Objective: Coronavirus disease 2019 (COVID-19) is a major challenge facing the world. Certain guidelines recommend intravenous immunoglobulin (IVIG) for adjuvant treatment of COVID-19. However, there is a lack of clinical evidence to support the use of IVIG. Methods: This single-center retrospective cohort study included all adult patients with laboratory-confirmed severe COVID-19 in the Respiratory and Critical Care Unit of Dabie Mountain Regional Medical Center, China. Patient information, including demographic data, laboratory indicators, the use of glucocorticoids and IVIG, hospital mortality, the application of mechanical ventilation, and the length of hospital stay was collected. The primary outcome was the composite end point, including death and the use of mechanical ventilation. The secondary outcome was the length of hospital stay. Results: Of the 285 patients with confirmed COVID-19, 113 severely ill patients were included in this study. Compared with the non-IVIG group, more patients in the IVIG group reached the composite end point [12 (25.5%) vs 5 (7.6%), P=0.008]. However, there was no statistically significant difference in the primary outcome between the two groups (P=0.167) after adjusting for confounding factors. Patients in the IVIG group had a longer hospital stay [23.0 (19.0-31.0) vs 16.0 (13.8-22.0), P<0.001]. After adjusting for confounding factors, there was still a statistically significant difference between the two groups (P=0.041). Conclusion: Adjuvant therapy with IVIG did not improve the in-hospital mortality rate or the need for mechanical ventilation in patients with severe COVID-19. In contrast, the application of IVIG was related to a longer hospital stay.
Intravenous Immunoglobulin-based Adjuvant Therapy for Severe COVID-19: a Single-center Retrospective Cohort Study