Open AccessClinical efficacy of intravenous immunoglobulin therapy in critical ill patients with COVID‐19: a multicenter retrospective cohort study
Author(s) -
Shao Ziyun,
Feng Yongwen,
Zhong Li,
Xie Qifeng,
Lei Ming,
Liu Zheying,
Wang Conglin,
Ji Jingjing,
Liu Huiheng,
Gu Zhengtao,
Hu Zhongwei,
Su Lei,
Wu Ming,
Liu Zhifeng
Publication year - 2020
Publication title -
clinical and translational immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.321
H-Index - 34
ISSN - 2050-0068
DOI - 10.1002/cti2.1192
Subject(s) - medicine , confounding , cohort , covid-19 , retrospective cohort study , cohort study , disease , pediatrics , infectious disease (medical specialty)
Abstract Objective Coronavirus disease 2019 (COVID‐19) outbreak is a major challenge all over the world, without acknowledged treatment. Intravenous immunoglobulin (IVIG) has been recommended to treat critical coronavirus disease 2019 (COVID‐19) patients in a few reviews, but the clinical study evidence on its efficacy in COVID‐19 patients was lacking. Methods 325 patients with laboratory‐confirmed critical COVID‐19 were enrolled from 4 government‐designated COVID‐19 treatment centres in southern China from December 2019 to March 2020. The primary outcomes were 28‐ and 60‐day mortality, and the secondary outcomes were the total length of in‐hospital and the total duration of the disease. Subgroup analysis was carried out according to clinical classification of COVID‐19, IVIG dosage and timing. Results In the enrolled 325 patients, 174 cases used IVIG and 151 cases did not. The 28‐day mortality was improved with IVIG after adjusting confounding in overall cohort ( P = 0.0014), and the in‐hospital and the total duration of disease were longer in the IVIG group ( P < 0.001). Subgroup analysis showed that only in patients with critical type, IVIG could significantly reduce the 28‐day mortality, decrease the inflammatory response and improve some organ functions (all P < 0.05); the application of IVIG in the early stage (admission ≤ 7 days) with a high dose (> 15 g per day) exhibited significant reduction in 60‐day mortality in the critical‐type patients. Conclusion Early administration of IVIG with high dose improves the prognosis of critical‐type patients with COVID‐19. This study provides important information on clinical application of IVIG in the treatment of SARS‐CoV‐2 infection, including patient selection and administration dosage and timing.