Ayyildiz Ayse, Yildirim Ozge Turgay, Ucan Anil, Ayyildiz Fatih Alper, Mutlu Fezan
Department of Intensive Care, Eskisehir City Hospital, Eskisehir, Turkiye.
Department of Cardiology, Eskisehir City Hospital, Eskisehir, Turkiye.
North Clin Istanb. 2023 Aug 26;10(5):560-566. doi: 10.14744/nci.2023.50336. eCollection 2023.
The popularity of intravenous immunoglobulin (IVIG) therapy in Acute Respiratory Distress Syndrome (CARDS) secondary to COVID-19 infection is increasing day by day. In this study, we aimed to retrospectively evaluate the possible cardiac effects in our CARDS patients treated with IVIG.
Demographic and clinical characteristics, mortality, sequential electrocardiography (ECG), echocardiography, cardiac markers, and other laboratory parameters of CARDS patients who received IVIG treatment were recorded.
The mean age of the patients was 68.7±13.6%, and 70.5% were female. The mean number of days of hospitalization in the intensive care unit was 18.2±9.7, and the mortality rate was recorded as 35.2%. No pathological rhythm or ischemic change was observed in sequential ECG follow-ups. However, in consecutive ECO follow-ups, the sPAP values at the treatment end were numerically lower, although not statistically significant.
Our study suggests that IVIG therapy may be used safely in COVID-19 patients with cardiovascular side effects. However, due to the high risk of coagulopathy in these patients, the use of IVIG therapy in COVID-19 infection should be monitored with close monitoring, as it may increase the potential for cardiovascular risk. Furthermore, monitoring cardiac parameters are also essential as it may predict high cardiovascular risk in patients. For this reason, patients need lower infusion rates, steroid combination, adequate hydration, and effective anticoagulation therapy to avoid these side effects.
静脉注射免疫球蛋白（IVIG）疗法在新型冠状病毒肺炎（COVID-19）感染继发的急性呼吸窘迫综合征（CARDS）中的应用日益广泛。在本研究中，我们旨在回顾性评估接受IVIG治疗的CARDS患者可能出现的心脏影响。
记录接受IVIG治疗的CARDS患者的人口统计学和临床特征、死亡率、连续心电图（ECG）、超声心动图、心脏标志物及其他实验室参数。
患者的平均年龄为68.7±13.6%，女性占70.5%。在重症监护病房的平均住院天数为18.2±9.7天，死亡率记录为35.2%。在连续的心电图随访中未观察到病理性节律或缺血性改变。然而，在连续的超声心动图随访中，治疗结束时的收缩期肺动脉压（sPAP）值在数值上较低，尽管无统计学意义。
我们的研究表明，IVIG疗法可在有心血管副作用的COVID-19患者中安全使用。然而，由于这些患者发生凝血病的风险较高，在COVID-19感染中使用IVIG疗法时应密切监测，因为它可能增加心血管风险的可能性。此外，监测心脏参数也至关重要，因为它可能预测患者的高心血管风险。因此，患者需要较低的输注速率、类固醇联合用药、充分补液和有效的抗凝治疗以避免这些副作用。
