Successful IgM-enriched immunoglobulin treatment in severe COVID-19 pneumonia: a case report

Farzaneh  Dastan; Golnaz  Afzal; Somayeh  Ghadimi; Hamidreza  Jamaati; Raha  Eskandari; Mohammad Farzad  Nazari; Sahar  Yousefian; Seyed Mohammad Reza  Hashemian; Ali Amir  Savadkoohi; Payam Tabarsi

doi:10.54034/mic.e1342

Authors

Farzaneh Dastan Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran https://orcid.org/0000-0001-7253-4333
Golnaz Afzal Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Somayeh Ghadimi Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Hamidreza Jamaati Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
Raha Eskandari Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran https://orcid.org/0000-0002-6038-1250
Mohammad Farzad Nazari Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Sahar Yousefian Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
Seyed Mohammad Reza Hashemian Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
Ali Amir Savadkoohi Anesthesia and Critical Care Department, Chairman of Iranian Critical Care Society, Mehrad Hospital, Tehran, Iran
Payam Tabarsi Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

DOI:

https://doi.org/10.54034/mic.e1342

Keywords:

IgM-enriched immunoglobulin (Pentaglobin), Coronavirus disease (COVID-19), Acute respiratory distress syndrome (ARDS)

Abstract

Coronavirus disease (COVID-19) pandemic has turned into one of the most considerable challenges worldwide. The optimal treatment strategy, particularly in severely ill patients, is still unrecognized. IgM-enriched immunoglobulin (Pentaglobin®, Biotest AG, Dreieich, Germany) contains IgM, IgA and IgG against a variety of pathogens representing passive immune protection for affected individuals and it may be effective in the treatment of COVID-19. On March 16, 2020, a 32-year-old woman presented to Masih Daneshvari Hospital, Tehran, Iran. On admission, the peripheral oxygen saturation (O2 Sat) was 84%. Spiral chest computed tomography (CT) scan revealed bilateral ground-glass opacification (GGO) involvement. On March 19, 2020, the clinical condition was deteriorated, and her O2 Sat decreased to 70% in ambient air. Treatment with IgM-enriched immunoglobulin was immediately initiated over the course of three days (total dose for the patient was calculated to be 1500 ml). On the seventh day of hospitalization, the patient was discharged with satisfactory general condition, without any complaints, and with stable vital signs and O2 Sat of 95% on room air. In conclusion, IgM-enriched immunoglobulin could be considered as a potential option for the treatment of severely ill patients with COVID-19.

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