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 |