Dataset Information

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

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.

SUBMITTER: Liu J

PROVIDER: S-EPMC8131555 | biostudies-literature | 2021 Oct

REPOSITORIES: biostudies-literature

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Publications

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

Liu Jiao J Chen Yizhu Y Li Ranran R Wu Zhixiong Z Xu Qianghong Q Li Zhongyi Z Annane Djillali D Feng Huibin H Huang Sisi S Guo Jun J Zhang Lidi L Ye Xiaofei X Zhu Wei W Du Hangxiang H Liu Yong'an Y Wang Tao T Chen Limin L Wen Zhenliang Z Teboul Jean-Louis JL Chen Dechang D

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases 20210519 10

<h4>Objectives</h4>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.<h4>Methods</h4>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 ...[more]

PMID: 34020032

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Project description:IntroductionThe rapid worldwide spread of COVID-19 has caused a global health crisis. To date, symptomatic supportive care has been the most common treatment. It has been reported that the mechanism of COVID-19 is related to cytokine storms and subsequent immunogenic damage, especially damage to the endothelium and alveolar membrane. Vitamin C (VC), also known as L-ascorbic acid, has been shown to have antimicrobial and immunomodulatory properties. A high dose of intravenous VC (HIVC) was proven to block several key components of cytokine storms, and HIVC showed safety and varying degrees of efficacy in clinical trials conducted on patients with bacterial-induced sepsis and acute respiratory distress syndrome (ARDS). Therefore, we hypothesise that HIVC could be added to the treatment of ARDS and multiorgan dysfunction related to COVID-19.Methods and analysisThe investigators designed a multicentre prospective randomised placebo-controlled trial that is planned to recruit 308 adults diagnosed with COVID-19 and transferred into the intensive care unit. Participants will randomly receive HIVC diluted in sterile water or placebo for 7 days once enrolled. Patients with a history of VC allergy, end-stage pulmonary disease, advanced malignancy or glucose-6-phosphate dehydrogenase deficiency will be excluded. The primary outcome is ventilation-free days within 28 observational days. This is one of the first clinical trials applying HIVC to treat COVID-19, and it will provide credible efficacy and safety data. We predict that HIVC could suppress cytokine storms caused by COVID-19, help improve pulmonary function and reduce the risk of ARDS of COVID-19.Ethics and disseminationThe study protocol was approved by the Ethics Committee of Zhongnan Hospital of Wuhan University (identifiers: Clinical Ethical Approval No. 2020001). Findings of the trial will be disseminated through peer-reviewed journals and scientific conferences.Trial registration numberNCT04264533.

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Dataset Information

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

Objectives

Methods

Results

Discussion

Publications

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

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