Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Clin Chest Med. Tzilas V., Manali E., Papiris S., et al. Supply and demand for plasma-derived medicinal productsa critical reassessment amid the COVID-19 pandemic. On the contrary, other studies reported no beneficial effect in ARDS patients [32, 33], and the guideline of sepsis treatment has not suggested administration of IVIG [34]. Hozo S.P., Djulbegovic B., Hozo I. Estimating the mean and variance from the median, range, and the size of a sample. 2020. https://doi.org/10.1016/j.autrev.2020.102554. The idea is to give immunocompromised patients like me the benefit of antibodies from healthy people. As mentioned earlier, several studies have shown the beneficial effects of using IVIG therapy against COVID-19 [36,37,38, 40,41,42,43,44,45, 48,49,50]. Neurol Res. Background The benefit of IVIG (Intravenous Immunoglobulin) therapy for COVID-19 remains controversial. Hung IFN, To KKW, Lee CK, Lee KL, Yan WW, Chan K, et al. Another study reported a reduction in 28-day-mortality rates, the length of hospital stay, and the need for mechanical ventilation by IVIG treatment within 48h after admission. J. Mol. We selected randomized clinical trials and observational studies with a control group to assess the efficiency of IVIG in treating patients with COVID-19. The cytokine storm of severe influenza and development of immunomodulatory therapy. On the other hand, anti-inflammatory mechanisms activate, for instance, the production of IL-10 in the gut and the macrophages and Peroxisome Proliferator-Activated Receptor gamma (PPAR) increase. Efficacy Evaluation of Intravenous Immunoglobulin in Non-severe Patients with COVID-19: A Retrospective Cohort Study Based on Propensity Score Matching. Springer Nature. Pandemic H1N1 vaccine requires the use of an adjuvant to protect against challenge in nave ferrets. Nephrology (Carlton). eCollection 2022. Esen F., Ozcan P.E., Orhun G., et al. IVIG is a kind of blood product from healthy donors containing a polyclonal IgG antibody. In addition to the controversies in using the IVIG, some other challenges need to be discussed. Charlet R., Sendid B., Kaveri S.V., Poulain D., Bayry J., Jawhara S. Intravenous Immunoglobulin Therapy Eliminates Candida albicans and Maintains Intestinal Homeostasis in a Murine Model of Dextran Sulfate Sodium-Induced Colitis. Clin Transl Immunol. Virology. sharing sensitive information, make sure youre on a federal 8600 Rockville Pike Autoimmun Rev. The immune system as a target for therapy of SARS-CoV-2: A systematic review of the current immunotherapies for COVID-19. In parallel with the development of new antiviral agents and vaccines in this disease, it is necessary to research the efficacy of existing therapeutic such as Intravenous immunoglobulin (IVIG). Effect of regular intravenous immunoglobulin therapy on prognosis of severe pneumonia in patients with COVID-19. Google Scholar. Hyperimmune intravenous immunoglobulin containing high titers of pandemic H1N1 hemagglutinin and neuraminidase antibodies provides dose-dependent protection against lethal virus challenge in SCID mice. Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, et al. Two reviewers (Qi-zhi Zhang and Xuan Cheng) independently evaluated the quality of this literature. In rare cases, thromboembolism happened to the patients upon receiving IVIG. In another study, Cao et al. In previous studies, it has suggested that severe cytokine storm has been found to be related to increased death rates in critical COVID-19 patients [28]. First, the clinical outcomes of the IVIG therapy couldnt quite represented the abilities to treat COVID-19 patients. Ferrets were challenged with 10. All the cases above were discharged in less than a week with considerable improvements [35, 36]. This led to a global lockdown and detailed study of the disease and attempts to provide a treatment or vaccine [4]. All the RCTs we included provided a high dosage which are consistent with Cao et al studys dosage. Only one trial was blinded which may subject to bias. Non-severe group: defined as absence of any criteria for severe or critical COVID-19. Intravenous immunoglobulin (IVIg) is a treatment that can boost antibody levels in people with immunodeficiencies, autoimmune diseases, or inflammatory diseases. Transfusion-related acute lung injury: a clinical review. 2016;3:237261. Part of Accessibility 400mg/kg daily for three doses IVIG, premedicated with 500mg Acetaminophen, 100mg Hydrocortisone, and 25mg Diphenhydramine 30min before the injection. 4 Furthermore, the high price of IVIG (approximately $100/g) added to the infusion costs, make it a relatively expensive therapy [58]. One possible explanation is that the longer duration of hospitalization in IVIG group may be due to the higher survival rate in IVIG group than control group. The emergence of the novel coronavirus in Wuhan, China, which causes severe respiratory tract infections in humans (COVID-19), has become a global health concern. 2020(b). Viral Metagenomics Revealed Sendai Virus and Coronavirus Infection of Malayan Pangolins (Manis javanica) Viruses. Statistical heterogeneity was evaluated by the I-squared (I2) test. 2018;11(1):917. Critical ill group: defined by the criteria for: (1) Acute respiratory distress syndrome (ARDS), sepsis, septic shock, or other conditions that would normally require the provision of life-sustaining therapies such as mechanical ventilation (invasive or non-invasive) or vasopressor therapy. 2020;216:108459. We performed a meta-analysis to investigate the efficacy of IVIG treatment in patients with COVID-19. There is no adequate evidence to confirm that using IVIG is beneficial for SARS patients [24, 25], however, there are controversies about using IVIG against MERS [26, 27]. 2020;258:118185. and transmitted securely. Moreover, the advantage of IVIG therapy in the early phase of the disease in patients unresponsive to corticosteroid and initial antibiotic therapy has been reported [31]. However, the efficacy of IVIg would be better if the immune IgG antibodies were collected from patients who have recovered from COVID-19 in the same city, or the surrounding area, in order to increase the chance of neutralizing the virus. The role of adjuvant immunomodulatory agents for treatment of severe influenza. Nat Rev Neurol. IVIG and the Coronavirus. The https:// ensures that you are connecting to the 2014;60(23):3209. We performed this review to summarize recent studies and knowledge about the effectiveness of IVIG treatment for COVID-19. (RCTs: n=4, Retrospective cohort studies (RCSs): n=3) including 825 patients [17], [18], [19], [20], [21], [22], [23]. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Baras B, de Waal L, Stittelaar KJ, Jacob V, Giannini S, Kroeze EJ, van den Brand JM, van Amerongen G, Simon JH, Hanon E, Mossman SP, Osterhaus AD. Google Scholar. claimed that the Gamunex-C and Flebogamma DIF (Grifols) intravenous immunoglobulin (IVIG) products, manufactured before the pandemic, cross-neutralize SARS, MERS, and the newly emerged SARS-CoV-2 [65]. All listed authors reviewed and approved the final manuscript. Kubota-Koketsu R, Terada Y, Yunoki M, Sasaki T, Nakayama EE, Kamitani W, et al. Immunol., 127 (3) (2011) 823830.e821-827. The RR for severe subgroup was 0.76 (95% CI: 0.511.14, I2=35%) and for non-severe subgroup was 1.39 (95%CI: 0.238.23., I2=20%) which both showed no significant difference. J Med Virol. PubMed Central COVID-19 Clinical management: living guidance. The ultimate goal of this therapy is to normalize a compromised immune system. The use of IVIG compared to the control group did not impact the length of hospitalizations. Herth et al. Severe group: defined by any of: (1) Oxygen saturation<93% on room air. Muccioli L, Pensato U, Bernab G, Ferri L, Tappat M, Volpi L, et al. 2020 Jun 23;9:e57877. The COVID-19 pandemic inflicted additional pressure on the supply and demand balance, pushing it toward a shortage of IVIG [57]. Weights are from fixed-effects analysis. Chest. Due to the Shao et al. government site. More clinical trials on the effect of IVIG therapy in COVID-19 patients should be performed to establish a certain conclusion about IVIG effectiveness. Is malaria immunity a possible protection against severe symptoms and outcomes of COVID-19? It's made up mostly of immunoglobulin IgG. official website and that any information you provide is encrypted Quinti I, Lougaris V, Milito C, Cinetto F, Pecoraro A, Mezzaroma I, et al. Published by Elsevier B.V. All rights reserved. Antibody; IVIg; Influenza; Intravenous immunoglobulin; Passive immunotherapy; Plasma; Serum. Treatment of neonatal sepsis with intravenous immune globulin. We only tested the impact of IVIG use on duration of ICU in severe patients because of the limited number of articles. Morgan O.W., Bramley A., Fowlkes A., Freedman D.S., Taylor T.H., Gargiullo P. Morbid obesity as a risk factor for hospitalization and death due to 2009 pandemic influenza A(H1N1) disease. Keywords: ADE requires prior exposure to similar antigens, suggesting that sera-containing antibodies against other coronaviruses may play a role in this phenomenon. Note: IVIG: intravenous immunoglobulin; SOC: standard of care; NM: not mention. IVIg administered at the time of influenza virus exposure led to a significant reduction in lung viral load following pH1N1 challenge. Overall, immunotherapy with immune IgG antibodies combined with antiviral drugs may be an alternative treatment against COVID-19 until stronger options such as vaccines are available. IVIg; coronavirus; immunotherapy; nCoV-2019; virus. They suggested IVIG treatment in patients who were not improved with the antiviral and chloroquine-class drugs, whose oxygen saturation is persistently under 90%, patients with more than 30% of lung involvement in CT scan, and patients whose lungs are progressively being involved in serial CT scans [42]. Tong R, Luo L, Zhao Y, Sun M, Li R, Zhong J, Chen Y, Hu L, Li Z, Shi J, Lyu Y, Hu L, Guo X, Liu Q, Shuang T, Zhang C, Yuan A, Sun L, Zhang Z, Qian K, Chen L, Lin W, Chen AF, Wang F, Pu J. Emerg Microbes Infect. IVIG is a blood product. PubMed Dis. 2020;548:15. CAS found inconclusive results about the effectiveness of IVIG in COVID-19 [53]. Care Med. The authors declare no conflict of interest. GUID:3E2FEE26-C53F-4963-8191-7F36CFA7DDFF. . It provides the body with antibodies to protect against bacteria and viruses. Characterizing the cellular and molecular variabilities of peripheral immune cells in healthy recipients of BBIBP-CorV inactivated SARS-CoV-2 vaccine by single-cell RNA sequencing. eCollection 2020. Theoretically, if IVIG pose an effective impact, the length of the hospital or ICU stay would be shorter than control group. Available from: https://www.who.int/publications/i/item/WHO-2019-nCoV-clinical-2021-1. Written by Susan Bernstein Medically Reviewed by Jennifer Robinson, MD on August 15, 2022 This therapy can help people with weakened immune systems or other diseases fight off infections. . Some other risks should be considered too. Bissel SJ, Wang G, Carter DM, Crevar CJ, Ross TM, Wiley CA. 2020. https://doi.org/10.1080/1744666X.2020.1750954. Maddur M.S., Kaveri S.V., Bayry J. WHO. Orish VN, Boakye-Yiadom E, Ansah EK, Alhassan RK, Duedu K, Awuku YA, Owusu-Agyei S, Gyapong JO. Intravenous immunoglobulin (IVIG) is a pooled antibody, and a biological agent used to manage various immunodeficiency states and a plethora of other conditions, including autoimmune, infectious, and inflammatory states. PubMed Before Adjunctive therapies and immunomodulating agents for severe influenza. Hyperimmune IV immunoglobulin treatment: a multicenter double-blind randomized controlled trial for patients with severe 2009 influenza A(H1N1) infection. Almost all cervical cancer deaths now occur in developing countries. Nguyen AA, Habiballah SB, Platt CD, Geha RS, Chou JS, McDonald DR. Immunoglobulins in the treatment of COVID-19 infection: Proceed with caution. Overall, the quality of the seven included studies was low. 2018;7:154. doi: 10.1038/s41426-018-0155-5. PubMed Advanced Molecular and Immunological Diagnostic Methods to Detect SARS-CoV-2 Infection. Rotondo JC, Martini F, Maritati M, Caselli E, Gallenga CE, Guarino M, De Giorgio R, Mazziotta C, Tramarin ML, Badiale G, Tognon M, Contini C. Microorganisms. 2019;20 doi: 10.3390/ijms20061473. No effects were apparent on the total duration of the disease or the length of hospital stay [40]. Tanzania is trying to inoculate girls against the . Prevention of the disease progression and rapid improvement following IVIG therapy combined with conventional antibiotic therapy has been demonstrated in M. pneumoniae pneumonia. 2020;130(9):72633. Early additional immune-modulators for mycoplasma pneumoniae pneumonia in children: an observation study. These studies are summarized in Table 1. Intravenous immunoglobulin also called IVIG is a medicine that is given through the vein. See Fig. Well-designed clinical trials to identify the clinical and biochemical characteristics in COVID-19 patients population that could benefit from IVIG are warranted in the future. Human polyclonal immunoglobulin G from transchromosomic bovines inhibits MERS-CoV in vivo. Patients commonly go through three clinical stages of the COVID-19: the acute or pneumonia stage, the viremia stage, and the recovery stage. Autoimmun Rev. No restriction on the geographical location or language of the studies. All authors read and approved the final manuscript. Pol Arch Intern Med. Clinical efficacy of intravenous immunoglobulin therapy in critical ill patients with COVID-19: a multicenter retrospective cohort study. But there was no significant difference in the severe or non-severe subgroups. Ghana Med J. Intravenous immunoglobulin (IVIG) significantly reduces respiratory morbidity in COVID-19 pneumonia: a prospective randomized trial. The Newcastle-Ottawa Scale (NOS) [13] was to evaluate the quality of the non-RCTs which comprises patient selection, comparability between two groups, and research results three components. 2020;125(3):34950. History of immunoglobulin replacement. Immunopharmacol., 84 (2020) 106560. Transfus Med Rev. Sometimes a high software price tag is enough to send people to look for a pirated . Another proposed mechanism is the blockage of Fas-mediated cell death, causing a decrease in inflammatory reactions [16, 17]. PubMed Central Only download legitimate software. Though the fixed-effect results provided good results that IVIG could increasing the hospital stay in critical and severe subgroup and reducing the days in non-severe subgroup, we still chosen the random-effect meta-analysis results due to the high heterogeneity. Improvements started to become evident in the first 34days [44]. Reducing thrombotic events in renal transplant recipients treated with IVIg for antibody-mediated rejection. Circulating Normal IgG as Stimulator of Regulatory T Cells: Lessons from Intravenous Immunoglobulin. 2020 (a), and of the severe type patients as Shao et al. Exp. This shift to IVIG changed the face of PI treatment. 2019;11 doi: 10.3390/v11110979. Update on the use of immunoglobulin in human disease: A review of evidence. Pedraza-Snchez S, Cruz-Gonzlez A, Palmeros-Rojas O, Glvez-Romero JL, Bellanti JA, Torres M. Front Immunol. Perez E.E., Orange J.S., Bonilla F., et al. Hagiwara J., Yamada M., Motoda N., et al. These immune IgG antibodies will be specific against COVID-19 by boosting the immune response in newly infected patients. https://doi.org/10.1016/j.intimp.2021.107732, IVIG (human) flebo gamma 5% DIF GRIFOLS, four vials of 5 gm5 IVIG daily for three consecutive days; receive the same treatments as were introduced initially, Placebo; receive the same treatments as were introduced initially, 1. Shao Z., Feng Y., Zhong L., et al. In addition, different lots of IVIG may have different titers . Lancet. Protection was also afforded by purified F(ab')2 but not Fc fragments derived from IVIg, supporting a specific antibody-mediated mechanism of protection. The cytokine release syndrome (CRS) of severe COVID-19 and Interleukin-6 receptor (IL-6R) antagonist Tocilizumab may be the key to reduce the mortality. Please enable it to take advantage of the complete set of features! Weights are from fixed-effects analysis. We pooled the data of mortality and other outcomes using either a fixed-effect model or a random-effects model. 1):213. Wenxin Peng, and Huairong Xiang designed this study; Xuan Cheng and Yun Li ran the searched strategy; Huairong Xiang and Wenwen Luo selected articles and extracted data; Qizhi Zhang and Xuan Cheng evaluate the quality of the literature. A case report by El-Zein et al. Immunol. FOIA Accessibility One of the diagnostic methods for COVID-19 is antibody measurement in patients serum. This topic will review the uses, proposed mechanisms of action, and administration of intravenous immune globulin (IVIG). In 2019, a novel coronavirus disease (COVID-19) which caused by the severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) has aroused an outbreak worldwide. Copyright 2017 The Authors. It is unknown whether IVIG products derived from pooled donor plasma contain high titers of SARS-CoV-2 neutralizing antibodies. A combination of search terminologies (Coronavirus Disease 2019 OR COVID-19 OR SARS-Cov-2 OR 2019-nCoVDiseases OR COVID 19Virus Infection) AND (IVIG OR immunoglobulin OR IVIG). Int J Mol Sci. 2020;20(9):e23844. Int Immunopharmacol. Life Sci. 2020 Sep;13(5):835-837. doi: 10.1111/cts.12816. Tabarsi P., Barati S., Jamaati H., et al. and transmitted securely. Careers. Dis. Google Scholar. Front Immunol. [7] reported an opposite meta- analysis result that IVIG were not associated with reducing mortality in this population. 2023 Mar 23;36(1):e0004022. Several studies have reported the results of IVIG therapy in different respiratory syndromes, including severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), acute respiratory distress syndrome (ARDS), influenza pandemics, and seasonal influenza [22, 23]. All the authors approved submission of this paper to this journal. Your US state privacy rights, Clin Transl Sci. 1. Liu et al. See Fig. Moher D., Liberati A., Tetzlaff J., et al. (2) Respiratory rate>30 breaths/min in adults (3) PaO2/FiO2300mmHg. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Infect. [65] used antigens from EIA kits instead of virus-infected cells [66]. Note: CI=confidence interval, IVIG=intravenous immunoglobulin. have performed a retrospective study on the data collected from patients developing encephalopathy who received IVIG at the dosage of 0.4g/kg. The Panel recommends against the routine use of IVIG monotherapy for the treatment of MIS-C unless glucocorticoid use is contraindicated (AIIb). Unauthorized use of these marks is strictly prohibited. Immunomodulatory therapy for the management of severe COVID-19. All statistical analysis was conducted by RevMan 5.4 software. The authors declare that they have no competing interests. PMC Reduced pH1N1 lung viral loads in ferrets administered intravenous IVIg. J Infect Dis. 5 Effectiveness of intravenous immunoglobulin for children with severe COVID-19: a rapid review. Maddur MS, Rabin M, Hegde P, Bolgert F, Guy M, Vallat JM, et al. IVIG is used to prevent or reduce the severity of infections in persons with immunodeficiency. Microbes Infect. Different procedures may be used to remove or inactivate any possible pathogens from the plasma of recovered coronavirus patient derived immune IgG, including solvent/detergent, 60 C heat-treatment, and nanofiltration. Crit Care Med. J Autoimmun. Active Therapy with Passive Immunotherapy May Be Effective in the Fight against COVID-19. Neutralizing and binding activities against SARS-CoV-1/2, MERS-CoV, and human coronaviruses 229E and OC43 by normal human intravenous immunoglobulin derived from healthy donors in Japan. -, Chan J.F., Yuan S., Kok K.H., To K.K., Chu H., Yang J., Xing F., Liu J., Yip C.C., Poon R.W., et al. volume17, Articlenumber:105 (2021) Zhang L, Liu Y. Alijotas-Reig J, Esteve-Valverde E, Belizna C, Selva-OCallaghan A, Pardos-Gea J, Quintana A, et al. Carannante N., Fiorentino G., Corcione A., et al. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. Pulse Therapy With Corticosteroids and Intravenous Immunoglobulin in the Management of Severe Tocilizumab-Resistant COVID-19: A Report of Three Clinical Cases. Antiviral Res. 2022 Jun 10;10(6):1193. doi: 10.3390/microorganisms10061193. 3. Allergy, Asthma & Clinical Immunology Mair-Jenkins J, Saavedra-Campos M, Baillie JK, Cleary P, Khaw FM, Lim WS, et al. Google Scholar. 2020 Oct 1;258:118185. doi: 10.1016/j.lfs.2020.118185. Nature. As a library, NLM provides access to scientific literature. In the three cases reported by Cao et al. Phase II/III trial of hyperimmune anti-COVID-19 intravenous immunoglobulin (C-IVIG) therapy in severe COVID-19 patients: study protocol for a randomized controlled trial. http://www.who.int/mediacentre/factsheets/fs211/en/. 1. Int Immunol. Schwaiger J, Karbiener M, Aberham C, Farcet MR, Kreil TR. 2002;109(6):10014. Sera derived from SARS patients [64] and sera before the pandemic [56] have no cross-neutralization with SARS-CoV-2 [25]. The .gov means its official. All three retrospective cohort studies have adjusted the confounders in the analysis and the range of score is 56. PMC : IJID: off. The receptor-binding domain (RBD), contained within the S1 subunit of the coronavirus spike protein, mediates viral entry by binding to the angiotensin-converting enzyme 2 receptor on host cells. Conversely, Diez et al. There are some limitations on our meta-analysis. Reactivity of IVIg against seasonal and pandemic strains. Daneshpazhooh M., Soori T., Isazade A., et al. Google Scholar. Cao W, Liu X, Bai T, Fan H, Hong K, Song H, et al. Influenza is a highly contagious, acute, febrile respiratory infection that can have fatal consequences particularly in individuals with chronic illnesses. We still need more RCTs or at least observational studies with a control group to confirm the results of the study. Clinical efficacy of intravenous immunoglobulin therapy in critical ill patients with COVID-19: a multicenter retrospective cohort study. Muccioli et al. Please enable it to take advantage of the complete set of features! IVIG is made from pooled donated blood products. Estimating Mortality from COVID-19. eCollection 2022 Jul. Xie Y., Cao S., Dong H., et al. PubMed Central study provided both severe and critical patients outcomes, we defined the data of critical type patients as Shao et al. The use of intravenous immunoglobulin gamma for the treatment of severe coronavirus disease 2019: a randomized placebo-controlled double-blind clinical trial. 2014 Apr 16;11:70. doi: 10.1186/1743-422X-11-70. Zahra Kolahchi, Sara Ekrami Nasab, Hesan Jelodari Mamaghani, Maryam Keyfari Alamdari, and Hanye Sohrabi searched the literature and drafted the manuscript. Allergy Clin. As shown in Fig. More randomized clinical trials with large sample sizes are required to decide the amount of IVIG efficacy. Accessed 27 Sept 2021. Medicinal Immunoglobulin G Products (2020) Show High Infectivity Neutralizing Activity Against Seasonal Influenza Virus Strains Selected for Future Vaccines (2020-2022). PubMed Central Accessibility The therapeutic effect of IVIG in COVID-19 patients has been investigated. Antibodies to SARS-CoV-2 and their potential for therapeutic passive immunization. But, it is still debatable that whether the IVIG can promote ADE or not [62, 69, 70]. Clipboard, Search History, and several other advanced features are temporarily unavailable. Patients received IVIG at the dose of 0.30.5g/kg for five days, in a way that no one received less than 25g of IVIG. M.S. . 2013;144(2):46473. reported 5 cases of COVID-19, in whom administering hydroxychloroquine and antibacterial agents failed to improve the condition. 2020;288:198114. As of today, the case fatality ratio (CFR) of COVID-19 ranges from less than 0.1% to more than 25% varying between countries, and the overall CFR is probably around 1% [2, 3]. In spite of it all, there are numerous influencing factors to affect the results such as time of the IVIG administration, the function of standard of care and so on. However, IVIG administration in 24h did not show this result. Vlaar AP, Juffermans NP. Based on the experience of treating previous coronavirus diseases such as severe acute respiratory syndrome (SARS) [3], Middle East respiratory syndrome (MERS) [4] and swine-origin influenza virus (SOIV) H1N1 [5], though no sufficient clinical data, it might be believed that IVIG could be used in COVID-19 patients and be one of worthwhile therapeutic options. Intravenous immunoglobulins (IVIG) are produced from thousands of pooled plasma donations, and thus contain a wide variety of antibodies the donors have generated against infectious disease agents. The protocol for this study has been registered in the International Prospective Register of Systematic Reviews (PROSPERO, CRD42021238498). Luke T.C., Casadevall A., Watowich S.J., et al. These uncertainties and the shortage of IVIG supply and its high cost suggest that its use must be supported with strong evidence. Bethesda, MD 20894, Web Policies There may be a relationship between the efficacy of IVIG and the COVID-19 disease severity. Sun X., Wang T., Cai D., et al. In primary or secondary hypogammaglobulinemia (low IgG), Ig replacement therapy protects against infections by providing an adequate amount of IgG in the . This study was approved by the Ethics committee of Tehran University of Medical Sciences. Stockman LJ, Bellamy R, Garner P. SARS: systematic review of treatment effects. There still exist types of studies which have evaluated the efficiency of IVIG in patients with COVID-19 so far [9], [10]. official website and that any information you provide is encrypted See Table 2 The benefit of IVIG (Intravenous Immunoglobulin) therapy for COVID-19 remains controversial. 8600 Rockville Pike Autoimmun Rev. Dis., 7 (3) (2020) ofaa102. J. Infect. Also, a review by Moradimajd et al. Mustafa S, Balkhy H, Gabere MN. 2020. https://doi.org/10.1093/ofid/ofaa102. Improve their clinical outcome including serum creatinine, white blood cell which were higher in the control group, IVIG 0.5g/Kg for 3days and SOC; All received methylprednisolone, Receive anytreatment not partofa RCT atthe timeofenrollment. Prete M, Favoino E, Catacchio G, Racanelli V, Perosa F. SARS-CoV-2 infection complicated by inflammatory syndrome. However, the efficacy of IVIg would be better if the immune IgG antibodies were collected from patients who have recovered from COVID-19 in the same city, or the surrounding area, in order to increase the chance of neutralizing the virus. Brocklehurst P, Farrell B, King A, Juszczak E, Darlow B, Haque K, et al. The studies mentioned above have limitations that make it difficult to persuade the use of IVIG. Lesson from patients with agammaglobulinemia. In Xie et al study [25], the mortality rate of patients with COVID-19 is associated with received IVIG time which suggested that administered early on IVIG treatment. Int J Mol Sci. Antibodies are proteins your body makes to help you fight certain infections. This is the first meta-analysis included 4 RCTs and 3 RCSs investigating the effect of IVIG on clinical outcomes of different severity types patients diagnosed with COVID-19. doi: 10.7554/eLife.57877. Coronavirus disease (COVID-2019) situation reports. Google Scholar. Severe Coronavirus Disease 2019 That Recovered from Respiratory Failure by Treatment That Included High-dose Intravenous Immunoglobulin. Potential therapeutic approach of intravenous immunoglobulin against COVID-19. Open Forum Infect Dis. Ferrets were, F(ab) 2 but not Fc fragments of IVIg protect ferrets against lethal H5N1, IVIg contains antibodies that inhibit the neuraminidase activity of purified N1 and H5N1, MeSH 2023 Feb 25;16:11786329231157467. doi: 10.1177/11786329231157467. R R.S., Barge V.B., Darivenula A.K., et al. Epub 2013 Dec 26. As an adjunct treatment in severe influenza, IVIG is an efficacious treatment for the pulmonary lesions in influenza pneumonia and Mycoplasma pneumoniae pneumonia [28,29,30]. Intravenous Immunoglobulin (IVIG) Significantly Reduces Respiratory Morbidity in COVID-19 Pneumonia: A Prospective Randomized Trial. Their primary function is to bind to . Rojas M, Rodrguez Y, Monsalve DM, Acosta-Ampudia Y, Camacho B, Gallo JE, et al. Publ. Article 2005;59(5):1099106. National Library of Medicine also showed clinical improvement upon the usage of IVIG and cytokine blocking drugs in an acute demyelinating encephalomyelitis associated with COVID-19 [45]. Reduce the number of days to clinical improvement, 1. Careers. Alhazzani W, Mller MH, Arabi YM, Loeb M, Gong MN, Fan E, et al. SN Compr Clin Med. This site needs JavaScript to work properly. sharing sensitive information, make sure youre on a federal Perspectives of Immune Therapy in Coronavirus Disease 2019. Arch Med Res. 2018 May 28;2018:9747549. doi: 10.1155/2018/9747549. [accessed 1 March 2021]. Therefore, more randomized clinical trials should be performed to shed light on the IVIG efficacy. The rationale behind this difference could be the dissimilarity of study methods, as Diez et al. study, despite a reduction in the duration of hospitalization [54]. A pneumonia outbreak associated with a new coronavirus of probable bat origin. The site is secure. [15] and Wan et al. 2020;21(7):2272. Search were down on February 17, 2021. Fig. Fourth, If the sera collected from the general population lacks the anti-SARS-CoV-2 antibodies, its use provides no benefit [63]. Clin. Keywords: Ferrets ( n = 4/group) were administered, Effect of IVIg dose on protection of ferrets against H5N1 challenge. A more recent study has shown that immunoglobulins can decrease the ability of activated T cells in engaging with microglia, a mechanism that led to the detection of lower levels of tumor necrosis factor-alpha and interleukin-10 in T-cell- microglia co-culture [18]. Expert Rev Clin Immunol. the contents by NLM or the National Institutes of Health. Immune globulin derived from the plasma of paid donors is used in the treatment of an array of disorders, including primary and secondary immune deficiency states and a variety of autoimmune and inflammatory disorders. Available: https://www.who.int/publications/m/item/weekly-epidemiological-update---23-february-2021. A meta-analysis to review these evidences is greatly essential for the use of IVIG for COVID-19. 2020. https://doi.org/10.1111/trf.16161. Simultaneously, the expression of Toll-like receptor-4 (TLR-4) is reduced [22, 35, 47]. Key words: Immune globulin, immunoglobulin, IVIG, SCIG, IGIV, transfusion, adverse events, primary immunodeciency, immunomo-dulation, immune modulating, autoimmunity Immunoglobulin is increasingly recognized as a treatment of a variety of medical conditions, not only for its ability to ght infection as a replacement therapy but also for . -, Pizzorno A., Abed Y., Boivin G. Influenza drug resistance. (3) Outcome: The primary outcome measure was defined as mortality. We investigated the potential of human IVIg to ameliorate influenza infection in ferrets exposed to either the pandemic H1N1/09 virus (pH1N1) or highly pathogenic avian influenza (H5N1). Inclusion in an NLM database does not imply endorsement of, or agreement with, Hohenadl C, Wodal W, Kerschbaum A, Fritz R, Howard MK, Farcet MR, Portsmouth D, McVey JK, Baker DA, Ehrlich HJ, Barrett PN, Kreil TR. 2011;7(3):30116. What are the indications for intravenous immunoglobulin? Hanaei S, Rezaei N. COVID-19: Developing from an outbreak to a pandemic. IVIG group significantly prolonged median survival time and reduced plasma levels of C-reactive protein. The potential reason may be that neither the retrospective studies nor the available RCTs was included in their pooled results that lead to the quality of the analysis was low. The severity of COVID-19 is associated with the efficiency of IVIG. The possible pathogenesis of COVID-19 is that lymphocyte count in the early phase of the disease (114days) is normal or slightly low [41]. Allergy Asthma Clin Immunol 17, 105 (2021). Before It gained the title of a "worm" due to its self-spreading by exploiting SMB vulnerabilities using the . Vaccine. IVIg could be useful prophylactically in the event of a pandemic to protect vulnerable population groups and in the critical care setting as a first stage intervention. Well-designed clinical trials to identify the clinical and biochemical characteristics in COVID-19 patients population that could benefit from IVIG are warranted in the future. Clinicians treating severe hospitalized COVID-19 may administer monthly high-dose intravenous immune globulin (IVIg-HD) therapy at doses of 1 - 2 grams per kilogram (g/kg) over 3 to 5 days to delay progression and improve mortality of SARS-CoV-2-related illness [ 9 ]. High-dose intravenous immunoglobulin as a therapeutic option for deteriorating patients with coronavirus disease 2019. Intravenous immunoglobulin induces proliferation and immunoglobulin synthesis from B cells of patients with common variable immunodeficiency: a mechanism underlying the beneficial effect of IVIg in primary immunodeficiencies. Would you like email updates of new search results? Infect. However, considering the high price and side effect, IVIG was used usually to severe or critical ill patients. Therefore, more clinical trials on the effect of IVIG therapy in COVID-19 patients should be performed to establish a certain conclusion about IVIG effectiveness. CAS included 325 patients, from which 174 cases received IVIG. It is determined that these effects of IVIG on the inflammatory storm do not incline patients towards immunosuppression [36]. 2020;20(1):786. The select indicators were included dichotomous data and continuous data. 2023 Jan 9;13:987231. doi: 10.3389/fimmu.2022.987231. J Infect Dis. Cookies policy. Immunoglobulins have been used widely in medicine for a variety of diseases including infectious diseases. Furthermore, B lymphocyte reduction is observed during the early stage [2]. 2009;158(Suppl. 2013;122(8):141927. Gasparyan AY, Misra DP, Yessirkepov M, Zimba O. J Korean Med Sci. A recent systematic review performed by Mansourabadi et al. Wan X., Wang W., Liu J., et al. Tetro JA. IVIG is routinely used as an effective treatment for primary immunodeficiency, immune thrombocytopenic purpura, Kawasaki disease, dermatomyositis, and Guillain-Barr syndrome primarily as an antibody moderator [13]. Int. Takeaway. Recently, we showed that intravenous immunoglobulin (IVIg) treatment reduces inflammation of intestinal epithelial cells and eliminates overgrowth of the opportunistic human fungal pathogen Candida albicans in the murine gut. WHO Influenza (Seasonal) Fact Sheet. IVIg is a common blood plasma product that is used to treat other immune disorders. Mansourabadi AH, Sadeghalvad M, Mohammadi-Motlagh HR, Rezaei N. Life Sci. All the authors were involved in either drafting or critical revision of the paper. The .gov means its official. Shao Z, Feng Y, Zhong L, Xie Q, Lei M, Liu Z, et al. The site is secure. Mohtadi N, Ghaysouri A, Shirazi S, Sara A, Shafiee E, Bastani E, et al. It was found that continuous injection of IVIG influences the process of lymphocyte differentiation and maturation, which finally leads to the normal immune response of white blood cells and prevents the production of inflammatory factors. In the 1960s, a new method of treatment for inflammation-related diseases was introduced. 2011;32(4):409422. 2020;19(7):102569. We performed a meta-analysis to investigate the efficacy of IVIG treatment in patients with COVID-19. Wunderink RG. Received 2021 Mar 16; Revised 2021 Apr 12; Accepted 2021 Apr 26. Ten sites within the lungs of each ferret (5 groups, IVIg protects ferrets against H5N1 challenge. Second, the analysis was included only four RCTs with small sample sizes. There were six articles reported on the length of hospitalization. Tables 2 and 3 illustrate the studies that reported no significant effect of IVIG and those that found inconclusive results. Moreover, no improvement in CT scan or the overall course of the disease was observed in Tabarsi et al. Huang L, Kanellis J, Mulley W. Slow and steady. As a result, even if the patient recovers from the COVID-19, he/she may still be vulnerable and must be vaccinated as soon as possible [62]. This systemic inflammation gives rise to the infiltration of monocytes and lymphocytes in the lung and the heart. H1N1, but not H3N2, influenza A virus infection protects ferrets from H5N1 encephalitis. IVIG showed multiple effects in enhancing the pro-inflammatory cells activation, and indirectly suppressing T-cell and B-cell proliferation by cytokines [29], [30], [31], [32]. For severe subgroup the result [MD=1.75 (1.94 5.45)] demonstrated that IVIG could increase the length of duration in hospitalization but no statistical significance difference. eCollection 2023. For critical subgroup, the pooled RR was 0.57 (95% CI: 0.420.79, I2=0) which showed the mortality of critical ill patients treated with IVIG was lower compared with the control group. -. Two of the main confounding factors are the small sample size and the simultaneous administration of other therapy methods (such as glucocorticoids and plasma exchange). Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. This study does not recommend IVIG therapy as a definitive cure for the acute phase of COVID-19 but instead summarizes the evidence and gives clues for upcoming trials. Sci. The therapeutic effect of IVIG in COVID-19 patients has been investigated. Furthermore, the elevation of C-reactive protein (CRP), lactate dehydrogenase (LDH), D-dimer, and ferritin in infected patients, showed more evidence of a hyperinflammatory state [7, 8]. 2010;5(3):e9694. A possible role for B cells in COVID-19? Unable to load your collection due to an error, Unable to load your delegates due to an error. MD=0.68 (3.49 2.13, I2=84%). Subjects were divided into non-severe, severe and critical three subgroups based on the information of the study and the World Health Organization (WHO) definition of severity. Risk of bias assessment of the included studies in the systematic review using the new Cochrane risk of bias tool for randomized controlled trials. 2011 Mar 3;29(11):2120-6. doi: 10.1016/j.vaccine.2010.12.125. IVIG therapy is used as an effective treatment for immunodeficient patients and patients with inflammatory or autoimmune conditions. Cell Mol Immunol. 2011;36(1):915. Moreover, IVIG therapy has multi-level effects on the immune system in the second type (high-dose IVIG). Aljaberi R, Wishah K. Positive outcome in a patient with coronavirus disease 2019 and common variable immunodeficiency after intravenous immunoglobulin. Study data is available in the journal article "Intravenous Immunoglobulin (IVIg) Significantly Reduces Respiratory Morbidity in COVID-19 Pneumonia: A Prospective Randomized Trial," published by. Once they gain access to a computer, they can perform any malicious action. government site. Students International Committee of Medical Schools (SICoMS), School of Medicine, Tehran University of Medical Sciences, Tehran, Iran, Zahra Kolahchi,Hanye Sohrabi,Sara Ekrami Nasab,Hesan Jelodari Mamaghani&Maryam Keyfari Alamdari, Research Center for Immunodeficiencies, Childrens Medical Center, Tehran University of Medical Sciences, Dr. Qarib St, Keshavarz Blvd, 14194, Tehran, Iran, Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran, Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran, You can also search for this author in J Infect Public Health. Mustafa S., Balkhy H., Gabere M.N. Bookshelf 2020 doi: 10.1016/S0140-6736(20)30154-9. Is COVID-19 receiving ADE from other coronaviruses? Int J Antimicrob Agents. Front Nutr. eCollection 2018. IVIG has demonstrated clinical efficacy on critical ill patients with COVID-19. 2011;365(13):120111. Note: CI=confidence interval, IVIG=intravenous immunoglobulin. It shows that IVIG may be an effective therapeutic intervention when administered early. PubMed Two reviewers (Huai-rong Xiang, Wen-wen Luo) independently screened the titles and abstracts of the studies to retrieve articles and extracted data based on the inclusion and exclusion criteria. The striking mimics between COVID-19 and malaria: A review. 2020;61(2):35660. 2017;38(1):3743. J Infect. Bayry J, Fournier EM, Maddur MS, Vani J, Wootla B, Sibril S, et al. Intravenous immunoglobulin (IVIg), prepared prior to a pandemic, prevents pandemic influenza disease in ferrets. Dez J-M, Romero C, Gajardo R. Currently available intravenous immunoglobulin contains antibodies reacting against severe acute respiratory syndrome coronavirus 2 antigens. Based on other case series [33], [34] that patients treated with IVIG, the results appear to be favorable and consistent which supported IVIG might be beneficial for covid-19 patients especially for severe or critical ill patients. Characteristics of the studies included in the metaanalysis. 8600 Rockville Pike The high infection rate and mortality pose an unprecedented challenge to clinicians. Therefore, IVIG treatment in ARDS patients is still debatable. In the lethal H5N1 model, the majority of animals given IVIg survived challenge in a dose dependent manner. 2016. Furthermore, neither IVIG nor antibiotics brought about an increase in survival rate in Pei et al. 2 Open Forum Infect Dis. Elevated levels of interleukin (IL)-2, IL-6, IL-7, interferon-gamma (IFN-) inducible protein 10 (IP-10), and tumor necrosis factor-alpha (TNF-) indicates a cytokine cascade and a cytokine release syndrome as an underlying immunopathology [5, 6]. Kaveri SV, Maddur MS, Hegde P, Lacroix-Desmazes S, Bayry J. IVIg effectively reduced viral levels of pandemic H1N1 influenza and prevented disease due to avian influenza H5N1. In random-effect meta-analysis, the critical subgroup analysis conducted that IVIG could prolong the time of hospitalization while the severe subgroup also showed a slightly trend on prolonging the days in hospital but nostatisticalsignificance. 2020;60(11):274852. An official website of the United States government. Numerous clinical trials, retrospective studies and observational studies about SARS-Cov-2 disease are underway, and we found some effective antiviral agents against the infection but the lack of standardized therapy makes the condition worse. Impact of IVIg on the interaction between activated T cells and microglia. statement and Evolution of Therapeutic Antibodies, Influenza Virus Biology, Influenza, and Influenza Immunotherapy. government site. Tabarsi P, Barati S, Jamaati H, Haseli S, Marjani M, Moniri A, et al. Pei et al. Immunol Allergy Clin North Am. To achieve a more accurate result, Gharebaghi et al. 2020 May 11;35(18):e176. Evaluating the effects of Intravenous Immunoglobulin (IVIg) on the management of severe COVID-19 cases: A randomized controlled trial. Epub 2011 Jan 14. Reduced morbidity, inhibition of disease progression, and preventing permanent systemic organ injury are identified as outcomes of these treatments under sufficient dose and early administration [28]. CAS Current treatment options and the role of peptides as potential therapeutic components for Middle East Respiratory Syndrome (MERS): A review. 2020;222(12):19604. Federal government websites often end in .gov or .mil. Virus Res. After comprehensively screening 129 full text, only 7 eligible studies were included. Two reviewers (Yun Li and Xuan Cheng) searched Web of Science, PubMed, Embase, the Cochrane Library, MedRxiv for clinical trials and observational studies. 2011;16(2):23942. Intravenous immunoglobulin exerts reciprocal regulation of Th1/Th17 cells and regulatory T cells in Guillain-Barr syndrome patients. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. FOIA Reactivity of IVIg against seasonal and pandemic strains. 2022 Nov 8;23(1):932. doi: 10.1186/s13063-022-06860-2. [10] Immunoglobulin therapy (IVIG) is based on the intravenous injection of human immunoglobulin to patients suffering from specific inflammatory conditions. Known for its anti-inflammatory reactions, it has been used to treat patients with inflammatory diseases including Kawasaki diseases, multiple sclerosis and so on [2]. Intravenous immunoglobulinsunderstanding properties and mechanisms. Hence the results should be interpreted with great caution. 2020;55:105954. However, it has other roles, such as normalizing monocyte differentiation toward DC [14] and inducing proliferation of B cells and antibody production in CVID patients[15]. Antiviral agents, glucocorticoids, antibiotics, and intravenous immunoglobulin in 1142 patients with coronavirus disease 2019: a systematic review and meta-analysis. For each domain, risk of bias judgements is high, unclear or low. First of all, the life of many immunodeficient patients depends on the IVIG lots [56]. However, significant lymphopenia in the late phase (714days after symptoms appear) occurs when viremia takes place. Antiviral Approaches against Influenza Virus. Flowchart of literature search study selection. Administration of Immunoglobulins in SARS-CoV-2-Positive Patient Is Associated With Fast Clinical and Radiological Healing: Case Report. According to the inclusion criteria of the article and the characteristic of patients at baseline, we divided subjects into non-severe (two studies), severe (four studies) and critical (two studies) three subgroups to address heterogeneity. 2014;46(4):23947. And our analysis suggested that IVIG may have an impact, with a low level of certainty, in reducing the rate of mortality and prolong the hospital stay in critical patients. Clin Exp Immunol. [24] suggests that high-dose of IVIG (0.30.5g per kg weight for five doses) combined corticosteroids could perform a fine outcome and be a valid and safe immunotherapy in COVID-19 patients. Some of. Mansourabadi AH, Sadeghalvad M, Mohammadi-Motlagh HR, Rezaei N. The immune system as a target for therapy of SARS-CoV-2: a systematic review of the current immunotherapies for COVID-19. 2020;9(10):e1192. Effect of regular intravenous immunoglobulin therapy on prognosis of severe pneumonia in patients with COVID-19. Intravenous immunoglobulin therapy in COVID-19-related encephalopathy. With the discovery of well-tolerated preparations of IVIG in the 1980s, the suboptimal, painful IM administration was no longer used 2. Any discrepancies would be resolved through discussion (with a third author, if necessary). Mucous membrane pemphigoid and COVID-19 treated with high-dose intravenous immunoglobulins: a case report. Pei L, Zhang S, Huang L, Geng X, Ma L, Jiang W, et al. Nima Rezaei critically revised the manuscript. PLoS One. Google Scholar. Crit. Annu. Liu Q, Zhou YH, Yang ZQ. Higgins J.P., Altman D.G., Gotzsche P.C., et al. Furthermore, a multicenter retrospective cohort study by Shao et al. Stockman L.J., Bellamy R., Garner P. SARS: systematic review of treatment effects. It contains antibodies which are. J Dermatolog Treat. Beyond the anti-viral therapy: a comprehensive review. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Pulmonary viral loads, IVIg protects ferrets against H5N1 challenge. Luke T, Wu H, Zhao J, Channappanavar R, Coleman CM, Jiao JA, et al. Eibl MM. Methods We searched articles from Web of Science, PubMed, Embase, the Cochrane Library, MedRxiv between 1 January 2020 and February 17, 2021. 2008;28(4):73764. An official website of the United States government. Google Scholar. Immunotherapy with IVIg could be employed to neutralize COVID-19. Would you like email updates of new search results? The site is secure. The recent case report from Freire-Alvarez et al. Note: CI=confidence interval, IVIG=intravenous immunoglobulin. Rev. The https:// ensures that you are connecting to the Pulmonary viral loads in the lungs of 15 swine origin 2009 H1N1 (pH1N1) challenged ferrets. HHS Vulnerability Disclosure, Help Computer worms are defined by their ability to spread themselves without user interaction. Two RCTs [18], [20] provided the methods for the random sequence generation. Gharebaghi N., Nejadrahim R., Mousavi S.J., et al. Bethesda, MD 20894, Web Policies Emerg Microbes Infect . 2021 Jun;55(2 Suppl):56-63. doi: 10.4314/gmj.v55i2s.9. Microbes Infect. 2010;38(4 Suppl):e52e57. Biomed Res Int. Daneshpazhooh M, Soori T, Isazade A, Noormohammadpour P. Mucous membrane pemphigoid and COVID-19 treated with high-dose intravenous immunoglobulins: a case report. J Med Virol. Surviving Sepsis Campaign: guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19). Kaur SP, Gupta V. COVID-19 vaccine: a comprehensive status report. 2020;39(7):208594. Google Scholar. Privacy Gharebaghi N, Nejadrahim R, Mousavi SJ, Sadat-Ebrahimi SR, Hajizadeh R. The use of intravenous immunoglobulin gamma for the treatment of severe coronavirus disease 2019: a randomized placebo-controlled double-blind clinical trial. [. In line with these findings, Mohtadi et al. Lancet. Before describing the challenges of IVIG therapy, it is worth mentioning that not all the studies using IVIG as a treatment adjunct ended in positive results. After screening of titles and abstracts we excluded 4213 studies as these include reviews, commentaries, mechanism researches, and irrelevant to COVID-19. Suzuki Y., Tanino Y., Nikaido T., et al. MeSH Nima Rezaei. Nili H, Bouzari M, Attaran HR, Ghalegolab N, Rabani M, Mahmoudian A. Lack of cross-neutralization by SARS patient sera towards SARS-CoV-2. PubMed described a 40-year-old man with SARS-CoV-2-associated meningitis/encephalitis infection whose condition markedly improved with administration of IVIG for five days [43]. The following are the Supplementary data to this article: National Library of Medicine Front Immunol. 2020;579(7798):2703. Epub 2020 Jun 26. BMJ Case Rep. 2020. https://doi.org/10.1136/bcr-2020-237364. Efficacy of IVIG on duration of hospitalization in COVID-19 patients. El-Zein RS, Cardinali S, Murphy C, Keeling T. COVID-19-associated meningoencephalitis treated with intravenous immunoglobulin. 2020. https://doi.org/10.1101/2020.02.17.20024166v3. Article Comparing SARS-CoV-2 with SARS-CoV and influenza pandemics. Article 2022 Apr 28;9(7):ofac216. Intravenous immunoglobulin expands regulatory T cells via induction of cyclooxygenase-2-dependent prostaglandin E2 in human dendritic cells. Other community respiratory viruses. Immunoglobulins, also called antibodies, are molecules produced by white blood cells that help your body defend against infections and cancer. Cite this article. Hark back: passive immunotherapy for influenza and other serious infections. Transfusion. HHS Vulnerability Disclosure, Help Diebel LN, Liberati DM, Diglio CA, Brown WJ. Hartmann J, Klein HG. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. 1 Sporadic reports suggest that intravenous immunoglobulin (IVIg) may be efficacious in the influenza setting. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: A study of a family cluster. Recently, we showed that intravenous immunoglobulin (IVIg) treatment reduces inflammation of intestinal epithelial cells and eliminates overgrowth of the opportunistic human fungal pathogen Candida albicans in the murine gut. Liu Y, Sun W, Li J, Chen L, Wang Y, Zhang L, et al. 2017;29(11):4918. According to the Cochran's Handbook for the systematical reviews of intervention, I2 value: 0% to 40% may represent not important heterogeneity, 40% to 75% represent moderate heterogeneity, 75% to 100% represent considerable level of heterogeneity. Second, administering a high dose of IVIG to reach a serum level of 2535mg/ml can be used in patients with inflammatory or autoimmune conditions. BMC Infect Dis. COVID-19 has been diagnosed in 110.7 million cases and over 2.4 million deaths since the start of the pandemic [1]. , the total search process yielded 5287 records. The search was imposed restriction on the date between 1.1 2020 to 2.17 2021. IVIG is a pool of collected antibodies (IgG types) from healthy donors [11]. All patients recovered completely after a mean time of 29.8days. In late 2019, a new type of Coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was introduced and soon gave rise to a world-level pandemic [1]. have recently performed a randomized placebo-controlled double-blind clinical trial with a total of 59 patients. The https:// ensures that you are connecting to the The SARS-Cov-2 virus is a member of coronavirus family. Virol J. Tuck pants into socks, and tuck shirts into pants. Lnemann JD, Nimmerjahn F, Dalakas MC. Patients in the IVIG group survived and stayed longer in the hospital until full recovery, while patients in the control group died earlier. Pei L., Zhang S., Huang L., et al. Freire-lvarez E, Guilln L, Lambert K, Baidez A, Garca-Quesada M, Andreo M, et al. Application of IVIG within 48h of ICU could significantly decrease mortality, the use of mechanical ventilation, shortened duration of ICU and length of hospital stay. Kumari R, Sharma SD, Kumar A, Ende Z, Mishina M, Wang Y, Falls Z, Samudrala R, Pohl J, Knight PR, Sambhara S. Clin Microbiol Rev. Third, the benefits of IVIG are difficult to evaluate when it is coupled with corticosteroids or the recombinant modified IL-1 receptor antagonist, Tocilizumab. Cytokine storm intervention in the early stages of COVID-19 pneumonia. J Neurol. The total duration of disease was longer in the IVIG group, a dose 30g/day IVIG for five consecutive days. IVIG therapy generally functions as a replacement for the missing antibodies in the first type of administration (replacement therapy). Expert Rev Clin Immunol. Disclaimer. https://www.who.int/news-room/commentaries/detail/estimating-mortality-from-covid-19. The .gov means its official. FOIA Kubota-Koketsu R, Terada Y, Yunoki M, Sasaki T, Nakayama EE, Kamitani W, et al. 2020. https://doi.org/10.1007/s00415-020-10248-0. No SARS-CoV-2 neutralization by intravenous immunoglobulins produced from plasma collected before the 2020 pandemic. Federal government websites often end in .gov or .mil. A Phase II Safety and Efficacy Study on Prognosis of Moderate Pneumonia in COVID-19 patients with Regular Intravenous Immunoglobulin Therapy. Int J Antimicrob Agents. 2006;3(9):e343. 2016;13(1):310. Neutralisation studies were conducted with wild-type SARS-CoV-2 virus and psueudoviruses representing the native strain and several VOC. Simple preventative measures are the best way to protect your PC against malware. [26] also confirmed this viewpoint which early administration of IVIG was correlated with shorter length of hospital duration, while late administration of IVIG was related to longer hospital duration. Data was extracted and entered to a pre-defined and piloted Microsoft excel database. Terms and Conditions, 2020;81(2):31856. Our meta-analysis retrieved 4 clinical trials and 3 cohort studies including 825 hospitalized patients. 2013;382(9896):98494. We conclude that pre-pandemic IVIg can modulate serious influenza infection-associated mortality and morbidity. Intravenous Immunoglobulin Attenuates Cecum Ligation and Puncture-Induced Acute Lung Injury by Inhibiting Apoptosis of Alveolar Epithelial Cells. 2020;90:107205. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. Not only did they not adjust the confounders according the patients baseline characteristics, but the heterogeneity also was very high. The effectiveness of convalescent plasma and hyperimmune immunoglobulin for the treatment of severe acute respiratory infections of viral etiology: a systematic review and exploratory meta-analysis. It has been shown that the positive effects of the IVIG therapy remain far beyond the IgG half-life, which extends IVIG function from a simple injection of antibodies to a more stable and effective method of treatment [14]. Scid mice antibodies provides dose-dependent protection against severe acute Respiratory syndrome ( )... Cao et al of an adjuvant to protect your PC against malware will review the uses proposed... Be supported with strong evidence blood plasma product that does ivig protect against viruses given through the.... 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