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Effects of adjunct treatment with intravenous immunoglobulins on the course of severe COVID-19: results from a retrospective cohort study.
Esen, Figen; Özcan, Perihan E; Orhun, Günseli; Polat, Özlem; Anakli, Ilkay; Alay, Gülçin; Tuna, Verda; Çeliksoy, Emre; Kiliç, Mehmet; Mercan, Mutlu; Tukek, Tufan.
  • Esen F; Department of Anesthesiology and Intensive Care, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
  • Özcan PE; Department of Anesthesiology and Intensive Care, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
  • Orhun G; Department of Anesthesiology and Intensive Care, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
  • Polat Ö; Department of Anesthesiology and Intensive Care, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
  • Anakli I; Department of Anesthesiology and Intensive Care, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
  • Alay G; Department of Anesthesiology and Intensive Care, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
  • Tuna V; Department of Anesthesiology and Intensive Care, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
  • Çeliksoy E; Department of Anesthesiology and Intensive Care, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
  • Kiliç M; Department of Anesthesiology and Intensive Care, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
  • Mercan M; Department of Anesthesiology and Intensive Care, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
  • Tukek T; Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Curr Med Res Opin ; 37(4): 543-548, 2021 04.
Article in English | MEDLINE | ID: covidwho-1081490
ABSTRACT

OBJECTIVES:

To evaluate the effect of adjunct treatment with Octagam, an intravenous immunoglobulin (IVIG) product, on clinical outcomes and biomarkers in critically ill COVID-19 patients.

METHODS:

Data from a single center was analyzed retrospectively. Patients had received preliminary standard intensive care (SIC) according to a local treatment algorithm, either alone or along with IVIG 5% at 30 g/day for 5 days. The two groups were compared regarding baseline characteristics, survival and changes in inflammation markers. Imbalance in baseline APACHE II scores was addressed by propensity score matching. Otherwise, Kaplan-Meier and multiple logistic regression models were used.

RESULTS:

Out of 93 patients, 51 had received IVIG and 42 had not. About 75% of patients were male and both groups had comparable body mass index and AB0 blood type distribution. IVIG-treated patients were younger (mean 65 ± 15 versus 71 ± 15 years, p = .066) and had slightly lower baseline disease scores (APACHE II 20.6 versus 22.4, p = .281; SOFA 5.0 versus 7.0, p = .006). Overall survival was 61% in the SIC + IVIG and 38% in the SIC only group (odds ratio 2.2, 95% confidence interval 0.9-5.4, p = .091 after controlling for baseline imbalances). IVIG significantly prolonged median survival time (68 versus 18 days, p = .014) and significantly reduced plasma levels of C-reactive protein (median change from baseline -71.5 versus -0.3 mg/L, p = .049).

CONCLUSION:

Clinically relevant benefits through adjunct IVIG treatment in COVID-19 need to be confirmed in a randomized, controlled trial.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Immunoglobulins, Intravenous / SARS-CoV-2 / COVID-19 Drug Treatment Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Variants Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Curr Med Res Opin Year: 2021 Document Type: Article Affiliation country: 03007995.2020.1856058

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Immunoglobulins, Intravenous / SARS-CoV-2 / COVID-19 Drug Treatment Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Variants Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Curr Med Res Opin Year: 2021 Document Type: Article Affiliation country: 03007995.2020.1856058