High-dose intravenous immunoglobulin therapy for novel coronavirus disease 2019: A brief report of two cases

To the Editor,Novel coronavirus disease 2019 (2019-nCoV) is a global pandemic which threatens all over the world. Thefirst cases were seen in Wuhan, China, in December2019 (Guo et al. 2020; Chen et al. 2020). It has spreadrapidly, and now, there are more than 2.3 million reported cases and 160,000 deaths worldwide. 2019-nCoVmay cause multi-system infections especially respiratoryinfections such as severe acute respiratory syndrome(SARS) and Middle East respiratory syndrome (MERS)(Guo et al. 2020; Chen et al. 2020; Sanders et al. 2020).In some cases, infections may be mild (only cough orfever, etc.); however, in some cases, infections may be severe (acute respiratory failure with diffuse pneumonia).In severe cases, there is an exaggerated immune response with low peripheral lymphocyte levels and highcytokine levels. This mechanism of pathogenesis may beresponsible for the multiple organ failures (Cao et al.2019; Lin et al. 2020). In this early stage of the 2019-nCoV, the infection may be treated successfully withimmunomodulation (Cao et al. 2019). So, the immunomodulation options like intravenous immunoglobulinshould be kept in mind. The intravenous immunoglobulin (IVIg) has been used as a replacement therapy insome immunodeficiency syndromes (Ballow 2008; DeRanieri 2017). IVIg plays an immunomodulatory andanti-inflammatory role in such cases like 2019-nCoV(Cao et al. 2019; Lin et al. 2020).