Low Admission Immunoglobulin G Levels Predict Poor Outcome in Patients with Mild-to-Critical COVID-19: A Prospective, Single-Center Study

Vrettou, Charikleia S.; Vassiliou, Alice G.; Kakkas, Ioannis; Jahaj, Edison; Tsipilis, Stamatios; Athanasiou, Nikolaos; Zacharis, Alexandros; Keskinidou, Chrysi; Papageorgiou, Aikaterini; Orfanos, Stylianos E.; Kotanidou, Anastasia; Dimopoulou, Ioanna

INTRODUCTION: Immunoglobulins (Igs) comprise a critical part of the immune response. Little information exists on Ig serum levels in COVID-19 patients. We, therefore, investigated whether hospital admission Igs in patients with mild-to-critical disease are associated with clinical outcome. MATERIALS AND METHODS: This prospective, observational, single-center, cross-sectional study included 126 consecutive non-critically ill and critically ill and COVID-19 patients, in whom IgG, IgM, and IgA were measured on hospital admission. RESULTS: The cohort was divided in survivors and non-survivors, based on in-hospital mortality. Median IgG levels of survivors were significantly higher than non-survivors (p < 0.01). The cohort was subsequently divided in IgG deficient (< 690 mg/dl) and sufficient (≥ 690 mg/dl) patients. IgG-deficient patients had a higher mortality rate (p < 0.01). The multivariate logistic regression model showed that subnormal IgG was significantly associated with increased mortality risk (p < 0.01). CONCLUSION: In our COVID-19 cohort, admission subnormal IgG levels might be independently associated with reduced survival.