PDF(Pubmed)
Abstract：
The clinical benefits of high-dose intravenous immunoglobulin (IVIg) in treating COVID-19 remained controversial.
We systematically searched databases up to February 17, 2022, for studies examining the efficacy of IVIg compared to routine care. Meta-analyses were conducted using the random-effects model. Subgroup analysis, meta-regression, and trial series analysis w ere performed to explore heterogeneity and statistical significance.
A total of 4,711 hospitalized COVID-19 patients (1,925 IVIg treated and 2786 control) were collected from 17 studies, including five randomized controlled trials (RCTs) and 12 cohort studies. The application of IVIg was not associated with all-cause mortality (RR= 0.89 [0.63, 1.26], P= 0.53; I2 = 75%), the length of hospital stays (MD= 0.29 [-3.40, 6.44] days, P= 0.88; I2 = 96%), the needs for mechanical ventilation (RR= 0.93 ([0.73, 1.19], P= 0.31; I2 = 56%), or the incidence of adverse events (RR= 1.15 [0.99, 1.33], P= 0.06; I2 = 20%). Subgroup analyses showed that overall mortality among patients with severe COVID-19 was reduced in the high-dose IVIg subgroup (RR= 0.33 [0.13, 0.86], P= 0.02, I2 = 68%; very low certainty).
Results of this study suggest that severe hospitalized COVID-19 patients treated with high-dose IVIg would have a lower risk of death than patients with routine care.
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021231040, identifier CRD42021231040.
We systematically searched databases up to February 17, 2022, for studies examining the efficacy of IVIg compared to routine care. Meta-analyses were conducted using the random-effects model. Subgroup analysis, meta-regression, and trial series analysis w ere performed to explore heterogeneity and statistical significance.
A total of 4,711 hospitalized COVID-19 patients (1,925 IVIg treated and 2786 control) were collected from 17 studies, including five randomized controlled trials (RCTs) and 12 cohort studies. The application of IVIg was not associated with all-cause mortality (RR= 0.89 [0.63, 1.26], P= 0.53; I2 = 75%), the length of hospital stays (MD= 0.29 [-3.40, 6.44] days, P= 0.88; I2 = 96%), the needs for mechanical ventilation (RR= 0.93 ([0.73, 1.19], P= 0.31; I2 = 56%), or the incidence of adverse events (RR= 1.15 [0.99, 1.33], P= 0.06; I2 = 20%). Subgroup analyses showed that overall mortality among patients with severe COVID-19 was reduced in the high-dose IVIg subgroup (RR= 0.33 [0.13, 0.86], P= 0.02, I2 = 68%; very low certainty).
Results of this study suggest that severe hospitalized COVID-19 patients treated with high-dose IVIg would have a lower risk of death than patients with routine care.
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021231040, identifier CRD42021231040.
摘要：
未经证实：大剂量静脉注射免疫球蛋白（IVIg）治疗COVID-19的临床益处仍存在争议。
UNASSIGNED：我们系统地搜索了截至2022年2月17日的数据库，以研究IVIg与常规治疗相比的疗效。采用随机效应模型进行Meta分析。亚组分析,元回归，并进行试验系列分析，探讨异质性和统计学意义。
未经评估：共收集了17项研究中的4,711例住院COVID-19患者（1,925例接受IVIg治疗，2786例对照），包括5项随机对照试验（RCTs）和12项队列研究。IVIg的应用与全因死亡率无关（RR=0.89[0.63,1.26]，P=0.53；I2=75%），住院时间（MD=0.29[-3.40，6.44]天，P=0.88；I2=96%），机械通气的需求(RR=0.93([0.73，1.19]，P=0.31；I2=56%），或不良事件的发生率(RR=1.15[0.99，1.33]，P=0.06；I2=20%）。亚组分析显示，高剂量IVIg亚组严重COVID-19患者的总死亡率降低(RR=0.33[0.13,0.86]，P=0.02，I2=68%；非常低的确定性）。
UNASSIGNED：这项研究的结果表明，接受大剂量IVIg治疗的严重住院COVID-19患者的死亡风险比接受常规治疗的患者低。
UNASSIGNED：https://www。crd.约克。AC.uk/prospro/display_record.php?ID=CRD42021231040，标识符CRD42021231040。
UNASSIGNED：我们系统地搜索了截至2022年2月17日的数据库，以研究IVIg与常规治疗相比的疗效。采用随机效应模型进行Meta分析。亚组分析,元回归，并进行试验系列分析，探讨异质性和统计学意义。
未经评估：共收集了17项研究中的4,711例住院COVID-19患者（1,925例接受IVIg治疗，2786例对照），包括5项随机对照试验（RCTs）和12项队列研究。IVIg的应用与全因死亡率无关（RR=0.89[0.63,1.26]，P=0.53；I2=75%），住院时间（MD=0.29[-3.40，6.44]天，P=0.88；I2=96%），机械通气的需求(RR=0.93([0.73，1.19]，P=0.31；I2=56%），或不良事件的发生率(RR=1.15[0.99，1.33]，P=0.06；I2=20%）。亚组分析显示，高剂量IVIg亚组严重COVID-19患者的总死亡率降低(RR=0.33[0.13,0.86]，P=0.02，I2=68%；非常低的确定性）。
UNASSIGNED：这项研究的结果表明，接受大剂量IVIg治疗的严重住院COVID-19患者的死亡风险比接受常规治疗的患者低。
UNASSIGNED：https://www。crd.约克。AC.uk/prospro/display_record.php?ID=CRD42021231040，标识符CRD42021231040。
