Monitoring of Immunoglobulin Treatment Compliance of Patients with an Inborn Error of Immunity During the Pandemic Period

Overview

Journal BMC Immunol

Publisher Biomed Central

Specialty Allergy & Immunology

Date 2025 Mar 16

PMID 40089660

Authors

Yasin Karali

Zuhal Karali

Sukru Cekic

Irem Cakir

Sara Sebnem Kilic

Affiliations

Soon will be listed here.

Abstract

Background: During the coronavirus disease 2019 (COVID-19) pandemic, significant challenges have been encountered in managing patients with chronic diseases. This study aimed to evaluate the effects of the pandemic on follow-up and treatment adherence in patients receiving immunoglobulin replacement therapy (IRT).

Methods: A study examining the changes in IRT application methods was conducted between March 2020 and September 2021. An online message line, under the control of nurses and doctors, was established for our patients, and their usage rates for this communication system were recorded.

Results: A total of 169 patients, 93 males and 76 females, were included in the study. Among the patients, 124 (73.4%) received intravenous immunoglobulin (IVIG), and 45 (26.6%) received subcutaneous immunoglobulin (SCIG) treatment. Male sex was more common in both the IVIG and SCIG groups. Although all patients in the subcutaneous treatment group continued the treatments regularly, this rate was 80.6% in the IVIG group. During the pandemic, 26 patients switched from IVIG to SCIG treatment. Furthermore, 24 patients interrupted immunoglobulin treatment for various reasons. Patients who received subcutaneous treatment took a long break from their hospital controls, although they applied them properly at home. Routine immunoglobulin trough values were measured in only 17 (37.7%) patients who were on SCIG. In the presence of symptoms, 100% of SCIG patients contacted the remote medical team via the online message line, compared to 48.3% of IVIG patients.

Conclusion: During the pandemic, the route of immunoglobulin treatment should be individualized based on each patient's characteristics and expectations. Telehealth services have emerged as a crucial tool for monitoring patients with chronic disorders, facilitating effective communication and personalized care.

References

Shaker M, Oppenheimer J, Grayson M, Stukus D, Hartog N, Hsieh E . COVID-19: Pandemic Contingency Planning for the Allergy and Immunology Clinic. J Allergy Clin Immunol Pract. 2020; 8(5):1477-1488.e5. PMC: 7195089. DOI: 10.1016/j.jaip.2020.03.012. View

Delavari S, Abolhassani H, Abolnezhadian F, Babaha F, Iranparast S, Ahanchian H . Impact of SARS-CoV-2 Pandemic on Patients with Primary Immunodeficiency. J Clin Immunol. 2020; 41(2):345-355. PMC: 7707812. DOI: 10.1007/s10875-020-00928-x. View

Quinti I, Mezzaroma I, Milito C . Clinical management of patients with primary immunodeficiencies during the COVID-19 pandemic. Expert Rev Clin Immunol. 2021; 17(2):163-168. DOI: 10.1080/1744666X.2021.1873767. View

Marcus N, Frizinsky S, Hagin D, Ovadia A, Hanna S, Farkash M . Minor Clinical Impact of COVID-19 Pandemic on Patients With Primary Immunodeficiency in Israel. Front Immunol. 2021; 11:614086. PMC: 7840610. DOI: 10.3389/fimmu.2020.614086. View

Hammarstrom L, Abolhassani H, Baldanti F, Marcotte H, Pan-Hammarstrom Q . Development of passive immunity against SARS-CoV-2 for management of immunodeficient patients-a perspective. J Allergy Clin Immunol. 2020; 146(1):58-60. PMC: 7215168. DOI: 10.1016/j.jaci.2020.04.043. View

Zhang Q, Bastard P, Liu Z, Le Pen J, Moncada-Velez M, Chen J . Inborn errors of type I IFN immunity in patients with life-threatening COVID-19. Science. 2020; 370(6515). PMC: 7857407. DOI: 10.1126/science.abd4570. View

Quinti I, Mitrevski M . Modulatory Effects of Antibody Replacement Therapy to Innate and Adaptive Immune Cells. Front Immunol. 2017; 8:697. PMC: 5472665. DOI: 10.3389/fimmu.2017.00697. View

Aljaberi R, Wishah K . Positive outcome in a patient with coronavirus disease 2019 and common variable immunodeficiency after intravenous immunoglobulin. Ann Allergy Asthma Immunol. 2020; 125(3):349-350. PMC: 7272161. DOI: 10.1016/j.anai.2020.06.006. View

Nagelkerke S, Kuijpers T . Immunomodulation by IVIg and the Role of Fc-Gamma Receptors: Classic Mechanisms of Action after all?. Front Immunol. 2015; 5:674. PMC: 4301001. DOI: 10.3389/fimmu.2014.00674. View

10.

Prete M, Favoino E, Catacchio G, Racanelli V, Perosa F . SARS-CoV-2 infection complicated by inflammatory syndrome. Could high-dose human immunoglobulin for intravenous use (IVIG) be beneficial?. Autoimmun Rev. 2020; 19(7):102559. PMC: 7252087. DOI: 10.1016/j.autrev.2020.102559. View

11.

Carvelli J, Demaria O, Vely F, Batista L, Chouaki Benmansour N, Fares J . Association of COVID-19 inflammation with activation of the C5a-C5aR1 axis. Nature. 2020; 588(7836):146-150. PMC: 7116884. DOI: 10.1038/s41586-020-2600-6. View

12.

Kwapisz D, Boguslawska J . Intravenous immunoglobulins (IVIG) in severe/critical COVID-19 adult patients. Biomed Pharmacother. 2023; 163:114851. PMC: 10160523. DOI: 10.1016/j.biopha.2023.114851. View

13.

Tangye S, Al-Herz W, Bousfiha A, Cunningham-Rundles C, Franco J, Holland S . Human Inborn Errors of Immunity: 2022 Update on the Classification from the International Union of Immunological Societies Expert Committee. J Clin Immunol. 2022; 42(7):1473-1507. PMC: 9244088. DOI: 10.1007/s10875-022-01289-3. View

14.

Schwaiger J, Karbiener M, Aberham C, Farcet M, Kreil T . No SARS-CoV-2 Neutralization by Intravenous Immunoglobulins Produced From Plasma Collected Before the 2020 Pandemic. J Infect Dis. 2020; 222(12):1960-1964. PMC: 7546122. DOI: 10.1093/infdis/jiaa593. View

15.

Srivastava R, Ramakrishna C, Cantin E . Anti-inflammatory activity of intravenous immunoglobulins protects against West Nile virus encephalitis. J Gen Virol. 2015; 96(Pt 6):1347-1357. PMC: 4635485. DOI: 10.1099/vir.0.000079. View

16.

Matheu V, Gonzalez-Perez R, Poza-Guedes P, Alava-Cruz C, Mederos Luis E, Sanchez-Machin I . Support Through Social Networks of e-Health in Adults with Primary Immunodeficiencies During COVID-19 Pandemic. Telemed J E Health. 2020; 26(12):1438-1439. DOI: 10.1089/tmj.2020.0240. View

17.

Zhao Y, Wei L, Liu B, Du D . Management of transplant patients outside hospital during COVID-19 epidemic: A Chinese experience. Transpl Infect Dis. 2020; 22(5):e13327. PMC: 7262000. DOI: 10.1111/tid.13327. View

18.

Kayser M, Valtin C, Greer M, Karow B, Fuge J, Gottlieb J . Video Consultation During the COVID-19 Pandemic: A Single Center's Experience with Lung Transplant Recipients. Telemed J E Health. 2020; 27(7):807-815. DOI: 10.1089/tmj.2020.0170. View

19.

Kaplan H, Thakkar S, Burns L, Chini B, Dykes D, McPhail G . Protocol of a Pilot Study of Technology-Enabled Coproduction in Pediatric Chronic Illness Care. JMIR Res Protoc. 2017; 6(4):e71. PMC: 5429432. DOI: 10.2196/resprot.7074. View

20.

Becker S, Kribben A, Meister S, Diamantidis C, Unger N, Mitchell A . User profiles of a smartphone application to support drug adherence--experiences from the iNephro project. PLoS One. 2013; 8(10):e78547. PMC: 3806829. DOI: 10.1371/journal.pone.0078547. View