Table 1.
Summary of studies related to IVIg treatment in COVID-19 patients presenting neurological conditions.
| References | Neurological disease | IVIg-treated | IVIg regimen | Key findings | Associated immunosuppressantsa, b |
|---|---|---|---|---|---|
| Sriwastava et al. (2021) | COVID-19-related Guillain-Barré syndrome. | 44 patients. All patients of the study were 50: 33 in the AIDP group (mean age 62 ± 9.9 years), 17 in the non-AIDP group (mean age 52 ± 16.3). | 0.4 g/kg/day for 14 AIDP and 8 non-AIDP patients. 2 g/kg for 6 AIDP and 2 non-AIDP patients. All over 5 days. | Either full or partial recovery in almost all patients. No data about side effects. |
Four patients also received plasma exchange for GBS treatment; 1 also received tocilizumab for COVID-19 treatment. |
| Filosto et al. (2021) | COVID-19-related Guillain-Barré syndrome. | 25 patients (mean age of IVIg + non IVIg- treated of 59.2 ± 12.1 years). | Mostly 0.4 g/kg/day for 5 days. | Improvement in at least the 80% of cases. No data about side effects. |
No data about concomitant immunosuppressant treatments. |
| Abu-Rumeileh et al. (2021) | COVID-19-related Guillan-Barré syndrome spectrum. | 60 patients (mean age of IVIg + non IVIg-treated of 55 ± 17 years). | Mostly 0.4 g/kg/day for 5 days. | Variable improvement of at least some symptoms in almost all patients. No data about side effects. |
4 patients also received plasma exchange for GBS treatment; 6 also received corticosteroids for COVID-19 treatment; 2 received also tocilizumab for COVID-19 treatment. |
| Elzouki et al. (2021) | COVID-19-related Guillan-Barré syndrome spectrum. | 85 patients treated only with IVIg. | Almost all patients treated with 0.4 g/kg/day for 5 days. | 64 patients had a favorable outcome, 17 poor, 4 died. No data about side effects. |
6 patients also received plasma exchange and 2 methylprednisolone for GBS treatments. |
| Garcia et al. (2021) | COVID-19-related Guillain-Barré syndrome during pregnancy. | A 22-year-old pregnant woman. | 0.4 g/kg/day for 5 days. | Complete recovery within 1 month after IVIg cycle. No adverse events. Vaginal birth at term. | No plasma exchange neither immunosuppressant treatments other than IVIg. |
| Assini et al. (2020) | COVID-19-related Guillain-Barré syndrome spectrum. | Two men aged 55 and 60 years. | 0.4 g/kg/day for 5 days. | Marked improvement. No adverse events. |
No plasma exchange neither immunosuppressant treatments other than IVIg. |
| Khaja et al. (2020) | Bilateral facial palsy in COVID-19-related Guillain-Barré syndrome. | A 44-year-old man. | 0.4 g/kg/day for 5 days. | Nearly complete recovery. No adverse events. |
No plasma exchange neither immunosuppressant treatments other than IVIg. |
| Gutiérrez-Ortiz et al. (2020) | COVID-19-related Miller Fisher syndrome. | A 50-year-old man. | 0.4 g/kg/day for 5 days. | Almost complete recovery. No adverse events. |
No plasma exchange neither immunosuppressant treatments other than IVIg. |
| Reyes-Bueno et al. (2020) | COVID-19-related Miller Fisher syndrome. | A 51-year-old woman. | 0.4 g/kg/day for 5 days. | Progressive improvement. No adverse events. |
No plasma exchange neither immunosuppressant treatments other than IVIg. |
| Dinkin et al. (2020) | COVID-19-related Miller-Fisher syndrome. | A 36-year-old man. | 2g/kg over three days | Partial recovery. No adverse events. |
No plasma exchange neither immunosuppressant treatments other than IVIg. |
| Yousuf et al. (2021) | COVID-19-related autoimmune encephalitis. | A 60-year-old man. | 0.4 g/kg/day for 5 days. | Almost complete recovery. No adverse events. |
No data about concomitant immunosuppressant treatments. |
| Chenna et al. (2021) | COVID-19-related encephalitis. | A 58-year-old man. | 0.4 g/kg/day for 5 days. | Complete recovery. No adverse events. |
Methylprednisolone for COVID-19 treatment. |
| McAlpine et al. (2021) | COVID-19-related autoimmune encephalitis. | A 30-year-old man. | 2 g/kg of IVIg over 3 days | Complete recovery. No adverse events. |
No plasma exchange neither immunosuppressant treatments other than IVIg. |
| Burr et al. (2021) | COVID-19-related autoimmune encephalitis. | A 23-month-old female. | 2g/kg (over a non-specified number of days). | Complete recovery. No adverse events. |
Intravenous methylprednisolone 30 mg/kg/day for five days (ineffective). |
| Gaughan et al. (2021) | COVID-19-associated encephalitis. | A 16-year-old female. | 0.4 g/kg/day for 5 days for one cycle. A second cycle was started and promptly discontinued, due to an adverse reaction. | Nearly complete recovery after 6 months. No adverse events in the first cycle. A widespread rash in the second cycle. |
Intravenous methylprednisolone 1 g/day for 3 days after the first IVIg cycle. |
| Fukushima et al. (2021) | Post-infectious COVID-related encephalitis. | A 20-year-old man. | 0.4 g/kg/day for 5 days. | Complete recovery within 2 months. Remission of MRI lesions. No major side effects. |
No plasma exchange neither immunosuppressant treatments other than IVIg. |
| Delamarre et al. (2020) | COVID-19–associated acute necrotising encephalopathy. | A 51-year-old male. | Total dose of 2 g/kg over 5 days. | Significant improvement of MRI lesions after 35 days and complete motor recovery. No adverse events. |
Intravenous methylprednisolone 1 g/day for 3 days concomitantly with IVIg. |
| El-Zein et al. (2020) | COVID-19-associated meningoencephalitis. | A 40-year-old male. | 0.4 g/kg/day for 5 days. | Complete recovery 2 months after the discharge. No adverse events. |
No plasma exchange neither immunosuppressant treatments other than IVIg. |
| Muccioli et al. (2021) | COVID-19-related encephalopathy. | Five patients (including two females) with a mean age of 66.8 years. | 0.4 g/kg/day for a minimum of 3 and a maximum of 5 days. | Almost complete clinical and radiological recovery soon after the therapy. No adverse events. |
2 patients also received tocilizumab and low-dose corticosteroids and 1 also received tocilizumab alone for COVID-19 treatment; 1 also received methylprednisolone 1 g/day for 5 days for encephalopathy treatment. |
| Abdel-Mannan et al. (2020) | COVID-19-related encephalopathy. | A 15-year-old female. | One dose of 1 g/kg. | Resolution. Discharge after 18 days. No adverse events. |
No plasma exchange neither immunosuppressant treatments other than IVIg in this selected case. |
| Delorme et al. (2020) | COVID-19-related encephalopathy. | A 72-year-old man. | 2 g/kg over a non-specified number of days. | Gradual recovery. No adverse events. |
No plasma exchange neither immunosuppressant treatments other than IVIg in this selected case. |
| Manganotti et al. (2021b) | New-onset refractory status epilepticus (NORSE) in COVID-19. | Two males aged 37 and 71 years. | 0.4 g/kg/day for 5 days for one in the first case and two cycles in the second. | Partial decrease of antiepileptic drugs without severe residual cognitive impairment. No adverse events. |
No plasma exchange neither immunosuppressant treatments other than IVIg. |
| Leelamani and Mohammed Rajab (2021) | COVID-19-related NORSE. | A young adult female. | 0.4 g/kg/day for 5 days. | No focal neurological deficits after 15 days. No adverse events. |
No plasma exchange neither immunosuppressant treatments other than IVIg. |
| Stoian et al. (2021) | COVID-19-related critical illness polyneuropathy. | A 54-year-old woman. | 0.4 g/kg/day for 5 days. | Marked improvement. No side effects. |
No plasma exchange neither immunosuppressant treatments other than IVIg in this selected case. |
| Novak (2020) | Post-COVID-19 orthostatic hypoperfusion syndrome (OCHOS) and small fiber neuropathy (SFN). | A 64-year-old female. | 2 g/kg/month for 2 months, decreased to 1 g/kg/month. | Marked improvement of all symptoms. IVIG-induced headaches. | No plasma exchange neither immunosuppressant treatments other than IVIg. |
| Saleh et al. (2021) | COVID-19-related polyneuropathy. | A 56-year-old female. | 0.4 g/kg/day for 5 days. Another dose of 90 g after 4 weeks. | IVIg-induced headaches after the first cycle. None after the second. |
No plasma exchange neither immunosuppressant treatments other than IVIg. |
| Manganotti et al. (2021a) | Guillain-Barré spectrum polyradiculoneuritis and cranial polyneuritis. | Four males aged 72, 72, 76, and 94 years and a 49-year-old female. | 0.4 g/kg/day for 5 days. | Partial resolution of symptoms. No adverse events. |
No plasma exchange neither immunosuppressant treatments other than IVIg in these selected cases. |
| Delly et al. (2020) | Myasthenic crisis in concomitant COVID-19 syndrome. | A 56-year-old female. | A first cycle of 0.4 g/kg/day for 5 days. A second cycle of 650 mg/kg for 2 days in a row. | Greatly improved ventilatory function and motility. Not reported side effects. |
No plasma exchange neither immunosuppressant treatments other than IVIg. |
| Huber et al. (2020) | COVID-19-related onset of ocular myasthenia gravis. | A 21-year-old woman | 0.4 g/kg/day for 5 days. | Regression of ocular deficits. No adverse events. |
No plasma exchange neither immunosuppressant treatments other than IVIg. |
| Parsons et al. (2020) | COVID-19-associated acute disseminated encephalomyelitis. | A 51-year-old female. | 0.4 g/kg/day for 5 days. | Improvement of the alertness. Not reported side effects. |
Intravenous methylprednisolone 1 g/day for 5 days (ineffective) prior to IVIg. |
| Gupta et al. (2021) | COVID-19-related myositis. | A 49-year-old female. | 0.4 g/kg/day for 5 days. | Complete recovery in a few weeks. No side effects. |
No plasma exchange neither immunosuppressant treatments other than IVIg. |
| Ishaq et al. (2021) | COVID-19 related opsoclonus myoclonus syndrome. | A 63-year-old male. | 2 g/kg in 5 divided doses. | Gradual complete recovery. No adverse events. |
Intravenous methylprednisolone 1 g/day for 5 days (ineffective) prior to IVIg. |
aHydroxychloroquine (for COVID-19 treatment) has not been included. bUnless otherwise specified, corticosteroids were given prior to IVIg in order to treat COVID-19 (low dosage) or the COVID-19-related neurological condition (high dosage).