Table 1.
Characteristics of the studies included.
| First Author, Year [Ref.] |
Type of Study | Disease Severity | Population Size (Intervention/Control) |
Single IVIG Dose per Day (Intervention/Control) |
Duration (Days) | Cumulative Dose | Control | Safety | Main Results |
|---|---|---|---|---|---|---|---|---|---|
| Cao, 2021 [23] |
RCS | Severe COVID-19 | 26/89 | 0.4–1 g/kg | 2–5 days | 2 g/kg | ST | No AEs | High-dose IVIG reduced 28-day mortality (HR 0.24, 95% CI 0.06–0.99; p < 0.001). Early treatment (within 7 days of onset) was associated with greater benefit |
| Esen, 2021 [24] |
RCS | Severe COVID-19 | 51/42 | 0.4 g/kg * | 5 days | 2 g/kg | ST | NR | IVIG significantly prolonged median survival time (68 versus 18 days, p = 0.014) |
| Gharebaghi, 2020 [25] | RCT | Severe COVID-19 | 30/29 | 0.3 g/kg * | 3 days | 0.9 g/kg | placebo | NR | IVIG significantly reduced mortality rate (aOR 0.003, 95% CI 0.001–0.815; p = 0.042) |
| Hou, 2021 [26] |
RCS | Severe COVID-19 | 47/66 | 0.5 g/kg | NR | NR | ST | NR | IVIG did not improve in-hospital mortality rates or the need for mechanical ventilation |
| Huang, 2021 [27] |
RCS | Non-severe COVID-19 | 45/594 | 0.13 g/kg (8 patients) * | 3 days | 0.5 g/kg | ST | NR | No benefit was observed with IVIG in terms of mortality rate, progression to severe disease or length of hospital stay |
| 0.13 g/kg (13 patients) * | 5 days | 0.7 g/kg | |||||||
| 0.26 g/kg (16 patients) * | 3 days | 0.8 g/kg | |||||||
| 0.26 g/kg (8 patients) * | 5 days | 1.3 g/kg | |||||||
| Liu, 2021 [28] |
RCS | Severe COVID-19 | 421/429 | 0.13 g/day | 9.5 days | 1.3 g/kg | ST | NR | IVIG was not associated with significant changes in 28-day mortality in severe COVID-19 patients |
| Raman, 2021 [29] |
RCT | Non-severe COVID-19 | 50/50 | 0.4 g/kg | 5 days | 2 g/kg | ST | 17 (34%) mild to moderate | Duration of hospital stay was significantly lower in IVIG group (7.7 vs. 17.5 days, p = 0.0001) |
| Sakoulas, 2020 [30] |
RCT | Severe COVID-19 | 16/17 | 0.5 g/kg | 3 days | 1.5 g/kg | ST | No AEs | IVIG improved hypoxia and reduced hospital length of stay and progression to mechanical ventilation |
| Shao, 2020 [31] |
RCS | Severe or critical COVID-19 | 174/151 | 0.1 g/kg (100 patients) 0.5 g/kg (74 patients) |
5–15 days (not specified according to daily dose) | 0.5–5 g/kg (not specified according to daily dose) | ST | NR | Early administration (≤7 days after hospital admission) with high dose (>15 g/day) of IVIG significantly reduced 60-day mortality |
| Tabarsi, 2021 [32] |
RCT | Severe COVID-19 | 52/32 | 0.4 g/kg | 3 days | 1.2 g/kg | ST | NR | No benefit was observed with IVIG in terms of mortality rate and need for mechanical ventilation |
Abbreviations: AE, adverse events; aOR, adjusted odds ratio; BW, body weight; CI, confidence intervals; IVIG, intravenous immunoglobulin; HR, hazard ratio; NR, not reported; RCS, retrospective cohort study; RCT, randomized controlled trial; ST, standard therapy. * Assuming a mean recipient body weight of 75 kg.