Efficacy of intravenous immunoglobulin therapy in hospitalised patients with COVID-19: A randomized controlled trial

Objectives: Acute respiratory distress syndrome (ARDS) is one of the life-threateningcomplications of COVID-19. The occurrence of ARDS is due to overactivation of thehost immune response to the virus. The purpose of this study is to investigate whetheradministration of intravenous immunoglobulins (IVIG) could enhance the outcomes ofseverely ill COVID-19 patients with ARDS. Methods: In this randomized controlled trial at Milad Hospital of Isfahan, Iran, 88patients were randomly assigned between May and October 2020. The patients had nosignificant differences in age and sex. The patients were divided into two groups: thegroup who received IVIG and routine treatment (n=44, 50%) and the control group whowere just treated with routine treatment (n=44, 50%). The outcomes of patients, includinghospitalization duration, ICU admission period, and total death occurrence, besides clinicaland laboratory parameters, were followed and compared between the two groups. Results: Primary outcomes of patients, including hospitalization duration (P=0.18),ICU admission period (P=0.35), and mortality (P=0.621), had no significant differencebetween the IVIG group and the control group. At day 3 and day 5 of IVIG administration,clinical and laboratory outcomes were screened. The clinical parameter that improvedwas oxygen saturation compared to the control group (87.56 ± 6.72 vs. 86.72 ± 7.52).In the cardiovascular system, IVIG significantly decreased diastolic blood pressure(P=0.02). In terms of coagulation parameters, IVIG treatment decreased PTT while itincreased D-dimer, but no effect on platelet count and PT was seen. The inflammatoryparameters, including ESR, CRP, and IL6, had no superior changes between the IVIGgroup and the control group. Conclusion: Our study demonstrated that there were no superior advantages inCOVID-19 patients with ARDS who were treated with IVIG..