PMID- 33082954 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220417 IS - 2050-0068 (Print) IS - 2050-0068 (Electronic) IS - 2050-0068 (Linking) VI - 9 IP - 10 DP - 2020 TI - Clinical efficacy of intravenous immunoglobulin therapy in critical ill patients with COVID-19: a multicenter retrospective cohort study. PG - e1192 LID - 10.1002/cti2.1192 [doi] LID - e1192 AB - OBJECTIVE: Coronavirus disease 2019 (COVID-19) outbreak is a major challenge all over the world, without acknowledged treatment. Intravenous immunoglobulin (IVIG) has been recommended to treat critical coronavirus disease 2019 (COVID-19) patients in a few reviews, but the clinical study evidence on its efficacy in COVID-19 patients was lacking. METHODS: 325 patients with laboratory-confirmed critical COVID-19 were enrolled from 4 government-designated COVID-19 treatment centres in southern China from December 2019 to March 2020. The primary outcomes were 28- and 60-day mortality, and the secondary outcomes were the total length of in-hospital and the total duration of the disease. Subgroup analysis was carried out according to clinical classification of COVID-19, IVIG dosage and timing. RESULTS: In the enrolled 325 patients, 174 cases used IVIG and 151 cases did not. The 28-day mortality was improved with IVIG after adjusting confounding in overall cohort (P = 0.0014), and the in-hospital and the total duration of disease were longer in the IVIG group (P < 0.001). Subgroup analysis showed that only in patients with critical type, IVIG could significantly reduce the 28-day mortality, decrease the inflammatory response and improve some organ functions (all P < 0.05); the application of IVIG in the early stage (admission 15 g per day) exhibited significant reduction in 60-day mortality in the critical-type patients. CONCLUSION: Early administration of IVIG with high dose improves the prognosis of critical-type patients with COVID-19. This study provides important information on clinical application of IVIG in the treatment of SARS-CoV-2 infection, including patient selection and administration dosage and timing. CI - (c) 2020 The Authors. Clinical & Translational Immunology published by John Wiley & Sons Australia, Ltd on behalf of Australian and New Zealand Society for Immunology, Inc. FAU - Shao, Ziyun AU - Shao Z AD - Department of Nephrology General Hospital of Central Theater Command of PLA Wuhan 430070 China. FAU - Feng, Yongwen AU - Feng Y AD - Department of Critical Care Medicine and Hospital Infection Prevention and Control The Second People's Hospital of Shenzhen & First Affiliated Hospital of Shenzhen University Health Science Center Shenzhen 518035 China. AD - Department of Critical Care Medicine The Third People's Hospital of Shenzhen Shenzhen 518035 China. FAU - Zhong, Li AU - Zhong L AD - Department of Critical Care Medicine The First Affiliated Hospital Guizhou University of Chinese Medicine Guiyang 550001 China. FAU - Xie, Qifeng AU - Xie Q AD - Department of Critical Care Medicine General Hospital of Southern Theater Command of PLA Guangzhou 510010 China. FAU - Lei, Ming AU - Lei M AD - Department of Nephrology Guangzhou Eighth people's hospital Guangzhou Medical University Guangzhou 510060 China. FAU - Liu, Zheying AU - Liu Z AD - Department of Critical Care Medicine General Hospital of Southern Theater Command of PLA Guangzhou 510010 China. FAU - Wang, Conglin AU - Wang C AD - Department of Critical Care Medicine General Hospital of Southern Theater Command of PLA Guangzhou 510010 China. FAU - Ji, Jingjing AU - Ji J AD - Department of Critical Care Medicine General Hospital of Southern Theater Command of PLA Guangzhou 510010 China. FAU - Liu, Huiheng AU - Liu H AD - Department of Emergency Zhongshan Hospital of Xiamen University Xiamen 361000 China. FAU - Gu, Zhengtao AU - Gu Z AD - Department of Treatment Center for Traumatic Injuries The Third Affiliated Hospital Academy of Orthopedics Guangdong Province Southern Medical University Guangzhou Guangdong 515630 China. FAU - Hu, Zhongwei AU - Hu Z AD - Department of Nephrology Guangzhou Eighth people's hospital Guangzhou Medical University Guangzhou 510060 China. FAU - Su, Lei AU - Su L AD - Department of Critical Care Medicine General Hospital of Southern Theater Command of PLA Guangzhou 510010 China. FAU - Wu, Ming AU - Wu M AD - Department of Critical Care Medicine and Hospital Infection Prevention and Control The Second People's Hospital of Shenzhen & First Affiliated Hospital of Shenzhen University Health Science Center Shenzhen 518035 China. AD - Department of Critical Care Medicine General Hospital of Southern Theater Command of PLA Guangzhou 510010 China. FAU - Liu, Zhifeng AU - Liu Z AUID- ORCID: 0000-0001-6273-1667 AD - Department of Critical Care Medicine General Hospital of Southern Theater Command of PLA Guangzhou 510010 China. AD - Key Laboratory of Hot Zone Trauma Care and Tissue Repair of PLA General Hospital of Southern Theater Command of PLA Guangzhou 510010 China. LA - eng PT - Journal Article DEP - 20201014 PL - Australia TA - Clin Transl Immunology JT - Clinical & translational immunology JID - 101638268 PMC - PMC7557105 OTO - NOTNLM OT - COVID-19 OT - IVIG OT - SARS-CoV-2 OT - clinical efficacy OT - mortality COIS- The authors declare no conflict of interest. EDAT- 2020/10/22 06:00 MHDA- 2020/10/22 06:01 PMCR- 2020/10/14 CRDT- 2020/10/21 06:02 PHST- 2020/06/22 00:00 [received] PHST- 2020/09/09 00:00 [revised] PHST- 2020/09/13 00:00 [accepted] PHST- 2020/10/21 06:02 [entrez] PHST- 2020/10/22 06:00 [pubmed] PHST- 2020/10/22 06:01 [medline] PHST- 2020/10/14 00:00 [pmc-release] AID - CTI21192 [pii] AID - 10.1002/cti2.1192 [doi] PST - epublish SO - Clin Transl Immunology. 2020 Oct 14;9(10):e1192. doi: 10.1002/cti2.1192. eCollection 2020.