PDF(Pubmed)
Abstract：
UNASSIGNED: We performed a meta-analysis of randomized controlled trials (RCTs) to summarize the overall effect of intravenous immunoglobulin (IVIG) on mortality outcomes among hospitalized coronavirus disease 2019 (COVID-19) patients.
UNASSIGNED: We systematically searched electronic databases up to June 1, 2023. Pooled odds ratio (OR) of mortality with a 95% confidence interval (CI) was generated using a random-effects model. The risk of bias was appraised using the Cochrane risk-of-bias Version 2 tool for randomized trials.
UNASSIGNED: Nine RCTs were included: three RCTs had an overall low risk of bias, four RCTs had some concerns in the overall risk of bias, and two RCTs trials had an overall high risk of bias. The use of IVIG indicated a significant reduction in the odds of mortality (pooled OR = 0.69; 95% CI 0.50-0.96) relative to nonuse of IVIG. Subgroup analysis in patients with a severe course of COVID-19 revealed no significant reduction in the odds of mortality (pooled OR = 0.58; 95% CI 0.29-1.16).
UNASSIGNED: We suggest exercising caution when interpreting effectiveness of IVIG in reducing mortality among hospitalized patients with COVID-19. Our findings emphasize for larger trials with rigorous study designs to better understand the impact of IVIG, particularly in those with severe COVID-19.
UNASSIGNED: We systematically searched electronic databases up to June 1, 2023. Pooled odds ratio (OR) of mortality with a 95% confidence interval (CI) was generated using a random-effects model. The risk of bias was appraised using the Cochrane risk-of-bias Version 2 tool for randomized trials.
UNASSIGNED: Nine RCTs were included: three RCTs had an overall low risk of bias, four RCTs had some concerns in the overall risk of bias, and two RCTs trials had an overall high risk of bias. The use of IVIG indicated a significant reduction in the odds of mortality (pooled OR = 0.69; 95% CI 0.50-0.96) relative to nonuse of IVIG. Subgroup analysis in patients with a severe course of COVID-19 revealed no significant reduction in the odds of mortality (pooled OR = 0.58; 95% CI 0.29-1.16).
UNASSIGNED: We suggest exercising caution when interpreting effectiveness of IVIG in reducing mortality among hospitalized patients with COVID-19. Our findings emphasize for larger trials with rigorous study designs to better understand the impact of IVIG, particularly in those with severe COVID-19.
摘要：
■我们对随机对照试验（RCT）进行了荟萃分析，以总结静脉注射免疫球蛋白（IVIG）对住院冠状病毒病（COVID-19）患者死亡率结局的总体影响。
■我们系统地搜索了截至2023年6月1日的电子数据库。使用随机效应模型生成具有95%置信区间(CI)的总死亡率比值比(OR)。偏倚风险使用Cochrane偏倚风险第2版工具进行随机试验评估。
■纳入9项随机对照试验：3项随机对照试验总体偏倚风险较低，四个RCT对总体偏见风险有一些担忧，两项RCT试验总体偏倚风险较高.与不使用IVIG相比，使用IVIG表明死亡率的几率显着降低（合并OR=0.69；95％CI0.50-0.96）。在COVID-19病程严重的患者中进行的亚组分析显示，死亡率的几率没有显着降低(汇总OR=0.58；95%CI0.29-1.16)。
我们建议在解释IVIG降低COVID-19住院患者死亡率的有效性时谨慎行事。我们的研究结果强调了更大的试验与严格的研究设计，以更好地理解IVIG的影响，特别是那些患有严重COVID-19的人。
■我们系统地搜索了截至2023年6月1日的电子数据库。使用随机效应模型生成具有95%置信区间(CI)的总死亡率比值比(OR)。偏倚风险使用Cochrane偏倚风险第2版工具进行随机试验评估。
■纳入9项随机对照试验：3项随机对照试验总体偏倚风险较低，四个RCT对总体偏见风险有一些担忧，两项RCT试验总体偏倚风险较高.与不使用IVIG相比，使用IVIG表明死亡率的几率显着降低（合并OR=0.69；95％CI0.50-0.96）。在COVID-19病程严重的患者中进行的亚组分析显示，死亡率的几率没有显着降低(汇总OR=0.58；95%CI0.29-1.16)。
我们建议在解释IVIG降低COVID-19住院患者死亡率的有效性时谨慎行事。我们的研究结果强调了更大的试验与严格的研究设计，以更好地理解IVIG的影响，特别是那些患有严重COVID-19的人。
