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Summer 2023 - Vaccines

High-Dose IVIG Reduces Mortality Risk in Hospitalized Patients with Severe COVID-19: Systematic Review and Meta-Analysis

Clinical trials and observational studies compared the efficacy of IVIG to routine care for hospitalized COVID-19 patients.

A systematic search of leading databases and registries by Chinese collaborators identified a total of 17 clinical trials and observational studies, including 1,925 intravenous immune globulin (IVIG)-treated and 2,786 control patients, that compared the efficacy of IVIG to routine care for hospitalized COVID-19 patients.

Administration of IVIG was not associated with a significant reduction in all-cause mortality across all COVID-19 patients receiving any dosage of IVIG (relative risk [RR], 0.89; 95% confidence interval [CI], 0.63 to 1.26; P – 0.53). There were similarly no significant differences compared to standard care with respect to length of hospital stay (mean difference, 0.29 days; 95% CI, -3.40 to 6.44 days; P = 0.88), need for mechanical ventilation (RR, 0.93; 95% CI, 0.73 to 1.19; P = 0.31) or incidence of adverse events (RR, 1.15; 95% CI, 0.99 to 1.33; P = 0.06).

However, a subgroup analysis focusing on the mortality-related impact of variable IVIG daily dosage and disease severity found significantly reduced overall mortality in the patient subgroup with severe COVID-19 that received high-dose IVIG (RR, 0.33; 95% CI, 0.13 to 0.86; P = 0.02; very low certainty). High-dose IVIG therapy was defined as 0.3 to 0.5 grams per kilogram of body weight per day for five days.

“High-dose IVIG might reduce mortality in patients with severe COVID-19,” the authors concluded. “However, [due to the] combination of low quality of certainty due to the limited number of studies and the high risk [of] methodological heterogeneity, the results should be interpreted with great caution, and more research is needed to understand its specific effects.”


Liu, X, Zhang, Y, Lu, L, et al. Benefits of High-Dose Intravenous Immunoglobulin on Mortality in Patients with Severe COVID-19: An Updated Systematic Review and Meta-Analysis. Frontiers in Immunology, 2023 Jan 23;14:1116738.

BSTQ Staff
BioSupply Trends Quarterly [BSTQ] is the definitive source for industry trends, news and information for the biopharmaceuticals marketplace. With timely and critical information, each themed issue covers topics ranging from product breakthroughs, industry insights and innovations, up-to-the-minute news on the latest clinical trials, accessibility, and service and safety concerns.