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Intravenous Immunoglobulin Therapy for Critically Ill COVID-19 Patients With Different Inflammatory Phenotypes: A Multicenter, Retrospective Study.
Chen, Yan; Xie, Jianfeng; Wu, Wenjuan; Li, Shusheng; Hu, Yu; Hu, Ming; Li, Jinxiu; Yang, Yi; Huang, Tingrong; Zheng, Kun; Wang, Yishan; Kang, Hanyujie; Huang, Yingzi; Jiang, Li; Zhang, Wei; Zhong, Ming; Sang, Ling; Zheng, Xia; Pan, Chun; Zheng, Ruiqiang; Li, Xuyan; Tong, Zhaohui; Qiu, Haibo; Weng, Li; Du, Bin.
  • Chen Y; Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
  • Xie J; Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
  • Wu W; Department of Critical Care Medicine, Wuhan Jin-Yintan Hospital, Wuhan, China.
  • Li S; Department of Critical Care Medicine, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology, Wuhan, China.
  • Hu Y; Department of Critical Care Medicine, Union Hospital, Tongji Medical College Huazhong University of Science and Technology, Wuhan, China.
  • Hu M; Department of Infection Disease, Wuhan Pulmonary Hospital, Wuhan, China.
  • Li J; Department of Critical Care Medicine, Shenzhen Third Hospital, Shenzhen, China.
  • Yang Y; Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
  • Huang T; Department of Critical Care Medicine, Huangshi Hospital of Chinese Medicine, Huangshi, China.
  • Zheng K; Department of Critical Care Medicine, Huangshi Central Hospital, Huangshi, China.
  • Wang Y; Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
  • Kang H; Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
  • Huang Y; Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
  • Jiang L; Department of Critical Care Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.
  • Zhang W; Emergency Department, The 900th Hospital of Joint Service Corps of Chinese PLA, Fuzhou, China.
  • Zhong M; Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
  • Sang L; Department of Critical Care Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
  • Zheng X; Department of Critical Care Medicine, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
  • Pan C; Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
  • Zheng R; Department of Critical Care Medicine, Northern Jiangsu People's Hospital, Clinical Medical School, Yangzhou University, Yangzhou, China.
  • Li X; Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
  • Tong Z; Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
  • Qiu H; Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
  • Weng L; Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
  • Du B; Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
Front Immunol ; 12: 738532, 2021.
Article in English | MEDLINE | ID: covidwho-1686470
ABSTRACT

Background:

The benefits of intravenous immunoglobulin administration are controversial for critically ill COVID-19 patients.

Methods:

We analyzed retrospectively the effects of immunoglobulin administration for critically ill COVID-19 patients. The primary outcome was 28-day mortality. Inverse probability of treatment weighting (IPTW) with propensity score was used to account for baseline confounders. Cluster analysis was used to perform phenotype analysis.

Results:

Between January 1 and February 29, 2020, 754 patients with complete data from 19 hospitals were enrolled. Death at 28 days occurred for 408 (54.1%) patients. There were 392 (52.0%) patients who received intravenous immunoglobulin, at 11 (interquartile range (IQR) 8, 16) days after illness onset; 30% of these patients received intravenous immunoglobulin prior to intensive care unit (ICU) admission. By unadjusted analysis, no difference was observed for 28-day mortality between the immunoglobulin and non-immunoglobulin groups. Similar results were found by propensity score matching (n = 506) and by IPTW analysis (n = 731). Also, IPTW analysis did not reveal any significant difference between hyperinflammation and hypoinflammation phenotypes.

Conclusion:

No significant association was observed for use of intravenous immunoglobulin and decreased mortality of severe COVID-19 patients. Phenotype analysis did not show any survival benefit for patients who received immunoglobulin therapy.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Immunoglobulins, Intravenous / COVID-19 Type of study: Controlled clinical trial / Observational study / Randomized controlled trials / Risk factors Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: Front Immunol Year: 2021 Document Type: Article Affiliation country: Fimmu.2021.738532

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Immunoglobulins, Intravenous / COVID-19 Type of study: Controlled clinical trial / Observational study / Randomized controlled trials / Risk factors Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: Front Immunol Year: 2021 Document Type: Article Affiliation country: Fimmu.2021.738532