A Review of Intravenous Immunoglobulin in the Treatment of Neuroimmune Conditions, Acute COVID-19 Infection, and Post-Acute Sequelae of COVID-19 Syndrome

Abstract

Intravenous immunoglobulin (IVIG) is an immunomodulatory therapy that has been studied in several neuroimmune conditions, such as Guillain-Barré Syndrome, chronic inflammatory demyelinating polyneuropathy, multifocal motor neuropathy, and multiple sclerosis. It has also been proposed as a potential treatment option for acute COVID-19 infection and post-acute sequelae of SARS-CoV-2 infection (PASC). IVIG is thought to function by providing the recipient with a pool of antibodies, which can, in turn, modulate immune responses to infections or autoimmunity. In the case of acute COVID-19 infection, IVIG and plasmapheresis have been found to reduce the need for mechanical ventilation, shorten ICU and hospital stays, and lower mortality. Similarly, in patients with PASC, IVIG has been proposed as a potential treatment option to help alleviate persistent symptoms. While IVIG can be an effective therapy for many conditions, it is important to note that it can be costly and has been associated with adverse side effects, factors which should be considered prior to its administration. In this paper, we provide a comprehensive update on the use of IVIG in multiple neuroimmune conditions, myalgic encephalomyelitis, acute COVID-19, and PASC, as well as cover its history, production, pricing, and mechanisms of action. We also identify key areas of future research to optimize the use of Ig products across these conditions.