AUTHOR=Chen Yan , Xie Jianfeng , Wu Wenjuan , Li Shusheng , Hu Yu , Hu Ming , Li Jinxiu , Yang Yi , Huang Tingrong , Zheng Kun , Wang Yishan , Kang Hanyujie , Huang Yingzi , Jiang Li , Zhang Wei , Zhong Ming , Sang Ling , Zheng Xia , Pan Chun , Zheng Ruiqiang , Li Xuyan , Tong Zhaohui , Qiu Haibo , Weng Li , Du Bin 

TITLE=Intravenous Immunoglobulin Therapy for Critically Ill COVID-19 Patients With Different Inflammatory Phenotypes: A Multicenter, Retrospective Study

JOURNAL=Frontiers in Immunology

VOLUME=Volume 12 - 2021

YEAR=2022

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2021.738532

DOI=10.3389/fimmu.2021.738532

ISSN=1664-3224

ABSTRACT=Background: Benefits of intravenous immunoglobulin administration are controversial for critically ill COIVD-19 patients. 
Methods: We analyzed retrospectively the effects of immunoglobulin administration for critically ill COVID-19 patients. The primary outcome was 28-day mortality. Inverse probability of treatment weighting (IPTW) with propensity score was used to account for baseline confounders. Cluster analysis was used to perform phenotype analysis.
Results: Between January 1 and February 29, 2020, 754 patients with complete data from 19 hospitals were enrolled. Death at 28 days occurred for 408 (54.1%) patients. There were 392 (52.0%) patients who received intravenous immunoglobulin, at 11(IQR 8, 16) days after illness onset; thirty percent of these patients received intravenous immunoglobulin prior to ICU admission. By unadjusted analysis, no difference was observed for 28-day mortality between the immunoglobulin and non-immunoglobulin groups. Similar results were found by propensity score matching (n=506) and by IPTW analysis (n=731). Also, IPTW analysis did not reveal any significant difference between hyperinflammation and hypo-inflammation phenotypes.
Conclusion: No significant association was observed for use of intravenous immunoglobulin and decreased mortality of severe COVID- 19 patients. Phenotype analysis did not show any survival benefit for patients who received immunoglobulin therapy.