IVIG during COVID-19.

Many patients who are currently receiving IVIG (intravenous immunoglobulin) for numerous autoimmune disease conditions have wondered about the safety of IVIG products in relation to COVID-19 screening, testing, and virus inactivation during the treatment process.

IVIG contains the pooled immunoglobulin G (IgG) immunoglobulins from the plasma of approximately a thousand or more blood donors. The IDF (Immune Deficiency Foundation) provided the following statement in regards to the growing concerns around Coronavirus and screening procedures.

According to the Plasma Protein Therapeutics Association (PPTA) “based on strict screening procedures for plasma donors and the established processes of virus inactivation and removal during the manufacturing of plasma-derived products, PPTA concludes that the SARS-CoV-2 is not a concern for the safety margins of plasma protein therapies manufactured by PPTA member companies.”

Patients on therapies for their autoimmune disease that suppress the immune system may very well be at increased risk for contracting any infection. As such,  I am recommending that these patients strongly consider self-quarantining over the next month.  It is not recommended to stop medication, but we will discuss this on a case-by-case basis.    

Since the 1980s, IVIG has been known to have immune-modulating effects and benefits the immune system in multiple ways at the level of T cells, B cells, and macrophages by interfering with antibody production and degradation and modulating the complement cascade; IVIG also has effects on the cytokine network and contains natural antibodies and autoantibodies, which are very important in the immune mechanism of action. In other words, IVIG does not suppress the immune system so there should be no increased risk of COVID-19 while taking this therapy. But remember, we are all at risk and should exercise precautions such as social distancing, thorough hand-washing procedures, regular cleaning of contact surfaces and other measures.

IVIG many soon be recommended as a treatment for some severe cases COVID 19.  The Japanese drug maker Takeda Pharmaceutical Co. said it was developing a new coronavirus drug derived from the blood plasma of people who have recovered from Covid-19.

Medical literature published during the Spanish flu pandemic of 1918 includes case reports describing how transfusions of blood products obtained from survivors may have contributed to a 50% reduction in death among severely ill patients. In 1934, a measles outbreak at a Pennsylvania boarding school was halted when serum harvested from the first infected student was used to treat 62 fellow students. Only three of the 62 students developed measles — all mild cases.

With its new treatment, TAK-888, Takeda hopes to create an IVIG from the blood of people who have been infected with the coronavirus and who have recovered.   This treatment would only be used with those with severe disease.   

No doubt these are challenging and worrisome times, but every day we learn more to lead us forward in ways to better understand and deal with situations like the one we are in now.  

We are all in this together and together we are strong and invincible  

Let us pray collectively for all and continue to work toward finding ways to help more patients.

In health and healing,
Dr. Suzanne Gazda

For additional reading:

Science Magazine:
https://blogs.sciencemag.org/pipeline/archives/2020/03/09/covid-19-biologic-therapies-reviewed

Basic Principles of IVIG: https://link.springer.com/article/10.1007/s00415-006-5003-1