PMID- 34743710
OWN - NLM
STAT- MEDLINE
DCOM- 20211112
LR  - 20221207
IS  - 1471-2466 (Electronic)
IS  - 1471-2466 (Linking)
VI  - 21
IP  - 1
DP  - 2021 Nov 8
TI  - Clinical outcomes of intravenous immunoglobulin therapy in COVID-19 related acute 
      respiratory distress syndrome: a retrospective cohort study.
PG  - 354
LID - 10.1186/s12890-021-01717-x [doi]
LID - 354
AB  - BACKGROUND: Intravenous immunoglobulin (IVIG) has been used as an 
      immunomodulatory therapy to counteract severe systemic inflammation in 
      coronavirus disease 2019 (COVID-19). But its use in COVID-19 related acute 
      respiratory distress syndrome (ARDS) is not well established. METHODS: We 
      conducted a retrospective analysis of electronic health records of COVID-19 
      patients admitted to intensive care units (ICUs) at Hazm Mebaireek General 
      Hospital, Qatar, between March 7, 2020 and September 9, 2020. Patients receiving 
      invasive mechanical ventilation for moderate-to-severe ARDS were divided into two 
      groups based on whether they received IVIG therapy or not. The primary outcome 
      was all-cause ICU mortality. Secondary outcomes studied were ventilator-free days 
      and ICU-free days at day-28, and incidence of acute kidney injury (AKI). 
      Propensity score matching was used to adjust for confounders, and the primary 
      outcome was compared using competing-risks survival analysis. RESULTS: Among 590 
      patients included in the study, 400 received routine care, and 190 received IVIG 
      therapy in addition to routine care. One hundred eighteen pairs were created 
      after propensity score matching with no statistically significant differences 
      between the groups. Overall ICU mortality in the study population was 27.1%, and 
      in the matched cohort, it was 25.8%. Mortality was higher among IVIG-treated 
      patients (36.4% vs. 15.3%; sHR 3.5; 95% CI 1.98-6.19; P < 0.001). Ventilator-free 
      days and ICU-free days at day-28 were lower (P < 0.001 for both), and incidence 
      of AKI was significantly higher (85.6% vs. 67.8%; P = 0.001) in the IVIG group. 
      CONCLUSION: IVIG therapy in mechanically ventilated patients with COVID-19 
      related moderate-to-severe ARDS was associated with higher ICU mortality. A 
      randomized clinical trial is needed to confirm this observation further.
CI  - (c) 2021. The Author(s).
FAU - Ali, Husain S
AU  - Ali HS
AD  - Department of Medical ICU/Medicine, Hamad General Hospital, P.O. Box 3050, Doha, 
      Qatar. hali10@hamad.qa.
FAU - Elshafei, Moustafa S
AU  - Elshafei MS
AD  - Intensive Care Unit, Hazm Mebaireek General Hospital, Doha, Qatar.
FAU - Saad, Mohamed O
AU  - Saad MO
AD  - Department of Pharmacy, Al Wakra Hospital, Al Wakrah, Qatar.
FAU - Mitwally, Hassan A
AU  - Mitwally HA
AD  - Department of Pharmacy, Al Wakra Hospital, Al Wakrah, Qatar.
FAU - Al Wraidat, Mohammad
AU  - Al Wraidat M
AD  - Intensive Care Unit, Hazm Mebaireek General Hospital, Doha, Qatar.
FAU - Aroos, Asra
AU  - Aroos A
AD  - Intensive Care Unit, Hazm Mebaireek General Hospital, Doha, Qatar.
FAU - Shaikh, Nissar
AU  - Shaikh N
AD  - Department of Surgical ICU, Hamad General Hospital, Doha, Qatar.
FAU - Ananthegowda, Dore C
AU  - Ananthegowda DC
AD  - Intensive Care Unit, Hazm Mebaireek General Hospital, Doha, Qatar.
FAU - Abdelaty, Mohamed A
AU  - Abdelaty MA
AD  - Department of Medical ICU/Medicine, Hamad General Hospital, P.O. Box 3050, Doha, 
      Qatar.
FAU - George, Saibu
AU  - George S
AD  - Department of Medical ICU/Medicine, Hamad General Hospital, P.O. Box 3050, Doha, 
      Qatar.
FAU - Nashwan, Abdulqadir J
AU  - Nashwan AJ
AD  - Intensive Care Unit, Hazm Mebaireek General Hospital, Doha, Qatar.
FAU - Mohamed, Ahmed S
AU  - Mohamed AS
AD  - Intensive Care Unit, Hazm Mebaireek General Hospital, Doha, Qatar.
FAU - Khatib, Mohamad Y
AU  - Khatib MY
AD  - Intensive Care Unit, Hazm Mebaireek General Hospital, Doha, Qatar.
LA  - eng
PT  - Journal Article
DEP - 20211108
PL  - England
TA  - BMC Pulm Med
JT  - BMC pulmonary medicine
JID - 100968563
RN  - 0 (Immunoglobulins, Intravenous)
RN  - 0 (Immunologic Factors)
SB  - IM
MH  - Administration, Intravenous
MH  - Adult
MH  - Aged
MH  - COVID-19/complications/mortality
MH  - Female
MH  - Humans
MH  - Immunoglobulins, Intravenous/*therapeutic use
MH  - Immunologic Factors/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Propensity Score
MH  - Respiratory Distress Syndrome/*drug therapy/mortality/virology
MH  - Retrospective Studies
MH  - Severity of Illness Index
MH  - Survival Analysis
MH  - Treatment Outcome
MH  - *COVID-19 Drug Treatment
PMC - PMC8572690
OTO - NOTNLM
OT  - Acute respiratory distress syndrome
OT  - COVID-19
OT  - ICU mortality
OT  - Intravenous immunoglobulin
OT  - Mechanical ventilation
COIS- The authors declare that they have no competing interests.
EDAT- 2021/11/09 06:00
MHDA- 2021/11/16 06:00
PMCR- 2021/11/08
CRDT- 2021/11/08 05:35
PHST- 2021/04/26 00:00 [received]
PHST- 2021/10/29 00:00 [accepted]
PHST- 2021/11/08 05:35 [entrez]
PHST- 2021/11/09 06:00 [pubmed]
PHST- 2021/11/16 06:00 [medline]
PHST- 2021/11/08 00:00 [pmc-release]
AID - 10.1186/s12890-021-01717-x [pii]
AID - 1717 [pii]
AID - 10.1186/s12890-021-01717-x [doi]
PST - epublish
SO  - BMC Pulm Med. 2021 Nov 8;21(1):354. doi: 10.1186/s12890-021-01717-x.