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Table 1 summary of the studies supporting the use of IVIG in COVID-19

From: Potential therapeutic approach of intravenous immunoglobulin against COVID-19

Studies, that suggested the use of IVIG Type of Study Total Number of Cases Dosage of IVIG Measurement of treatment success Other therapies used in the course of disease Comorbidities Additional explanations
Cao et al. [35] Case series 3 25 g/day for 5 days or 0.3–0.4 g/kg/day for 5 days Improvied clinical status (fever, O2 saturation and difficulty of breathing) after 5 days Supportive care, oseltamvir, azithromycin, empirical moxifloxacin, lopinavir/ritonavir, prednisolone Patient 1: previously generally healthy
Patient 2: hypertension (2 years-well-controlled)
Patient 3: previously generally healthy
Xie et al.[39] Retrospective 58 20 g/day 28 day mortality rate Moxifloxacin, low–molecular weight heparin (LMWH), hypoalbuminemia correction, Thymosin, glucocorticoids Initiation of IVIG within the first 48 h of admission is beneficial
Shi et al.[37] Case report 1 20 g for 3 days Improved laboratory markers (such as lymphocyte count) and clinical status after 3 days Supportive care, inhaled interferon alpha-2b, Lopinavir/Ritonavir, G-CSF, dopamine (vasopressor), empirical ceftriaxone, IV piperacillin/tazobactam thymalfasin, methylprednisolone, Plasma exchange (PE),
Daneshpazhooh et al. [36] Case repost 1 2 g/kg total Improved clinical symptoms and recovered lymphopenia Prednisolone, rituximab, mycophenolate mofetil (MMF), hydroxychloroquine, oseltamivir, lopinavir/ritonavir, iv meropenem, vancomycin, ribavirin, levofloxacin, Mucous Membrane Pemphigoid (MMP), diabetes, hypertension, benign prostatic hypertrophy Minimizing or discontinuation of immunosuppressive medications is advised
Mohtadi et al.[38] Case series 5 0.3–0.5 g/kg for 5 consecutive days, not less than 25 g for each patient Improvement of pulmonary involvement in CT scan and O2 saturation after 5 days hydroxychloroquine, Kaletra, oseltamivir, vancomycin, levofloxacin, Tavanxm Meropenem, ceftriaxone, azithromycin, imipenem hydrocortisone, Mycophenolic acid, Cyclosporine Hypertension, kidney transplantation, diabetes, heart disease
Mansourabadi et al. [41] Retrospective 80 0.3–0.5 g/kg/day for 5 days Varied for different studies convalescent plasma therapy, monoclonal antibodies, interferon, mesenchymal stem cell therapy, Tocilizumab, corticosteroid, and Hydroxychloroquine
El-Zein et al.[43] Case Report 1 0.4 g/kg for 5 days Improved neurological condition after 5 days Hydroxychloroquine
Muccioli et al. [44] Retrospective 5 0.4 g/kg for 19–55 days Improvement of neurological symptoms in 3–4 days Supportive care Diabetes, hypertension, ischemic heart disease, iatrogenic parkinsonism, Bipolar disorder, Mild Cognitive Impairment, hypertensive cardiomyopathy
Gharebaghi et al.[42] randomized placebo-controlled double-blind clinical trial 59 20 g/day of IVIG for three days Lowered in hospital mortality rate in 7–9 days Supportive care
Freire-Alvarez et al. [45] Case report 1 0.4 g/kg for 5 days Improved clinical condition and discontinuation of mechanical support after 5 days Supportive care, Tocilizumab ( IL-6 receptor antagonist), intravenous acyclovir, lopinavir/ritonavir, subcutaneous interferon beta-1b
Sakoulas et al. [50] Prospective Randomized Trial 33 (16 in the IVIG group) 0.5 g/kg/day for 3 days Lowered length of hospital and ICU stay, lowered respiratory failures needed mechanical support, improved oxygenation Methylprednisolone, remdesevir, convalescent plasma, Lower rate of need for mechanical ventilation and a reduction in hospitalization length was observed in IVIG group