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Intravenous immunoglobulin therapy for COVID-19 in immunocompromised patients: A retrospective cohort study
Umeå University, Faculty of Medicine, Department of Clinical Microbiology.ORCID iD: 0000-0001-5384-8038
Umeå University, Faculty of Medicine, Department of Clinical Microbiology.
Umeå University, Faculty of Medicine, Department of Clinical Microbiology.ORCID iD: 0000-0003-2018-8592
Umeå University, Faculty of Medicine, Department of Clinical Microbiology.ORCID iD: 0000-0001-6904-742x
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2024 (English)In: International Journal of Infectious Diseases, ISSN 1201-9712, E-ISSN 1878-3511, Vol. 144, article id 107046Article in journal (Refereed) Published
Abstract [en]

Objectives: To investigate the effectiveness of intravenous immunoglobulin (IVIG) as treatment for COVID-19 in immunocompromised patients.

Methods: This retrospective study investigated outcomes for immunocompromised, vaccine non-responsive, patients that between September 2022 and April 2023 received IVIG as treatment for COVID-19 in the region of Västerbotten, Sweden. We analyzed clinical data, viral load, and anti-SARS-CoV-2 IgG binding and neutralization levels of patient serum samples and IVIG production batches. Primary and secondary outcomes were clinical cure and viral clearance, respectively.

Results: Sixteen patients were analyzed. After a median COVID-19 duration of 4 weeks, a median 60 g IVIG infusion increased SARS-CoV-2 binding and neutralizing antibody levels, with broad in vitro activity against tested variants. The treatment resulted in abrogation of viremia in all patients and general improvement in 15 survivors that all met the primary endpoint. Thirteen patients met the secondary endpoint at follow-up after a median of four months. Two subjects with persistent SARS-CoV-2 carriage relapsed but were successfully retreated with IVIG.

Conclusions: Antibodies in IVIG efficiently neutralized several SARS-CoV-2 variants. Treatment with IVIG was associated with clinical cure and viral clearance in immunocompromised patients. Our data suggests that IVIG could be a novel treatment alternative for COVID-19 for this patient category.

Place, publisher, year, edition, pages
Elsevier, 2024. Vol. 144, article id 107046
Keywords [en]
COVID-19, Humoral immunity, Immunocompromised, Intravenous immunoglobulin, SARS-CoV-2
National Category
Infectious Medicine
Identifiers
URN: urn:nbn:se:umu:diva-225264DOI: 10.1016/j.ijid.2024.107046PubMedID: 38615825Scopus ID: 2-s2.0-85192717007OAI: oai:DiVA.org:umu-225264DiVA, id: diva2:1867108
Funder
Umeå UniversityKnut and Alice Wallenberg Foundation, VC-2022-0028Knut and Alice Wallenberg Foundation, VC-2020-0015Knut and Alice Wallenberg Foundation, DNR 2023-01154-01Swedish Research Council, 2020-06235Region Västerbotten, RV-938855Region Västerbotten, RV-939393Swedish Heart Lung Foundation, 20220325Available from: 2024-06-10 Created: 2024-06-10 Last updated: 2024-06-10Bibliographically approved

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Gröning, RemigiusWalde, JonatanAhlm, ClasForsell, Mattias N. E.Normark, JohanRasmuson, Johan

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