Clin Microbiol Infect. 2021 May 18:S1198-743X(21)00234-2. doi: 10.1016/j.cmi.2021.05.012. Online ahead of print.
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 multicenter 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)was 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 (ATE = 0.008, 95% CI -0.081-0.097, 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- -0.002, p = 0.028).
CONCLUSIONS: 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.