Abstract：
OBJECTIVE: 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.
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.
摘要：
目的：探讨静脉注射免疫球蛋白（IVIG）治疗COVID-19的疗效。
方法：这项回顾性研究调查了免疫受损，疫苗无反应，2022年9月至2023年4月期间接受IVIG作为Västerbotten地区COVID-19治疗的患者，瑞典。我们分析了临床数据,病毒载量,患者血清样品和IVIG生产批次的抗SARS-CoV-2IgG结合和中和水平。主要和次要结果是临床治愈和病毒清除，分别。
结果：分析16例患者。在COVID-19的中位持续时间为四周后，中位60gIVIG输注增加SARS-CoV-2结合和中和抗体水平，具有针对测试变体的广泛体外活性。治疗导致所有患者的病毒血症消失，15名幸存者均达到主要终点。13例患者在中位随访4个月后达到次要终点。两名患有持续性SARS-CoV-2携带的受试者复发，但用IVIG成功治疗。
结论:IVIG中的抗体有效地中和了几种SARS-CoV-2变体。IVIG治疗与免疫功能低下患者的临床治愈和病毒清除有关。我们的数据表明，对于这类患者，IVIG可能是COVID-19的一种新的治疗方法。
方法：这项回顾性研究调查了免疫受损，疫苗无反应，2022年9月至2023年4月期间接受IVIG作为Västerbotten地区COVID-19治疗的患者，瑞典。我们分析了临床数据,病毒载量,患者血清样品和IVIG生产批次的抗SARS-CoV-2IgG结合和中和水平。主要和次要结果是临床治愈和病毒清除，分别。
结果：分析16例患者。在COVID-19的中位持续时间为四周后，中位60gIVIG输注增加SARS-CoV-2结合和中和抗体水平，具有针对测试变体的广泛体外活性。治疗导致所有患者的病毒血症消失，15名幸存者均达到主要终点。13例患者在中位随访4个月后达到次要终点。两名患有持续性SARS-CoV-2携带的受试者复发，但用IVIG成功治疗。
结论:IVIG中的抗体有效地中和了几种SARS-CoV-2变体。IVIG治疗与免疫功能低下患者的临床治愈和病毒清除有关。我们的数据表明，对于这类患者，IVIG可能是COVID-19的一种新的治疗方法。
