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Dergiler / Journal of Health Sciences and Medicine / 2026 / Volume: 9 Issue: 4

Concomitant IVIG and intermediate-dose methylprednisolone in critically ill patients with severe COVID-19: a retrospective cohort study

Dursun Elmas(UNIVERSITY OF HEALTH SCIENCES, HEALTH RESEARCH CENTER, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF INTERNAL MEDICINE, INTENSIVE CARE (MEDICINE))0000-0002-3452-529X
Muhammet Cemal Kızılarslanoğlu(UNIVERSITY OF HEALTH SCIENCES, HEALTH RESEARCH CENTER, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF INTERNAL MEDICINE, GERIATRICS (MEDICINE))0000-0002-7632-6811
Sayfa
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Yayın Tarihi
2026-07-20
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Yapay Zeka Hızlı Bakış & Çıkarımlar

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⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Prospective randomised trials are warranted.

📌 3 Maddede Bu Makale

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Amaç & Hipotez:Aims: Severe COVID-19 pneumonia with acute respiratory distress syndrome (ARDS) continues to carry high mortality in critically ill patients.
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Temel Bulgular & Veri:During the pre-dexamethasone era, various immunomodulatory strategies were explored.
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Sonuç & Katkı:Prospective randomised trials are warranted.
🔬Tür:Modelleme & Sayısal Simülasyon
📍Kapsam:2020 Verileri
⚙️Değişkenler:Acute respiratory distress syndrome · COVID-19 · cytokine storm

Abstract

Aims: Severe COVID-19 pneumonia with acute respiratory distress syndrome (ARDS) continues to carry high mortality in critically ill patients. During the pre-dexamethasone era, various immunomodulatory strategies were explored. We investigated whether early concomitant intravenous immunoglobulin (IVIG) and intermediate-dose methylprednisolone improved outcomes in ICU patients with severe COVID-19. Methods: Single-centre retrospective cohort study (30 March-14 November 2020) of 178 critically ill adults with laboratory-confirmed severe COVID-19. Eighty-eight patients received IVIG (400 mg/kg/day ×5 days) plus intermediate-dose methylprednisolone (250 mg/day ×5 days) within 7 days of ICU admission in addition to early-pandemic background therapy; 90 patients received background therapy alone. Combination therapy was modelled as a time-dependent covariate in an extended Cox model (primary analysis) with 7-day landmark sensitivity analysis. The primary outcome was in-hospital mortality. Results: Combination therapy was initiated at a median of 4 (IQR 3-6) days after ICU admission. In-hospital mortality was 30.7% in the combination group versus 81.1% in the control group. After multivariable adjustment, combination therapy was independently associated with substantially lower mortality (time-dependent adjusted HR 0.39, 95% CI 0.22-0.68; p 60% relative reduction in mortality without evidence of harm. Prospective randomised trials are warranted.

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Bu Makaleye Atıf Yap

Elmas, D., Kızılarslanoğlu, M. C. (2026). Concomitant IVIG and intermediate-dose methylprednisolone in critically ill patients with severe COVID-19: a retrospective cohort study. Journal of Health Sciences and Medicine, Volume: 9 Issue: 4. https://doi.org/10.32322/jhsm.1937161

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