a Division of Hospital Medicine, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Institute of Biotechnology and Chemical Engineering, I-Shou University, Kaohsiung, Taiwan.
Expert Rev Anti Infect Ther. 2022 Oct;20(10):1333-1340. doi: 10.1080/14787210.2022.2098112. Epub 2022 Jul 7.
Severe-to-critical COVID-19 has been associated with exaggerated immune responses, and anti-inflammatory agents including corticosteroid and interleukin-6 antagonist have been repurposed as the treatment modality against severe SARS-CoV-2 infections. However, the clinical efficacy and safety of intravenous immunoglobulin (IVIG) in the treatment of patients with COVID-19 was controversial.
This meta-analysis of randomized controlled trials (RCTs) investigated the effectiveness of IVIG in patients with COVID-19. Electronic databases were searched for RCTs that compared the clinical efficacy of IVIG with standard of care or placebo in the hospitalized patients with COVID-19 were included.
Six RCTs involving 472 patients were included. Patients who received IVIG had a similar mortality rate to the controls (25.3% vs 27.0%, odds ratio [OR], 0.60; 95% confidence interval [CI], 0.27-1.31). Compared with the control group, the study group demonstrated a similar incidence of receiving mechanical ventilation (OR, 0.70; 95% CI, 0.45-1.11), intensive care unit (ICU) admission (OR, 0.58; 95% CI, 0.22-1.53), length of hospital stay (mean difference [MD], -1.81 days; 95% CI, -8.42 to 4.81) and ICU stay (MD, -0.61 days; 95% CI, -2.80 to 1.58).
The administration of IVIG in hospitalized patients with COVID-19 does not improve clinical outcomes.
严重至危重症 COVID-19 与过度的免疫反应有关，包括皮质类固醇和白细胞介素-6 拮抗剂在内的抗炎药物已被重新用作治疗严重 SARS-CoV-2 感染的方法。然而，静脉注射免疫球蛋白（IVIG）治疗 COVID-19 患者的临床疗效和安全性仍存在争议。
本荟萃分析纳入了随机对照试验（RCT），旨在研究 IVIG 在 COVID-19 患者中的疗效。检索了比较 COVID-19 住院患者 IVIG 与标准治疗或安慰剂临床疗效的 RCT 电子数据库。
纳入了 6 项 RCT，共 472 例患者。接受 IVIG 的患者与对照组的死亡率相似（25.3% vs 27.0%，比值比 [OR]，0.60；95%置信区间 [CI]，0.27-1.31）。与对照组相比，研究组接受机械通气的发生率相似（OR，0.70；95% CI，0.45-1.11）、入住重症监护病房（ICU）（OR，0.58；95% CI，0.22-1.53）、住院时间（平均差值 [MD]，-1.81 天；95% CI，-8.42 至 4.81）和 ICU 入住时间（MD，-0.61 天；95% CI，-2.80 至 1.58）相似。
COVID-19 住院患者使用 IVIG 并不能改善临床结局。
