Author: 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
Title: Clinical efficacy of intravenous immunoglobulin therapy in critical ill patients with COVIDâ€19: a multicenter retrospective cohort study Cord-id: cqaiyevs Document date: 2020_10_14
ID: cqaiyevs
Snippet: OBJECTIVE: Coronavirus disease 2019 (COVIDâ€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 (COVIDâ€19) patients in a few reviews, but the clinical study evidence on its efficacy in COVIDâ€19 patients was lacking. METHODS: 325 patients with laboratoryâ€confirmed critical COVIDâ€19 were enrolled from 4 governmentâ€designated COVIDâ€19 treatment centres in
Document: OBJECTIVE: Coronavirus disease 2019 (COVIDâ€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 (COVIDâ€19) patients in a few reviews, but the clinical study evidence on its efficacy in COVIDâ€19 patients was lacking. METHODS: 325 patients with laboratoryâ€confirmed critical COVIDâ€19 were enrolled from 4 governmentâ€designated COVIDâ€19 treatment centres in southern China from December 2019 to March 2020. The primary outcomes were 28†and 60â€day mortality, and the secondary outcomes were the total length of inâ€hospital and the total duration of the disease. Subgroup analysis was carried out according to clinical classification of COVIDâ€19, IVIG dosage and timing. RESULTS: In the enrolled 325 patients, 174 cases used IVIG and 151 cases did not. The 28â€day mortality was improved with IVIG after adjusting confounding in overall cohort (P = 0.0014), and the inâ€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 28â€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 60â€day mortality in the criticalâ€type patients. CONCLUSION: Early administration of IVIG with high dose improves the prognosis of criticalâ€type patients with COVIDâ€19. This study provides important information on clinical application of IVIG in the treatment of SARSâ€CoVâ€2 infection, including patient selection and administration dosage and timing.
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