Intravenous immunoglobulin: A potential treatment for the post-acute sequelae of SARS-Cov-2 infection?

Following the recovery from an initial infection with SARS-CoV-2, a recent meta-analysis of almost 1 million patients worldwide suggested that an estimated 43% of patients had experienced a variety of sequelae [1]. Furthermore, numerous studies indicate that patients can develop somatic, musculoskeletal, neuropsychiatric, cardiovascular, dermatologic, renal, hepatic and gastrointestinal manifestations that are heterogeneous and vary in intensity and duration (for up to 12 months) [2,3]. The CDC has defined this phenomenon as “long-term symptoms that might be experienced weeks to months after primary infection with SARS-CoV-2, the virus that causes COVID-19 [4]” and proposed designations for this syndrome have included long covid, long chronic covid syndrome, chronic covid, post-COVID-19 syndrome, post-acute covid-19 syndrome and long – haulers [5]. On Feb. 23, 2021, Dr. Francis Collins indicated that the persistent symptoms that occur in patients after recovery from the initial infection could be designated, post-acute sequelae of SARS-CoV-2 (PASC), which we will use in this article. Currently, there is no clear or agreed upon definition or diagnostic criteria for PASC. PASC is most likely a post-infectious illness similar to that reported by patients that had long - term sequelae that persisted for up to 14 months after infection with SARS-CoV-1 or the Middle Eastern respiratory SARS virus (MERS) [6].