According to a study published in Critical Care Explorations, COVID-19 patients who were administered intravenous immunoglobulin (IVIG) therapy were less likely to be intubated and had a shorter hospital length of stay compared to standard care.
Researchers conducted the study to determine the effects of IVIG on adult COVID-19 patients with moderate-to-severe hypoxemia. They noted that IVIG had been previously shown to “attenuate neutrophil activation and NET formation” that may be related to severe lung injury in COVID-19 patients.
A total of 33 patients were randomized to receive either standard of care or 3 days of IVIG with methylprednisolone 40 mg plus standard care.
Among subjects with A-a gradient of greater than 200 mm Hg at enrollment, the IV immunoglobulin group showed: 1) a lower rate of progression to requiring mechanical ventilation (2/14 vs 7/12, p = 0.038 Fisher exact test), 2) shorter median hospital length of stay (11 vs 19 d), 3) shorter median ICU stay (2.5 vs 12.5 d), and 4) greater improvement in PaO2/FiO2 at 7 days (median [range] change from time of enrollment +131 [+35 to +330] vs +44·5 [–115 to +157]) than standard of care.1
Among the seven patients with A-a gradient less than or equal to 200 mm Hg, no patient required ICU stay during their illness and length of hospital stay ranged for 3-8 days. For the subjects with A-a gradient greater than 200, median length of hospital stay was 19 days (range, 4-30 d) and 11 days (range, 5-22 d) for the SOC and IVIG groups, respectively.1
Reference: Sakoulas, G, et al. Intravenous immunoglobulin plus methylprednisolone mitigate respiratory morbidity in coronavirus disease 2019. Critical Care Explorations. 2020 Nov:2(11). doi: 10.1097/CCE.0000000000000280