Intravenous Immunoglobulins Decrease the Incidence of Bacterial Secondary Infections in Patients With Severe COVID-19
By Nancy Melville
BRUSSELS -- September 7, 2021 -- The addition of intravenous (IV) immunoglobulin therapy to antibiotics significantly prevented secondary infections and mortality among patients with severe coronavirus disease 2019 (COVID-19) who required mechanical ventilation, according to research presented at the 40th International Symposium on Intensive Care and Emergency Medicine.
Malik Benlabed, MD, Lille University, Lille, France, and colleagues randomised 40 patients (median age, 65 years) who had been admitted to an intensive care unit (ICU) with severe COVID-19 between January 2021 and May 2021 to receive empirical broad spectrum antibiotics (imipenem and amikacin), with or without IV immunoglobulin. The IV immunoglobulin regimen was administered after the first dose of antibiotics, with a dose of 0.5 g/kg at a flow of 3 ml/kg/h during the first 3 days of ICU admission.
Patients randomised to receive IV immunoglobulin therapy had a significantly lower incidence of superinfections compared with the control group at day 14 (14% vs 27%; PPPP
Mean Sequential Organ Failure Assessment score on day 7 increased significantly more in the control group (7.33 ± 0.72) than the IV immunoglobulin group (4.45 ± 0.50; P
Greater improvements in Pao2/Fio2 at day 7 were also observed in the IV immunoglobulin group compared with the control group (310.8 ± 7 vs 132.4 ± 4.5; P
Length of ICU stay was 18.7 days in the IV immunoglobulin group compared with 30.6 days in the control group (PP
The 28-day mortality rate was significantly lower in the IV immunoglobulin group (50% vs 75%; P
“We can conclude that the early initiation of high doses of IV immunoglobulin with empirical antibiotics decrease the incidence of superinfections and are associated with better outcome in patients with severe COVID-19,” said Dr. Benlabed.
[Presentation title: Intravenous Immunoglobulins Decrease the Incidence of Bacterial Secondary Infections in Severe COVID-19 Patients. Abstract A277]