The effect of intravenous immunoglobulins on the outcomes of patients with COVID-19: a systematic review and meta-analysis of randomized controlled trials
a Division of Hospital Medicine, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan. Institute of Biotechnology and Chemical Engineering, I-Shou University, Kaohsiung, Taiwan. Department of Pharmacy, E-Da Hospital, Kaohsiung, Taiwan. Division of Pulmonary Medicine, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan. Department of Internal Medicine, E-Da Cancer Hospital, Kaohsiung, Taiwan. School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
Expert review of anti-infective therapy. 2022;:1-8
Hospitalised patients with COVID-19 (6 studies, n= 472).
Intervention
Intravenous immunoglobulin IVIG (Study group).
Comparison
Standard care or placebo (Control group).
Outcome
Patients who received IVIG had a similar mortality rate compared to patients receiving standard care or placebo (25.3% vs. 27.0%). Compared with the Control group, the Study group demonstrated a similar incidence of receiving mechanical ventilation, intensive care unit (ICU) admission, length of hospital stay (mean difference (MD) -1.81 days) and ICU stay (MD -0.61 days).
Abstract
OBJECTIVES Severe-to-critical COVID-19 has been associated with exaggerated immune responses, and anti-inflammatory agents including corticosteroid and interleukin-6 antagonist have been repurposed as the treatment modality against severe SARS-CoV-2 infections. However, the clinical efficacy and safety of intravenous immunoglobulin (IVIG) in the treatment of patients with COVID-19 was controversial. METHODS This meta-analysis of randomized controlled trials (RCTs) investigated the effectiveness of
IVIG in patients with COVID-19. Electronic databases were searched for RCTs that compared the clinical efficacy of IVIG with standard of care or placebo in the hospitalized patients with COVID-19 were included. RESULTS Six RCTs involving 472 patients were included. Patients who received IVIG had a similar mortality rate to the controls (25.3% vs 27.0%, odds ratio [OR], 0.60; 95% confidence interval [CI], 0.27-1.31). Compared with the control group, the study group demonstrated a similar incidence of receiving mechanical ventilation (OR, 0.70; 95% CI, 0.45-1.11), intensive care unit (ICU) admission (OR, 0.58; 95% CI, 0.22-1.53), length of hospital stay (mean difference [MD], -1.81 days; 95% CI, -8.42 to 4.81) and ICU stay (MD, -0.61 days; 95% CI, -2.80 to 1.58). CONCLUSIONS The administration of IVIG in hospitalized patients with COVID-19 does not improve clinical outcomes.
