenotype analysis did not show any survival benefit for patients who received immunoglobulin therapy.

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Section: Introductionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Intravenous Immunoglobulin Therapy for Critically Ill COVID-19 Patients With Different Inflammatory Phenotypes: A Multicenter, Retrospective Study

Chen

Xie

Wu³

et al. 2022

Front. Immunol.

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Section: Intravenous Immunoglobulin (Ivig)mentioning

confidence: 99%

“…Studies on efficacy of IVIg are largely retrospective cohort studies, and IVIg was utilized as a rescue medication following other medications like corticosteroids and tocilizumab [56,57]. Prospective RCTs are scarce and included a small number of patients with conflicting results [56,58,59]. Metaanalyzes of published studies suggest survival advantage in only critical COVID-19 patients characterized by ARDS, sepsis, septic shock that require intensive care admission [60].…”

Section: Intravenous Immunoglobulin (Ivig)mentioning

confidence: 99%

Immune dysfunction in COVID-19 and judicious use of antirheumatic drugs for the treatment of hyperinflammation

Tufan¹,

Matucci‐Cerinic²

2021

Turk J Med Sci

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In the Wuhan province of China, almost two years ago, in December 2019, the novel Coronavirus 2019 has caused a severe involvement of the lower respiratory tract leading to an acute life-threatening respiratory syndrome, coronavirus disease-19 (COVID-19). Subsequently, coronavirus 2 (SARS-CoV-2) rapidly spread to the entire world causing a pandemic and affected every single person on earth either directly or indirectly with destroying all facets of social life and economy. Since the announcement of COVID-19 as a global pandemic, we have witnessed tremendous scientific work on all aspects of COVID-19 across the globe, which has never been witnessed before. The most remarkable achievement would be the introduction of vaccines, which provide protection from the severe infection and is the only premise for the control of disease. However, despite the tremendous work, the number of treatments either antiviral or immunomodulatory for infected patients are considerably limited, yet disease is causing substantial morbidity and mortality. COVID-19 follows heterogenous disease course among infected individuals, and dysregulated immune system is primarily responsible for the worse outcomes. Immune deficiency, being on corticosteroids for inflammatory diseases, delayed interferon response and advanced age adversely influence prognosis with impairing viral clearance. On the other hand, exuberant immune response with features of cytokine storm is the leading cause of death, which can be alleviated by use of either general immunosuppression with corticosteroids or selective neutralization of potent pro-inflammatory cytokines such as interleukin (IL)-1 and IL-6. Herein, we summarized the potential effective immunomodulatory treatments emphasizing in which patient population it is the most suitable, which dose should be administered, and which is the most appropriate timepoint to administer the drug during the course of the disease.

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“…Thus, the effectiveness and safety of this intervention in COVID-19 infection are debatable. Based on several studies, IVIG administration in COVID-19 patients is controversial [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

The outcome of using intravenous immunoglobulin (IVIG) in critically ill COVID-19 patients’: a retrospective, multi-centric cohort study

et al. 2022

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Background During the COVID-19 pandemic, different treatments have been used in critically ill patients. Using intravenous immunoglobulin (IVIG) has been suggested in various studies as an effective option. Our study aims to access the efficacy of IVIG in critically ill COVID-19 patients. Methods In this retrospective matched cohort study, records of three tertiary centers with a large number of COVID-19 admissions were evaluated and used. Based on treatment options, patients were divided into two groups, standard COVID-19 treatment (109 patients) and IVIG treatment (74 patients) patients. Also, the effect of IVIG in different dosages was evaluated. Patients with IVIG treatment were divided into three groups of low (0.25 gr/kg), medium (0.5 gr/kg), and high (1 gr/kg) dose. Data analysis was performed using an independent t test and one-way analysis of variance (ANOVA) to compare the outcomes between two groups, including duration of hospitalization, intensive care unit (ICU) length of stay, and mortality rate. Results The duration of hospitalization in the IVIG group was significantly longer than standard treatment (13.74 days vs. 11.10 days, p < 0.05). There was no significant difference between the two groups in ICU length of stay, the number of intubated patients, and duration of mechanical ventilation (p > 0.05). Also, initial outcomes in IVIG subgroups were compared separately with the standard treatment group. The results indicated that only the duration of hospitalization in the IVIG subgroup with medium dose is significantly longer than the standard treatment group (p < 0.01). Conclusion Our data indicate that the use of IVIG in critically ill COVID-19 patients could not be beneficial, based on no remarkable differences in duration of hospitalization, ICU length of stay, duration of mechanical ventilation, and even mortality rate.

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Intravenous immunoglobulin treatment for patients with severe COVID-19: a retrospective multicentre study

Cited by 17 publications

References 41 publications

Intravenous Immunoglobulin Therapy for Critically Ill COVID-19 Patients With Different Inflammatory Phenotypes: A Multicenter, Retrospective Study

Intravenous Immunoglobulin Therapy for Critically Ill COVID-19 Patients With Different Inflammatory Phenotypes: A Multicenter, Retrospective Study

Immune dysfunction in COVID-19 and judicious use of antirheumatic drugs for the treatment of hyperinflammation

The outcome of using intravenous immunoglobulin (IVIG) in critically ill COVID-19 patients’: a retrospective, multi-centric cohort study

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