IVIG Safe, Effective Treating Pregnant Patients With Severe COVID-19

Intravenous immunoglobulin shows promise as a treatment option for pregnant patients with SARS-CoV-2, influenza, and other respiratory viruses.

Intravenous immunoglobulin (IVIG) may be a safe treatment option for pregnant patients who have severe COVID-19, while also avoiding pregnancy complications, according to a study published in the American Journal of Case Reports.

While clinical trials for COVID-19 vaccines and treatments have advanced at breakneck speed, pregnant patients have been largely excluded from initial studies, according to the authors of the current. Further, pregnant patients who are unvaccinated against SARS-CoV-2 have a greater risk of morbidity from severe COVID-19 versus patients of similar age and comorbidity status.

High-dose IVIG has been found to improve outcomes for individuals who have critical and severe COVID-19, according to the results of a separate study published in International Immunopharmacology. In that study, 255 individuals received IVIG, along with standard treatment, while 280 patients received the standard-of-care treatment. Investigators found that patients in the IVIG group required invasive ventilation significantly less often than the standard-of-care group at 33.2% and 40.4%, respectively. Additionally, in the IVIG Group, in-hospital mortality, length of stay in the intensive care unit, and 28-day mortality were all significantly lower. Individuals administered IVIG showed reduced in-hospital mortality of 10.2% and 28-day mortality of 8.9%.

The authors of the current study noted that IVIG has been found safe in treating pregnant patients with other diseases as well. They added that data show the potential of IVIG treatment in hospitalized patients with severe respiratory symptoms caused by COVID-19 when administered within 14 days of symptom onset.

For the study, the investigators gave IVIG (Privigen, CSL Behring) 0.5 g/kg daily for 3 straight days to 4 pregnant patients, ranging in age from 24-34 years, with gestational ages of 17, 26, 35, and 35 weeks. The patients were hospitalized with moderate-to-severe COVID-19 and were not vaccinated against SARS-CoV-2.

All of the patients were administered concomitant glucocorticoid therapy and all patients were discharged home breathing room air following a mean hospital stay of 15 days. Two of the patients had an uncomplicated cesarean section at 35 weeks during their hospital stay, according to the study.

Pre-term pregnancies at 17 and 26 weeks were intact at the time of hospital discharge and had normal vaginal deliveries at term, according to the study.

“IVIG may be a safe treatment consideration in pregnant women with severe COVID-19 to avoid pregnancy complications. Its use warrants further study in pregnancy acute respiratory distress syndrome (ARDS) due to SARS-CoV-2, influenza, and other respiratory viruses to which pregnant patients are vulnerable,” the study authors concluded.

Reference

Geriak M, McGrosso D, Gonzalez DJ, Dehner M, Sakoulas G. Case Series of Successful Intravenous Immunoglobulin (IVIG) Treatment in 4 Pregnant Patients with Severe COVID-19-Induced Hypoxia. Am J Case Rep. 2022 May 14;23:e936734. doi: 10.12659/AJCR.936734. PMID: 35567293.