Are intravenous immunoglobulins (IVIGs) a treatment option for patients with COVID-19?

The use of intravenous immunoglobulin (IVIG) has been reported in several series of COVID-19 patients, but no efficacy data are available. In the absence of adequate titers of neutralizing antibodies, standard intravenous immunoglobulin is unlikely to have a biologic effect in COVID-19.

While IVIG may have immunomodulatory actions, its use can, rarely, also be associated with an increased risk of serious adverse events including anaphylactic reactions, aseptic meningitis, renal failure, thromboembolism, hemolytic reactions, transfusion-related lung injury, and other late reactions.

Preparations of anti-SARS-CoV-2 polyclonal or monoclonal antibodies are being developed. However, data from recent trials on the use of antibody-based therapies (immune plasma, hyperimmune globulin, monoclonal antibody to hemagglutinin stalk) in hospitalized seasonal influenza patients did not demonstrate improvement in outcomes.