文献类型：期刊文献

英文题名：Intravenous immunoglobulin for treatment of hospitalized COVID-19 patients: an evidence mapping and meta-analysis

作者：Li, Mei-xuan[1,2,3,4];Li, Yan-fei[1,2,3,4];Xing, Xin[1,2,3,4,5];Niu, Jun-qiang[1,2,3,4,6];Yao, Liang[7];Lu, Meng-ying[1,8];Guo, Ke[1,2,3,4];Ma, Mi-na[1,2,3,4];Wu, Xiao-tian[1,8];Ma, Ning[1,2,3,4];Li, Dan[1,2,3,4];Li, Zi-jun[1,2,3,4];Guan, Ling[1,9];Wang, Xiao-man[1,2,3,4];Pan, Bei[1,2,3,4];Shang, Wen-ru[1,2,3,4];Ji, Jing[10];Song, Zhong-yang[11];Zhang, Zhi-ming[10];Wang, Yong-feng[12];Yang, Ke-hu[1,2,3,4]

第一作者：Li, Mei-xuan

通信作者：Yang, KH[1];Yang, KH[2];Yang, KH[3];Yang, KH[4];Zhang, ZM[5];Wang, YF[6]

机构：[1]Lanzhou Univ, Evidence Based Med Ctr, Sch Basic Med Sci, Lanzhou, Peoples R China;[2]Lanzhou Univ, Evidence Based Social Sci Res Ctr, Hlth Technol Assessment Ctr, Sch Publ Hlth, Lanzhou, Peoples R China;[3]Key Lab Evidence Based Med & Knowledge Translat Ga, Lanzhou, Peoples R China;[4]Lanzhou Univ, WHO Collaborating Ctr Guideline Implementat & Know, Lanzhou, Peoples R China;[5]Gansu Univ Chinese Med, Sch Publ Hlth, Lanzhou, Peoples R China;[6]Lanzhou Univ, Hosp 1, Dept Tradit Chinese Med, Lanzhou, Peoples R China;[7]McMaster Univ, Fac Hlth Sci, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada;[8]Lanzhou Univ, Sch Clin Med 1, Lanzhou, Peoples R China;[9]Lanzhou Univ, Hosp Stomatol, Sch, Lanzhou, Peoples R China;[10]Gansu Prov Hosp Tradit Chinese Med, Dept Orthopaed, Lanzhou, Peoples R China;[11]Gansu Univ Chinese Med, Affiliated Hosp, Lanzhou, Peoples R China;[12]Gansu Med Coll, Pingliang, Peoples R China

第一机构：Lanzhou Univ, Evidence Based Med Ctr, Sch Basic Med Sci, Lanzhou, Peoples R China

通信机构：[1]corresponding author), Lanzhou Univ, Evidence Based Med Ctr, Sch Basic Med Sci, Lanzhou, Peoples R China;[2]corresponding author), Lanzhou Univ, Evidence Based Social Sci Res Ctr, Hlth Technol Assessment Ctr, Sch Publ Hlth, Lanzhou, Peoples R China;[3]corresponding author), Key Lab Evidence Based Med & Knowledge Translat Ga, Lanzhou, Peoples R China;[4]corresponding author), Lanzhou Univ, WHO Collaborating Ctr Guideline Implementat & Know, Lanzhou, Peoples R China;[5]corresponding author), Gansu Prov Hosp Tradit Chinese Med, Dept Orthopaed, Lanzhou, Peoples R China;[6]corresponding author), Gansu Med Coll, Pingliang, Peoples R China.

年份：2024

卷号：32

期号：1

起止页码：335

外文期刊名：INFLAMMOPHARMACOLOGY

收录：;Scopus(收录号：2-s2.0-85180261913);WOS:【SCI-EXPANDED(收录号:WOS:001127128000001)】；

基金：No Statement Available

语种：英文

外文关键词：COVID-19; Intravenous immunoglobulin; Efficacy; Safety; Evidence mapping; Meta-analysis

摘要：BackgroundThe clinical efficacy and safety of intravenous immunoglobulin (IVIg) treatment for COVID-19 remain controversial. This study aimed to map the current status and gaps of available evidence, and conduct a meta-analysis to further investigate the benefit of IVIg in COVID-19 patients.MethodsElectronic databases were searched for systematic reviews/meta-analyses (SR/MAs), primary studies with control groups, reporting on the use of IVIg in patients with COVID-19. A random-effects meta-analysis with subgroup analyses regarding study design and patient disease severity was performed. Our outcomes of interest determined by the evidence mapping, were mortality, length of hospitalization (days), length of intensive care unit (ICU) stay (days), number of patients requiring mechanical ventilation, and adverse events.ResultsWe included 34 studies (12 SR/MAs, 8 prospective and 14 retrospective studies). A total of 5571 hospitalized patients were involved in 22 primary studies. Random-effects meta-analyses of very low to moderate evidence showed that there was little or no difference between IVIg and standard care or placebo in reducing mortality (relative risk [RR] 0.91; 95% CI 0.78-1.06; risk difference [RD] 3.3% fewer), length of hospital (mean difference [MD] 0.37; 95% CI - 2.56, 3.31) and ICU (MD 0.36; 95% CI - 0.81, 1.53) stays, mechanical ventilation use (RR 0.92; 95% CI 0.68-1.24; RD 2.8% fewer), and adverse events (RR 0.98; 95% CI 0.84-1.14; RD 0.5% fewer) of patients with COVID-19. Sensitivity analysis using a fixed-effects model indicated that IVIg may reduce mortality (RR 0.76; 95% CI 0.60-0.97), and increase length of hospital stay (MD 0.68; 95% CI 0.09-1.28).ConclusionVery low to moderate certainty of evidence indicated IVIg may not improve the clinical outcomes of hospitalized patients with COVID-19. Given the discrepancy between the random- and fixed-effects model results, further large-scale and well-designed RCTs are warranted.