Early Experience of High-dose Intravenous Mycobacterium w in Critically Ill Patients of COVID-19

Patel, P. S.; Patel, S.; Shah, V.; Aswani, V.; Narwaria, M.

Background: Immune dysregulation is one of the main reasons for mortality and morbidity in coronavirus disease 2019 (COVID-19). Mycobacterium w (Mw) is recently approved for Gram-negative sepsis. Moreover, it is also found effective in COVID-19 patients in previous studies. The traditional route of administration for Mw is intradermal, which has a limitation of administering 0.1 mL per injection and local injection site reaction. Intravenous (IV) administration of Mw has not been explored in COVID-19. We report the retrospective analysis of six critically ill COVID-19 patients who received Mw (IV). Patients and methods: At baseline, all patients in this case series required O-2 supplementation, and their inflammatory biomarkers were elevated. All patients received 0.6 mL Mw (high-dose) in normal saline along with the standard-of-care treatment. Results: After Mw administration, gradual improvement in O-2 requirement was observed and patients were discharged from the hospital with no mortality. A reduction in mean c-reactive protein (CRP) (51.48-18.52 mg/dL), interleukin-6 (IL-6) (260.22-14.47 pg/mL), and FiO(2) (81.67-43.33) was also observed. No side effects were observed with the use of Mw by IV route. Conclusions: Use of 0.6 mL Mw by IV route in this case series was associated with decreased O-2 supplementation without any side effects in critically ill patients of COVID-19.