Injection of intravenous immunoglobulin (IVIg) for the treatment of Coronavirus induced cytokine storm

F. Farnood, Hamed Valizadeh, K. Ansarin, S. Zununi Vahed, Seyyed Sina Hejazian, A. Sadeghi, Leila Namvar, F. Rashidi, S. M. Hejazian, M. Ardalan, A. Sharifi
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Abstract

Background. COVID-19 disease is the cause of daily morbidity and mortality worldwide due to its high transmissibility and pathogenicity. To date, intravenous immunoglobulin (IVIg) injection has been used as one of the various treatments for this disease. This study aimed to determine the effect of IVIg injection on the treatment of patients with Coronavirus-induced cytokine storm. Methods. A total of 174 patients with COVID-19 were included in this study based on their clinical characteristics and laboratory findings and were divided into two groups of IVIg recipients and non-recipients according to the treatment they received. Statistical analysis was performed using SPSS version 22.0. A p-value less than 0.05 was considered statistically significant. Results. IVIg was used to treat merely 20 patients and Kaletra and hemoperfusion drugs were used more among IVIg recipient patients (P=0.003 and P=0.001, respectively). COVID-19-positive PCR tests were significantly more frequent among IVIg recipients (P=0.026). The polymorphonuclear neutrophil (PMN) count (P=0.007) and sodium level (P=0.007) were significantly higher in the IVIg recipient group on the first admission day. Moreover, INR levels in the IVIg recipient group were significantly lower on the seventh admission day (P=0.020). The median of total intensive care unit (ICU) duration of hospitalization among IVIg recipients was significantly higher (P=0.001). Conclusion. It seems that the use of IVIg in COVID-19 patients should be further investigated. Practical Implications. IVIg injection could decrease mortality and slightly increase the survival rate among COVID-19 patients.
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静脉注射免疫球蛋白治疗冠状病毒诱导的细胞因子风暴
背景。由于其高传染性和致病性,COVID-19疾病是全球每日发病和死亡的原因。迄今为止,静脉注射免疫球蛋白(IVIg)已被用作治疗这种疾病的各种方法之一。本研究旨在确定注射IVIg对冠状病毒诱导的细胞因子风暴患者的治疗效果。方法。根据临床特征和实验室检查结果共纳入174例COVID-19患者,并根据其接受的治疗分为接受IVIg治疗组和未接受IVIg治疗组。采用SPSS 22.0进行统计分析。p值小于0.05被认为具有统计学意义。结果。仅20例患者使用了IVIg,而接受IVIg的患者使用Kaletra和血液灌流药物较多(P=0.003和P=0.001)。covid -19 PCR阳性检测在IVIg接受者中显著增加(P=0.026)。IVIg受体组患者入院第1天多形核中性粒细胞(PMN)计数(P=0.007)和钠水平(P=0.007)均显著升高。此外,IVIg受体组的INR水平在入院第7天显著降低(P=0.020)。IVIg受者重症监护病房(ICU)总住院时间中位数显著高于对照组(P=0.001)。结论。似乎应该进一步调查COVID-19患者使用IVIg的情况。实际意义。注射IVIg可以降低COVID-19患者的死亡率,并略微提高生存率。
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