Early and late results of intravenous immunoglobulin as potential adjuvant therapies in critically ill COVID-19 patients: a retrospective cohort study

Abstract

Introduction: Intravenous immunoglobulin (IVIG), which is one of the adjuvant therapy strategies, has been started to be used in critically ill COVID-19 patients due to its anti-inflammatory and immunomodulatory effects. Material and Method: In our study, it was aimed to evaluate the effect of IVIG used in critically ill COVID-19 patients in the intensive care unit on early laboratory findings and late lung damage. Twenty-two critically ill COVID-19 patients who met the inclusion criteria were included in the study. Laboratory data of the patients who received 0.4 gr/kg/day IVIG for 5 days were analyzed before the treatment and on the 1st and 5th days of the treatment. For the percentage of injured lung areas was evaluated with chest CT. Results: Respiratory rate and CRP decreased with IVIG, while an increase was observed in PaO2/FiO2, WBC, lymphocyte count, D-Dimer and fibrinogen values, which was statistically significant (p<0.05). When IL-6 values before treatment and on the 3rd day of treatment were compared, it was observed that there was a statistically significant decrease (p<0.001). A statistically significant improvement in lung damage was found when the average percentage of injured lung area calculated from chest CT taken at hospitalization and 1 month after discharge was compared (p<0.001). Conclusion: IVIG can be considered as an effective adjuvant therapy because it causes improvement in oxygenation, clinical symptoms and hyperinflammatory response. It should not be forgotten that it also provides improvement in the damaged lung areas in the late period.

Keywords

• COVID-19
• Immunoglobulin
• IVIG
• Pneumonia

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