Multicenter Study

. 2021 Oct;27(10):1488-1493.

doi: 10.1016/j.cmi.2021.05.012. Epub 2021 May 19.

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

Jiao Liu¹, Yizhu Chen¹, Ranran Li¹, Zhixiong Wu², Qianghong Xu³, Zhongyi Li⁴, Djillali Annane⁵, Huibin Feng⁶, Sisi Huang¹, Jun Guo⁷, Lidi Zhang¹, Xiaofei Ye⁸, Wei Zhu⁹, Hangxiang Du¹, Yong'an Liu¹, Tao Wang¹, Limin Chen¹, Zhenliang Wen¹, Jean-Louis Teboul¹⁰, Dechang Chen¹¹

Affiliations

¹ Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
² Department of Surgical Intensive Care Unit, Huadong Hospital Affiliated to Fudan University, Shanghai, China.
³ Department of Critical Care Medicine, Zhejiang Hospital, Hangzhou, China.
⁴ Department of Critical Care Medicine, Wuhan No.9 Hospital, Wuhan, China.
⁵ FHU SEPSIS (Saclay and Paris Seine Nord Endeavour to PerSonalize Interventions for Sepsis), RHU RECORDS (Rapid rEcognition of CORticosteroiD resistant or sensitive Sepsis), Department of Intensive Care, Hôpital Raymond Poincaré (APHP), Laboratory of Infection & Inflammation - U1173, School of Medicine Simone Veil, University Versailles Saint Quentin - University Paris Saclay, INSERM, Garches, France.
⁶ Intensive Care Unit, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University, Edong Healthcare Group, Huangshi, China.
⁷ Intensive Care Unit, Huazhong University of Science and Technology Union Jiangbei Hospital, Caidian District, Wuhan, China.
⁸ Department of Health Statistics, Second Military Medical University, Shanghai, China.
⁹ Intensive Care Unit, Tianyou Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China.
¹⁰ Service de Médecine-Intensive Réanimation, Hôpital Bicêtre, AP-HP, Université Paris-Saclay, Inserm UMR 999, Université Paris-Saclay, Le Kremlin-Bicêtre, France. Electronic address: jean-louis.teboul@aphp.fr.
¹¹ Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address: chendechangsh@hotmail.com.

PMID: 34020032
PMCID: PMC8131555
DOI: 10.1016/j.cmi.2021.05.012

Multicenter Study

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

Jiao Liu et al. Clin Microbiol Infect. 2021 Oct.

. 2021 Oct;27(10):1488-1493.

doi: 10.1016/j.cmi.2021.05.012. Epub 2021 May 19.

Authors

Affiliations

¹ Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
² Department of Surgical Intensive Care Unit, Huadong Hospital Affiliated to Fudan University, Shanghai, China.
³ Department of Critical Care Medicine, Zhejiang Hospital, Hangzhou, China.
⁴ Department of Critical Care Medicine, Wuhan No.9 Hospital, Wuhan, China.
⁵ FHU SEPSIS (Saclay and Paris Seine Nord Endeavour to PerSonalize Interventions for Sepsis), RHU RECORDS (Rapid rEcognition of CORticosteroiD resistant or sensitive Sepsis), Department of Intensive Care, Hôpital Raymond Poincaré (APHP), Laboratory of Infection & Inflammation - U1173, School of Medicine Simone Veil, University Versailles Saint Quentin - University Paris Saclay, INSERM, Garches, France.
⁶ Intensive Care Unit, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University, Edong Healthcare Group, Huangshi, China.
⁷ Intensive Care Unit, Huazhong University of Science and Technology Union Jiangbei Hospital, Caidian District, Wuhan, China.
⁸ Department of Health Statistics, Second Military Medical University, Shanghai, China.
⁹ Intensive Care Unit, Tianyou Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China.
¹⁰ Service de Médecine-Intensive Réanimation, Hôpital Bicêtre, AP-HP, Université Paris-Saclay, Inserm UMR 999, Université Paris-Saclay, Le Kremlin-Bicêtre, France. Electronic address: jean-louis.teboul@aphp.fr.
¹¹ Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address: chendechangsh@hotmail.com.

PMID: 34020032
PMCID: PMC8131555
DOI: 10.1016/j.cmi.2021.05.012

Abstract

Objectives: Intravenous immunoglobulin (IVIG) is commonly used to treat severe COVID-19, although the clinical outcome of such treatment remains unclear. This study evaluated the effectiveness of IVIG treatment in severe COVID-19 patients.

Methods: This retrospective multicentre study evaluated 28-day mortality in severe COVID-19 patients with or without IVIG treatment. Each patient treated with IVIG was matched with one untreated patient. Logistic regression and inverse probability weighting (IPW) were used to control confounding factors.

Results: The study included 850 patients (421 IVIG-treated patients and 429 non-IVIG-treated patients). After matching, 406 patients per group remained. No significant difference in 28-day mortality was observed after IPW analysis (average treatment effect (ATE) = 0.008, 95% CI -0.081 to 0.097, p 0.863). There were no significant differences between the IVIG group and non-IVIG group for acute respiratory distress syndrome, diffuse intravascular coagulation, myocardial injury, acute hepatic injury, shock, acute kidney injury, non-invasive mechanical ventilation, invasive mechanical ventilation, continuous renal replacement therapy and extracorporeal membrane oxygenation except for prone position ventilation (ATE = -0.022, 95% CI -0.041 to -0.002, p 0.028).

Discussion: IVIG treatment was not associated with significant changes in 28-day mortality in severe COVID-19 patients. The effectiveness of IVIG in treating patients with severe COVID-19 needs to be further investigated through future studies.

Keywords: COVID-19; Intravenous immunoglobulin; Mortality; Severe; Treatment.

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

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

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