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Clinical efficacy of intravenous immunoglobulin therapy in critical ill patients with COVID-19: a multicenter retrospective cohort study.

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机构: [1]Department of Nephrology, General Hospital of Central Theater Command of PLA, Wuhan, 430070, China [2]Department of Critical Care Medicine and Hospital Infection Prevention and Control, The Second People’s Hospital of Shenzhen & First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen, 518035, China [3]Department of Critical Care Medicine, The Third People’s Hospital of Shenzhen, Shenzhen, 518035, China [4]Department of Critical Care Medicine, The First Affiliated Hospital, Guizhou University of Chinese Medicine, Guiyang, 550001, China [5]Department of Critical Care Medicine, General Hospital of Southern Theater Command of PLA, Guangzhou, 510010, China [6]Department of Nephrology, Guangzhou Eighth people’s hospital, Guangzhou Medical University, Guangzhou, 510060, China [7]Department of Emergency, Zhongshan Hospital of Xiamen University, Xiamen, 361000, China [8]Department of Treatment Center for Traumatic Injuries, The Third Affiliated Hospital, Academy of Orthopedics Guangdong Province, Southern Medical University, Guangzhou, Guangdong, 515630, China [9]Key Laboratory of Hot Zone Trauma Care and Tissue Repair of PLA, General Hospital of Southern Theater Command of PLA, Guangzhou, 510010, China
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关键词: SARS-CoV-2 COVID-19 IVIG clinical efficacy mortality

摘要:
Coronavirus disease 2019 (COVID-19) outbreak is a major challenge all over the world, without acknowledged treatment. Intravenous immunoglobulin (IVIG) has been recommended to treat critical coronavirus disease 2019 (COVID-19) patients in a few reviews, but the clinical study evidence on its efficacy in COVID-19 patients was lacking. 325 patients with laboratory-confirmed critical COVID-19 were enrolled from 4 government-designated COVID-19 treatment centres in southern China from December 2019 to March 2020. The primary outcomes were 28- and 60-day mortality, and the secondary outcomes were the total length of in-hospital and the total duration of the disease. Subgroup analysis was carried out according to clinical classification of COVID-19, IVIG dosage and timing. In the enrolled 325 patients, 174 cases used IVIG and 151 cases did not. The 28-day mortality was improved with IVIG after adjusting confounding in overall cohort (P = 0.0014), and the in-hospital and the total duration of disease were longer in the IVIG group (P < 0.001). Subgroup analysis showed that only in patients with critical type, IVIG could significantly reduce the 28-day mortality, decrease the inflammatory response and improve some organ functions (all P < 0.05); the application of IVIG in the early stage (admission ≤ 7 days) with a high dose (> 15 g per day) exhibited significant reduction in 60-day mortality in the critical-type patients. Early administration of IVIG with high dose improves the prognosis of critical-type patients with COVID-19. This study provides important information on clinical application of IVIG in the treatment of SARS-CoV-2 infection, including patient selection and administration dosage and timing. © 2020 The Authors. Clinical & Translational Immunology published by John Wiley & Sons Australia, Ltd on behalf of Australian and New Zealand Society for Immunology, Inc.

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出版当年[2019]版:
大类 | 1 区 医学
小类 | 2 区 免疫学
最新[2025]版:
大类 | 3 区 医学
小类 | 3 区 免疫学
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Q1 IMMUNOLOGY
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Q2 IMMUNOLOGY

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第一作者机构: [1]Department of Nephrology, General Hospital of Central Theater Command of PLA, Wuhan, 430070, China
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通讯机构: [2]Department of Critical Care Medicine and Hospital Infection Prevention and Control, The Second People’s Hospital of Shenzhen & First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen, 518035, China [5]Department of Critical Care Medicine, General Hospital of Southern Theater Command of PLA, Guangzhou, 510010, China [6]Department of Nephrology, Guangzhou Eighth people’s hospital, Guangzhou Medical University, Guangzhou, 510060, China [9]Key Laboratory of Hot Zone Trauma Care and Tissue Repair of PLA, General Hospital of Southern Theater Command of PLA, Guangzhou, 510010, China [*1]Department of Critical Care Medicine, General Hospital of Southern Theater Command of PLA, Guangzhou, 510010, China. [*2]Department of Critical Care Medicine and Hospital Infection Prevention and Control, The Second People’s Hospital of Shenzhen & First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen, 518035, China. [*3]Department of Nephrology, Guangzhou Eighth people’s hospital, Guangzhou Medical University, Guangzhou, 510060, China.
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