Department of Liver Disease, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
Department of Infectious Disease, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
Int J Infect Dis. 2021 Apr;105:525-531. doi: 10.1016/j.ijid.2021.01.009. Epub 2021 Jan 9.
At the present time, there is an absence of any proven effective antiviral therapy for patients with coronavirus disease 2019 (COVID-19). The aim of this study was to assess the efficacy of intravenous immunoglobulin (IVIG) in non-severe patients with COVID-19.
A retrospective study based on propensity score matching (PSM) was designed. Primary outcomes included the severity and mortality rates. Secondary outcomes included the duration of fever, virus clearance time, length of hospital stay, and use of antibiotics.
A total of 639 non-severe patients with COVID-19 were enrolled. Forty-five patients received IVIG therapy and 594 received non-IVIG therapy. After PSM (1:2 ratio), the baseline characteristics were well balanced between the IVIG group (n = 45) and control group (n = 90). No statistically significant difference was found between the IVIG group and control group in the duration of fever (median 3 vs 3 days, p = 0.667), virus clearance time (median 11 vs 10 days, p = 0.288), length of hospital stay (median 14 vs 13 days, p = 0.469), or use of antibiotics (40% vs 38.9%, p = 0.901). Meanwhile, compared to the IVIG group, no more patients in the control group progressed to severe disease (3.3% vs 6.6%, p = 0.376) or died (0 vs 2.2%, p = 0.156).
In non-severe patients with COVID-19, no benefit was observed with IVIG therapy beyond standard therapy.
目前，对于 2019 冠状病毒病（COVID-19）患者，尚无有效的抗病毒治疗方法。本研究旨在评估静脉注射免疫球蛋白（IVIG）在 COVID-19 非重症患者中的疗效。
本研究采用基于倾向评分匹配（PSM）的回顾性研究。主要结局包括严重程度和死亡率。次要结局包括发热持续时间、病毒清除时间、住院时间和抗生素使用情况。
共纳入 639 例 COVID-19 非重症患者。45 例患者接受 IVIG 治疗，594 例患者接受非-IVIG 治疗。经 PSM（1:2 比例）后，IVIG 组（n=45）和对照组（n=90）的基线特征在两组间均衡可比。IVIG 组和对照组在发热持续时间（中位数 3 天比 3 天，p=0.667）、病毒清除时间（中位数 11 天比 10 天，p=0.288）、住院时间（中位数 14 天比 13 天，p=0.469）或抗生素使用情况（40%比 38.9%，p=0.901）方面均无统计学差异。同时，与 IVIG 组相比，对照组中没有更多的患者进展为重症疾病（3.3%比 6.6%，p=0.376）或死亡（0 比 2.2%，p=0.156）。
在 COVID-19 非重症患者中，IVIG 治疗除了标准治疗之外，没有观察到获益。
