Efficacy of intravenous immunoglobulin therapy in hospitalised patients with COVID-19: A randomized controlled trial

Behrooz  Ghezelbash; Alireza  Mafi; Mehdi  Rostami; Negah  Tavakol; Raziyeh  Salami; Yasaman  Gholinezhad; Mohammadreza  Kasravi; Alireza  Rajbzadeh; Nahid  Eskandari

doi:10.18502/abi.v2i2.17935

Behrooz Ghezelbash Department of Immunology, Faculty of Medicine, Isfahan University of Medical Science, Isfahan, Iran
Alireza Mafi Department of Clinical Biochemistry, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
Mehdi Rostami Department of Clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Negah Tavakol Department of Community Medicine, School of Medicine, Isfahan, Iran
Raziyeh Salami Department of Clinical Biochemistry, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Yasaman Gholinezhad Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Mohammadreza Kasravi Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Alireza Rajbzadeh Infectious Diseases Specialist, Isfahan Milad Hospital, Isfahan, Iran
Nahid Eskandari Department of Immunology, Faculty of Medicine, Isfahan University of Medical Science, Isfahan, Iran

DOI: https://doi.org/10.18502/abi.v2i2.17935

Keywords: IVIG, COVID-19, coronavirus, ARDS

Abstract

Objectives: Acute respiratory distress syndrome (ARDS) is one of the life-threateningcomplications of COVID-19. The occurrence of ARDS is due to overactivation of thehost immune response to the virus. The purpose of this study is to investigate whetheradministration of intravenous immunoglobulins (IVIG) could enhance the outcomes ofseverely ill COVID-19 patients with ARDS.

Methods: In this randomized controlled trial at Milad Hospital of Isfahan, Iran, 88patients were randomly assigned between May and October 2020. The patients had nosignificant differences in age and sex. The patients were divided into two groups: thegroup who received IVIG and routine treatment (n=44, 50%) and the control group whowere just treated with routine treatment (n=44, 50%). The outcomes of patients, includinghospitalization duration, ICU admission period, and total death occurrence, besides clinicaland laboratory parameters, were followed and compared between the two groups.

Results: Primary outcomes of patients, including hospitalization duration (P=0.18),ICU admission period (P=0.35), and mortality (P=0.621), had no significant differencebetween the IVIG group and the control group. At day 3 and day 5 of IVIG administration,clinical and laboratory outcomes were screened. The clinical parameter that improvedwas oxygen saturation compared to the control group (87.56 ± 6.72 vs. 86.72 ± 7.52).In the cardiovascular system, IVIG significantly decreased diastolic blood pressure(P=0.02). In terms of coagulation parameters, IVIG treatment decreased PTT while itincreased D-dimer, but no effect on platelet count and PT was seen. The inflammatoryparameters, including ESR, CRP, and IL6, had no superior changes between the IVIGgroup and the control group.

Conclusion: Our study demonstrated that there were no superior advantages inCOVID-19 patients with ARDS who were treated with IVIG..