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Research
Intravenous immunoglobulin treatment for patients with severe COVID-19: a retrospective multi-center study
Jean-Louis Teboul
Hopital Bicetre
Corresponding Author
Dechang Chen
Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital
Corresponding Author
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This work is licensed under a CC BY 4.0 License. Read Full License
Background: Intravenous immunoglobulin (IVIG) is commonly used to treat severe COVID-19, although the clinical outcomes remain unclear. This study evaluated the effectiveness of IVIG treatment for severe COVID-19.
Methods: This retrospective multi-center study evaluated 28-day mortality and time for SARS-CoV-2 RNA clearance in severe COVID-19 patients with or without IVIG treatment. Propensity score matching was used to control confounding factors. Logistic regression and competing risk analyses were performed.
Results: The study included 850 patients (421 patients received IVIG). No significant differences in 28-day mortality or time for SARS-CoV-2 RNA clearance were observed (p=0.357 and p=0.123, respectively). High-dose of IVIG treatment (>10 g/day) (n=27) was associated with decreased 28-day mortality (OR: 0.33, 95% CI: 0.14–0.77; p=0.011). The IVIG group had prolonged median hospitalization, less shock, and higher incidences of acute respiratory distress syndrome, myocardial injury. Furthermore, IVIG-treated patients were more likely to require non-invasive mechanical ventilation and less likely to require invasive mechanical ventilation.
Conclusions: IVIG treatment for severe COVID-19 patients was not associated with significant improvements in 28-day mortality or time for SARS-CoV-2 RNA clearance. However, some improvements in 28-day survival were observed for high-dose IVIG treatment (>10 g/day).
Keywords
Intravenous immunoglobulin, COVID-19, mortality, viral clearance
Figure 1
Figure 2
This is a list of supplementary files associated with this preprint. Click to download.
- supplfig1.tiff
Supplementary Figure 1. Time from IVIG therapy initiation to hospitalization. Day 0 includes patients who were already on IVIG therapy when hospitalized.
- supplfig2.tif
Supplementary Figure 2. Subgroup analysis of 28-day mortality according to IVIG treatment. APACHE II, Acute Physiology and Chronic Health Evaluation II score; SOFA, Sequential Organ Failure Assessment; COPD, Chronic Obstructive Pulmonary Disease; CCD, Chronic Cardiac Disease; IMV, invasive mechanical ventilation; WBC, white blood cells; CRP, C-reactive protein; APTT, Activated Partial Thromboplastin Time; PT, Prothrombin Time.
- SupplTable1.doc
- SupplTable2.doc
- supplTable3.doc
- supplTable4.doc
- supplTable5.doc
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This is a preprint. It has not completed peer review.
Research
Intravenous immunoglobulin treatment for patients with severe COVID-19: a retrospective multi-center study
Jean-Louis Teboul
Hopital Bicetre
Corresponding Author
Dechang Chen
Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 05 Aug, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Intravenous immunoglobulin (IVIG) is commonly used to treat severe COVID-19, although the clinical outcomes remain unclear. This study evaluated the effectiveness of IVIG treatment for severe COVID-19.
Methods: This retrospective multi-center study evaluated 28-day mortality and time for SARS-CoV-2 RNA clearance in severe COVID-19 patients with or without IVIG treatment. Propensity score matching was used to control confounding factors. Logistic regression and competing risk analyses were performed.
Results: The study included 850 patients (421 patients received IVIG). No significant differences in 28-day mortality or time for SARS-CoV-2 RNA clearance were observed (p=0.357 and p=0.123, respectively). High-dose of IVIG treatment (>10 g/day) (n=27) was associated with decreased 28-day mortality (OR: 0.33, 95% CI: 0.14–0.77; p=0.011). The IVIG group had prolonged median hospitalization, less shock, and higher incidences of acute respiratory distress syndrome, myocardial injury. Furthermore, IVIG-treated patients were more likely to require non-invasive mechanical ventilation and less likely to require invasive mechanical ventilation.
Conclusions: IVIG treatment for severe COVID-19 patients was not associated with significant improvements in 28-day mortality or time for SARS-CoV-2 RNA clearance. However, some improvements in 28-day survival were observed for high-dose IVIG treatment (>10 g/day).
Figure 1
Figure 2