Benefits of high-dose intravenous immunoglobulin on mortality in patients with severe COVID-19: An updated systematic review and meta-analysis
BackgroundThe clinical benefits of high-dose intravenous immunoglobulin (IVIg) in treating COVID-19 remained controversial.MethodsWe systematically searched databases up to February 17, 2022, for studies examining the efficacy of IVIg compared to routine care. Meta-analyses were conducted using the...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-01-01
|
| Series: | Frontiers in Immunology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2023.1116738/full |
| _version_ | 1797945487396962304 |
|---|---|
| author | Xiaosheng Liu Xiaosheng Liu Xiaosheng Liu Yuelun Zhang Lianfeng Lu Xiaodi Li Yuanni Wu Yang Yang Taisheng Li Taisheng Li Taisheng Li Wei Cao Wei Cao |
| author_facet | Xiaosheng Liu Xiaosheng Liu Xiaosheng Liu Yuelun Zhang Lianfeng Lu Xiaodi Li Yuanni Wu Yang Yang Taisheng Li Taisheng Li Taisheng Li Wei Cao Wei Cao |
| author_sort | Xiaosheng Liu |
| collection | DOAJ |
| description | BackgroundThe clinical benefits of high-dose intravenous immunoglobulin (IVIg) in treating COVID-19 remained controversial.MethodsWe systematically searched databases up to February 17, 2022, for studies examining the efficacy of IVIg compared to routine care. Meta-analyses were conducted using the random-effects model. Subgroup analysis, meta-regression, and trial series analysis w ere performed to explore heterogeneity and statistical significance.ResultsA total of 4,711 hospitalized COVID-19 patients (1,925 IVIg treated and 2786 control) were collected from 17 studies, including five randomized controlled trials (RCTs) and 12 cohort studies. The application of IVIg was not associated with all-cause mortality (RR= 0.89 [0.63, 1.26], P= 0.53; I2 = 75%), the length of hospital stays (MD= 0.29 [-3.40, 6.44] days, P= 0.88; I2 = 96%), the needs for mechanical ventilation (RR= 0.93 ([0.73, 1.19], P= 0.31; I2 = 56%), or the incidence of adverse events (RR= 1.15 [0.99, 1.33], P= 0.06; I2 = 20%). Subgroup analyses showed that overall mortality among patients with severe COVID-19 was reduced in the high-dose IVIg subgroup (RR= 0.33 [0.13, 0.86], P= 0.02, I2 = 68%; very low certainty).ConclusionsResults of this study suggest that severe hospitalized COVID-19 patients treated with high-dose IVIg would have a lower risk of death than patients with routine care.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021231040, identifier CRD42021231040. |
| first_indexed | 2024-04-10T20:55:53Z |
| format | Article |
| id | doaj.art-aa3798f2fd6443f0a1679b05d6c9a25c |
| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-04-10T20:55:53Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj.art-aa3798f2fd6443f0a1679b05d6c9a25c2023-01-23T06:20:53ZengFrontiers Media S.A.Frontiers in Immunology1664-32242023-01-011410.3389/fimmu.2023.11167381116738Benefits of high-dose intravenous immunoglobulin on mortality in patients with severe COVID-19: An updated systematic review and meta-analysisXiaosheng Liu0Xiaosheng Liu1Xiaosheng Liu2Yuelun Zhang3Lianfeng Lu4Xiaodi Li5Yuanni Wu6Yang Yang7Taisheng Li8Taisheng Li9Taisheng Li10Wei Cao11Wei Cao12Tsinghua-Peking Center for Life Sciences, Beijing, ChinaDepartment of Basic Medical Sciences, School of Medicine, Tsinghua University, Beijing, ChinaDepartment of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaMedical research center, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaTsinghua-Peking Center for Life Sciences, Beijing, ChinaDepartment of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaState Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, ChinaDepartment of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaState Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, ChinaBackgroundThe clinical benefits of high-dose intravenous immunoglobulin (IVIg) in treating COVID-19 remained controversial.MethodsWe systematically searched databases up to February 17, 2022, for studies examining the efficacy of IVIg compared to routine care. Meta-analyses were conducted using the random-effects model. Subgroup analysis, meta-regression, and trial series analysis w ere performed to explore heterogeneity and statistical significance.ResultsA total of 4,711 hospitalized COVID-19 patients (1,925 IVIg treated and 2786 control) were collected from 17 studies, including five randomized controlled trials (RCTs) and 12 cohort studies. The application of IVIg was not associated with all-cause mortality (RR= 0.89 [0.63, 1.26], P= 0.53; I2 = 75%), the length of hospital stays (MD= 0.29 [-3.40, 6.44] days, P= 0.88; I2 = 96%), the needs for mechanical ventilation (RR= 0.93 ([0.73, 1.19], P= 0.31; I2 = 56%), or the incidence of adverse events (RR= 1.15 [0.99, 1.33], P= 0.06; I2 = 20%). Subgroup analyses showed that overall mortality among patients with severe COVID-19 was reduced in the high-dose IVIg subgroup (RR= 0.33 [0.13, 0.86], P= 0.02, I2 = 68%; very low certainty).ConclusionsResults of this study suggest that severe hospitalized COVID-19 patients treated with high-dose IVIg would have a lower risk of death than patients with routine care.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021231040, identifier CRD42021231040. https://www.frontiersin.org/articles/10.3389/fimmu.2023.1116738/fullCOVID-19IVIgsystemic reviewmeta-analysismeta-regression |
| spellingShingle | Xiaosheng Liu Xiaosheng Liu Xiaosheng Liu Yuelun Zhang Lianfeng Lu Xiaodi Li Yuanni Wu Yang Yang Taisheng Li Taisheng Li Taisheng Li Wei Cao Wei Cao Benefits of high-dose intravenous immunoglobulin on mortality in patients with severe COVID-19: An updated systematic review and meta-analysis Frontiers in Immunology COVID-19 IVIg systemic review meta-analysis meta-regression |
| title | Benefits of high-dose intravenous immunoglobulin on mortality in patients with severe COVID-19: An updated systematic review and meta-analysis |
| title_full | Benefits of high-dose intravenous immunoglobulin on mortality in patients with severe COVID-19: An updated systematic review and meta-analysis |
| title_fullStr | Benefits of high-dose intravenous immunoglobulin on mortality in patients with severe COVID-19: An updated systematic review and meta-analysis |
| title_full_unstemmed | Benefits of high-dose intravenous immunoglobulin on mortality in patients with severe COVID-19: An updated systematic review and meta-analysis |
| title_short | Benefits of high-dose intravenous immunoglobulin on mortality in patients with severe COVID-19: An updated systematic review and meta-analysis |
| title_sort | benefits of high dose intravenous immunoglobulin on mortality in patients with severe covid 19 an updated systematic review and meta analysis |
| topic | COVID-19 IVIg systemic review meta-analysis meta-regression |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2023.1116738/full |
| work_keys_str_mv | AT xiaoshengliu benefitsofhighdoseintravenousimmunoglobulinonmortalityinpatientswithseverecovid19anupdatedsystematicreviewandmetaanalysis AT xiaoshengliu benefitsofhighdoseintravenousimmunoglobulinonmortalityinpatientswithseverecovid19anupdatedsystematicreviewandmetaanalysis AT xiaoshengliu benefitsofhighdoseintravenousimmunoglobulinonmortalityinpatientswithseverecovid19anupdatedsystematicreviewandmetaanalysis AT yuelunzhang benefitsofhighdoseintravenousimmunoglobulinonmortalityinpatientswithseverecovid19anupdatedsystematicreviewandmetaanalysis AT lianfenglu benefitsofhighdoseintravenousimmunoglobulinonmortalityinpatientswithseverecovid19anupdatedsystematicreviewandmetaanalysis AT xiaodili benefitsofhighdoseintravenousimmunoglobulinonmortalityinpatientswithseverecovid19anupdatedsystematicreviewandmetaanalysis AT yuanniwu benefitsofhighdoseintravenousimmunoglobulinonmortalityinpatientswithseverecovid19anupdatedsystematicreviewandmetaanalysis AT yangyang benefitsofhighdoseintravenousimmunoglobulinonmortalityinpatientswithseverecovid19anupdatedsystematicreviewandmetaanalysis AT taishengli benefitsofhighdoseintravenousimmunoglobulinonmortalityinpatientswithseverecovid19anupdatedsystematicreviewandmetaanalysis AT taishengli benefitsofhighdoseintravenousimmunoglobulinonmortalityinpatientswithseverecovid19anupdatedsystematicreviewandmetaanalysis AT taishengli benefitsofhighdoseintravenousimmunoglobulinonmortalityinpatientswithseverecovid19anupdatedsystematicreviewandmetaanalysis AT weicao benefitsofhighdoseintravenousimmunoglobulinonmortalityinpatientswithseverecovid19anupdatedsystematicreviewandmetaanalysis AT weicao benefitsofhighdoseintravenousimmunoglobulinonmortalityinpatientswithseverecovid19anupdatedsystematicreviewandmetaanalysis |