The outcome of using intravenous immunoglobulin (IVIG) in critically ill COVID-19 patients\u2019: a retrospective, multi-centric cohort study

Mahdi Barkhori Mehni,Mohammadreza Salehi,Mohammadmehdi Akbarian,Masoumeh Hosseinzadeh Emam,Nasim Khajavi Rad,Fereshteh Ghiasvand,Maryam Moradi,Saeedreza Jamali Moghaddam,Samrand Fattah Ghazi,Omid Moradi Moghaddam,Sayed Hamidreza Abtahi

doi:10.1186/s40001-022-00637-8

Abstract

BackgroundDuring 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.MethodsIn 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.ResultsThe 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).ConclusionOur 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.

Highlights

Novel coronavirus disease 2019 (COVID-19) pandemic has become a global concern since 2019
Based on the inclusion and exclusion criteria, 183 ICUadmitted COVID-19 patients were included in the study, of which 109 (59.6%) were males and 74 (40.4%) were females, with an average age of 62.71 (± 15.46) years
intensive care unit (ICU) cases COVID-19 PaƟents started on intravenous immunoglobulin (IVIG) treatment (n=202)

Summary

Introduction

Novel coronavirus disease 2019 (COVID-19) pandemic has become a global concern since 2019. No definitive treatment has been found, so it makes sense to consider the effects of possible treatments on the disease One of these possible treatments is intravenous immunoglobulin (IVIG), which has been reported to have contradictory effects in previous studies [2, 3]. The IVIG is a plasma-derived drug that was first used to treat some immune deficiencies [4] It has been used as an adjunct therapy in the management of some infections. Safety, and efficacy of this treatment in previous viral infections, some centers have utilized it in severe cases of COVID-19 infection. Despite its efficacy, this treatment is expensive and has various side effects [9]. Our study aims to access the efficacy of IVIG in critically ill COVID-19 patients

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Discussion

Conclusion