Factors affecting mortality in COVID-19 patients treated with intravenous immunoglobulin

ilkkilic, kadir; cüre, osman; Beyazal Polat, Hatice; Aydın, Esra; Şen, Bayram; Avci, Ugur; TÜFEKÇİ, Damla

doi:10.5455/annalsmedres.2023.06.140

Factors affecting mortality in COVID-19 patients treated with intravenous immunoglobulin

Kadir ILKKILIÇ, (Recep Tayyip Erdoğan Üniversitesi, Tıp Fakültesi, Hematoloji Anabilim Dalı, Rize, Türkiye)

Osman CURE, (Recep Tayyip Erdoğan Üniversitesi, Tıp Fakültesi, Romatoloji Anabilim Dalı, Rize, Türkiye)

Hatice BEYAZAL POLAT, (Recep Tayyip Erdoğan Üniversitesi, Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Rize, Türkiye)

Esra AYDIN, (Recep Tayyip Erdoğan Üniversitesi, Tıp Fakültesi, Tıbbi Onkoloji Anabilim Dalı, Rize, Türkiye)

Bayram SEN, (Recep Tayyip Erdoğan Üniversitesi, Tıp Fakültesi, Biyokimya Anabilim Dalı, Rize, Türkiye)

Ugur AVCI, (Recep Tayyip Erdoğan Üniversitesi, Tıp Fakültesi, Endokrinoloji Anabilim Dalı, Rize, Türkiye)

Damla TÜFEKÇİ (Recep Tayyip Erdoğan Üniversitesi, Tıp Fakültesi, Endokrinoloji Anabilim Dalı, Rize, Türkiye)

Annals of Medical Research

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Yıl: 2023 Cilt: 30 Sayı: 8 Sayfa Aralığı: 929 - 933 Metin Dili: İngilizce DOI: 10.5455/annalsmedres.2023.06.140 İndeks Tarihi: 01-11-2023

Factors affecting mortality in COVID-19 patients treated with intravenous immunoglobulin

Öz:

Aim: Intravenous immunoglobulin (IVIG), used as an option in the treatment of severe Coronavirus disease 2019 (COVID-19), has been shown to have effects on the suppression of the hyperinflammatory state through immunomodulatory actions. The aim of our study was to evaluate the factors associated with mortality in patients treated with IVIG for COVID-19. Materials and Methods: Patients diagnosed with COVID-19 and receiving IVIG therapy in addition to standard care therapy were included in the study. Results: A total of 46 patients who received IVIG treatment were included in the study. The mortality rate was higher in patients aged over 52 years (p:<0.001). The mortality rate was found to be higher in patients with an interval of more than 7 days between hospitalization and the start of IVIG treatment (p:0.009). Patients with a higher Charlson Comorbidity Index (CCI) score had a more mortal course (p<0.001). Mortality rate was higher in patients with high immunoglobulin A (Ig A) levels before IVIG treatment (p:0.004). Survival rate was lower in patients with high neutrophil lymphocyte ratio (NLR), urea and prothrombin time (PT)and low albumin and lymphocyte counts. Conclusion: A high Charlson Comorbidity Index score and high immunoglobulin A level are poor prognostic in COVID 19 patients treated with IVIG. Studying mortality risk factors is valuable in predicting response to IVIG therapy and may help in early identification of patients with poor prognosis and re-evaluate of treatment strategy.

Anahtar Kelime: COVID-19 Intravenous immunoglobulin Charlson Comorbidity Index Immunoglobulin A Mortality

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Ghebreyesus WD-GTA. WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020 USA: World Health Organisation; 2020. https://www.who.int/director-general/speeches/detail/whodirector-general-s-opening-remarks-at-the-media-briefing-oncovid-19---11-march-2020.
2. Soy M, Keser G, Atagündüz P, et al. Cytokine storm in COVID19: pathogenesis and overview of anti-inflammatory agents used in treatment. Clin Rheumatol. 2020 Jul;39(7): 2085-2094. https://doi.org/10.1007/s10067-020-05190-5.
3. Shimizu M. Clinical Features of Cytokine Storm Syndrome. In: Cytokine Storm Syndrome Cron R, Behrens E (eds). Springer, Cham 2019: 31–41. https://doi.org/10.1007/978-3-030-22094- 5_3.
4. Wiersinga WJ, Rhodes A, Cheng AC, et al. Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19): A Review. JAMA. 2020 Aug 25; 324 (8):782- 793. https://doi.org/10.1001/jama.2020.12839.
5. Mehta P, McAuley DF, Brown M, et al. HLH Across Speciality Collaboration, UK. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020 Mar 28;395(10229):1033-1034. https://doi.org/10.1016/S0140- 6736(20)30628-0.
6. Kim MS, An MH, Kim WJ, Hwang TH. Comparative efficacy and safety of pharmacological interventions for the treatment of COVID-19: A systematic review and network meta-analysis. PLoS Med. 2020 Dec 30;17(12): e1003501. https://doi.org/10.1371/journal.pmed.1003501.
7. Cao W, Liu X, Bai T, et al. High-Dose Intravenous Immunoglobulin as a Therapeutic Option for Deteriorating Patients With Coronavirus Disease 2019. Open Forum Infect Dis. 2020 Mar 21;7(3): ofaa102. https://doi.org/10.1093/ofid/ofaa102.
8. Parohan M, Yaghoubi S, Seraji A, et al. Risk factors for mortality in patients with Coronavirus disease 2019 (COVID19) infection: a systematic review and meta-analysis of observational studies. Aging Male. 2020 Dec;23(5):1416-1424. https://doi.org/10.1080/13685538.2020.1774748.
9. Grasselli G, Greco M, Zanella A, et al. COVID-19 Lombardy ICU Network. Risk Factors Associated with Mortality Among Patients With COVID-19 in Intensive Care Units in Lombardy,Italy. JAMA Intern Med. 2020 Oct 1;180 (10):1345-1355. https://doi.org/10.1001/jamainternmed.2020.3539.
10. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult in patients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020 Mar 28;395(10229):1054-1062. doi: 10.1016/S0140- 6736(20)30566-3. Epub 2020 Mar 11. Erratum in: Lancet. 2020 Mar 28;395(10229):1038. https://doi.org/10.1016/S0140- 6736(20)30566-3.
11. Gharebaghi N, Nejadrahim R, Mousavi SJ, et al. The use of intravenous immunoglobulin gamma for the treatment of severe coronavirus disease 2019: a randomized placebocontrolled double-blind clinical trial. BMC Infect Dis. 2020 Oct 21;20(1):786. https://doi.org/10.1186/s12879-020-05507-4.
12. Chen Y, Xie J, Wu W, et al. Intravenous Immunoglobulin Therapy for Critically Ill COVID-19 Patients With Different Inflammatory Phenotypes: A Multicenter, Retrospective Study. Front Immunol. 2022 Jan 27; 12:738532. https://doi.org/10.3389/fimmu.2021.738532.
13. Mitra AR, Fergusson NA, Lloyd-Smith E, et al. Baseline characteristics and outcomes of patients with COVID-19 admitted to intensive care units in Vancouver, Canada: a case series. CMAJ. 2020;192: E694–E701. https://doi.org/10.1503/cmaj.200794.
14. Ñamendys-Silva SA, Gutiérrez-Villaseñor A, RomeroGonzález JP. Hospital mortality in mechanically ventilated COVID-19 patients in Mexico. Intensive Care Med. 2020. https://doi.org/10.1007/s00134-020-06256-3.
15. Richardson S, Hirsch JS, Narasimhan M, et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA. 2020 May 26;323(20):2052-2059. https://doi.org/10.1001/jama.2020.6775.
16. Xie Y, Cao S, Dong H, et al. Effect of regular intravenous immunoglobulin therapy on prognosis of severe pneumonia in patients with COVID-19. J Infect. 2020 Aug;81(2):318-356. https://doi.org/10.1016/j.jinf.2020.03.044.
17. Shao Z, Feng Y, Zhong L, et al. Clinical efficacy of intravenous immunoglobulin therapy in critical ill patients with COVID-19: a multicenter retrospective cohort study. Clin Transl Immunology. 2020 Oct 14;9(10): e1192. https://doi.org/10.1002/cti2.1192.
18. Cervia C, Nilsson J, Zurbuchen Y, et al. Systemic and mucosal antibody responses specific to SARS-CoV-2 during mild versus severe COVID-19. J Allergy Clin Immunol. 2021 Feb;147(2):545- 557.e9. https://doi.org/10.1016/j.jaci.2020.10.040.
19. Austin SR, Wong YN, Uzzo RG, et al. Why Summary Comorbidity Measures Such As the Charlson Comorbidity Index and Elixhauser Score Work. Med Care. 2015 Sep;53(9): e65-72. https://doi.org/10.1097/MLR.0b013e318297429c.
20. TutyKuswardhani RA, Henrina J, Pranata R, et al. Charlson comorbidity index and a composite of poor outcomes in COVID-19 patients: A systematic review and metaanalysis. Diabetes MetabSyndr. 2020 Nov-Dec;14(6):2103-2109. https://doi.org/10.1016/j.dsx.2020.10.022.
21. Yang AP, Liu JP, Tao WQ, Li HM. The diagnostic and predictive role of NLR, d-NLR and PLR in COVID19 patients. Int Immunopharmacol. 2020 Jul; 84:106504. https://doi.org/10.1016/j.intimp.2020.106504.
22. Henry BM, de Oliveira MHS, Benoit S, et al. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis. Clin Chem Lab Med. 2020 Jun 25;58(7):1021-1028. https://doi.org/10.1515/cclm-2020-0369.
23. Cheng A, Hu L, Wang Y, et al. Diagnostic performance of initial blood urea nitrogen combined with D-dimer levels for predicting in-hospital mortality in COVID-19 patients. Int J Antimicrob Agents. 2020 Sep;56(3):106110. https://doi.org/10.1016/j.ijantimicag.2020.106110.
24. Violi F, Cangemi R, Romiti GF, et al. Is Albumin Predictor of Mortality in COVID-19? Antioxid Redox Signal. 2021 Jul 10;35(2):139-142. https://doi.org/10.1089/ars.2020.8142.
25. Singh S, Singh K. Blood Urea Nitrogen/Albumin Ratio and Mortality Risk in Patients with COVID-19. Indian J Crit Care Med. 2022 May;26(5):626-631.https://doi.org/10.5005/jpjournals-10071-24150.
26. Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J ThrombHaemost. 2020 Apr;18(4):844-847. https://doi.org/10.1111/jth.14768.
27. Levi M, Thachil J, Iba T, Levy JH. Coagulation abnormalities and thrombosis in patients with COVID-19. Lancet Haematol. 2020 Jun;7(6): e438-e440. https://doi.org/10.1016/S2352- 3026(20)30145-9.

APA	ilkkilic k, cüre o, Beyazal Polat H, Aydın E, Şen B, Avci U, TÜFEKÇİ D (2023). Factors affecting mortality in COVID-19 patients treated with intravenous immunoglobulin. , 929 - 933. 10.5455/annalsmedres.2023.06.140
Chicago	ilkkilic kadir,cüre osman,Beyazal Polat Hatice,Aydın Esra,Şen Bayram,Avci Ugur,TÜFEKÇİ Damla Factors affecting mortality in COVID-19 patients treated with intravenous immunoglobulin. (2023): 929 - 933. 10.5455/annalsmedres.2023.06.140
MLA	ilkkilic kadir,cüre osman,Beyazal Polat Hatice,Aydın Esra,Şen Bayram,Avci Ugur,TÜFEKÇİ Damla Factors affecting mortality in COVID-19 patients treated with intravenous immunoglobulin. , 2023, ss.929 - 933. 10.5455/annalsmedres.2023.06.140
AMA	ilkkilic k,cüre o,Beyazal Polat H,Aydın E,Şen B,Avci U,TÜFEKÇİ D Factors affecting mortality in COVID-19 patients treated with intravenous immunoglobulin. . 2023; 929 - 933. 10.5455/annalsmedres.2023.06.140
Vancouver	ilkkilic k,cüre o,Beyazal Polat H,Aydın E,Şen B,Avci U,TÜFEKÇİ D Factors affecting mortality in COVID-19 patients treated with intravenous immunoglobulin. . 2023; 929 - 933. 10.5455/annalsmedres.2023.06.140
IEEE	ilkkilic k,cüre o,Beyazal Polat H,Aydın E,Şen B,Avci U,TÜFEKÇİ D "Factors affecting mortality in COVID-19 patients treated with intravenous immunoglobulin." , ss.929 - 933, 2023. 10.5455/annalsmedres.2023.06.140
ISNAD	ilkkilic, kadir vd. "Factors affecting mortality in COVID-19 patients treated with intravenous immunoglobulin". (2023), 929-933. https://doi.org/10.5455/annalsmedres.2023.06.140

APA	ilkkilic k, cüre o, Beyazal Polat H, Aydın E, Şen B, Avci U, TÜFEKÇİ D (2023). Factors affecting mortality in COVID-19 patients treated with intravenous immunoglobulin. Annals of Medical Research, 30(8), 929 - 933. 10.5455/annalsmedres.2023.06.140
Chicago	ilkkilic kadir,cüre osman,Beyazal Polat Hatice,Aydın Esra,Şen Bayram,Avci Ugur,TÜFEKÇİ Damla Factors affecting mortality in COVID-19 patients treated with intravenous immunoglobulin. Annals of Medical Research 30, no.8 (2023): 929 - 933. 10.5455/annalsmedres.2023.06.140
MLA	ilkkilic kadir,cüre osman,Beyazal Polat Hatice,Aydın Esra,Şen Bayram,Avci Ugur,TÜFEKÇİ Damla Factors affecting mortality in COVID-19 patients treated with intravenous immunoglobulin. Annals of Medical Research, vol.30, no.8, 2023, ss.929 - 933. 10.5455/annalsmedres.2023.06.140
AMA	ilkkilic k,cüre o,Beyazal Polat H,Aydın E,Şen B,Avci U,TÜFEKÇİ D Factors affecting mortality in COVID-19 patients treated with intravenous immunoglobulin. Annals of Medical Research. 2023; 30(8): 929 - 933. 10.5455/annalsmedres.2023.06.140
Vancouver	ilkkilic k,cüre o,Beyazal Polat H,Aydın E,Şen B,Avci U,TÜFEKÇİ D Factors affecting mortality in COVID-19 patients treated with intravenous immunoglobulin. Annals of Medical Research. 2023; 30(8): 929 - 933. 10.5455/annalsmedres.2023.06.140
IEEE	ilkkilic k,cüre o,Beyazal Polat H,Aydın E,Şen B,Avci U,TÜFEKÇİ D "Factors affecting mortality in COVID-19 patients treated with intravenous immunoglobulin." Annals of Medical Research, 30, ss.929 - 933, 2023. 10.5455/annalsmedres.2023.06.140
ISNAD	ilkkilic, kadir vd. "Factors affecting mortality in COVID-19 patients treated with intravenous immunoglobulin". Annals of Medical Research 30/8 (2023), 929-933. https://doi.org/10.5455/annalsmedres.2023.06.140