Frontiers in Immunology (Jan 2022)

Intravenous Immunoglobulin Therapy for Critically Ill COVID-19 Patients With Different Inflammatory Phenotypes: A Multicenter, Retrospective Study

  • Yan Chen,
  • Jianfeng Xie,
  • Wenjuan Wu,
  • Shusheng Li,
  • Yu Hu,
  • Ming Hu,
  • Jinxiu Li,
  • Yi Yang,
  • Tingrong Huang,
  • Kun Zheng,
  • Yishan Wang,
  • Hanyujie Kang,
  • Yingzi Huang,
  • Li Jiang,
  • Wei Zhang,
  • Ming Zhong,
  • Ling Sang,
  • Xia Zheng,
  • Chun Pan,
  • Ruiqiang Zheng,
  • Xuyan Li,
  • Zhaohui Tong,
  • Haibo Qiu,
  • Li Weng,
  • Bin Du

DOI
https://doi.org/10.3389/fimmu.2021.738532
Journal volume & issue
Vol. 12

Abstract

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BackgroundThe benefits of intravenous immunoglobulin administration are controversial for critically ill COVID-19 patients.MethodsWe analyzed retrospectively the effects of immunoglobulin administration for critically ill COVID-19 patients. The primary outcome was 28-day mortality. Inverse probability of treatment weighting (IPTW) with propensity score was used to account for baseline confounders. Cluster analysis was used to perform phenotype analysis.ResultsBetween January 1 and February 29, 2020, 754 patients with complete data from 19 hospitals were enrolled. Death at 28 days occurred for 408 (54.1%) patients. There were 392 (52.0%) patients who received intravenous immunoglobulin, at 11 (interquartile range (IQR) 8, 16) days after illness onset; 30% of these patients received intravenous immunoglobulin prior to intensive care unit (ICU) admission. By unadjusted analysis, no difference was observed for 28-day mortality between the immunoglobulin and non-immunoglobulin groups. Similar results were found by propensity score matching (n = 506) and by IPTW analysis (n = 731). Also, IPTW analysis did not reveal any significant difference between hyperinflammation and hypoinflammation phenotypes.ConclusionNo significant association was observed for use of intravenous immunoglobulin and decreased mortality of severe COVID-19 patients. Phenotype analysis did not show any survival benefit for patients who received immunoglobulin therapy.

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