Tehran University of Medical Sciences Acta Biochimica Iranica 0001-5261 2 2 2024 07 30 87 95 Behrooz Ghezelbash Department of Immunology, Faculty of Medicine, Isfahan University of Medical Science, Isfahan, Iran Alireza Mafi Department of Clinical Biochemistry, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran. Mehdi Rostami Department of Clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Negah Tavakol Department of Community Medicine, School of Medicine, Isfahan, Iran Raziyeh Salami Department of Clinical Biochemistry, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Yasaman Gholinezhad Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mohammadreza Kasravi Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Alireza Rajbzadeh Infectious Diseases Specialist, Isfahan Milad Hospital, Isfahan, Iran Nahid Eskandari Department of Immunology, Faculty of Medicine, Isfahan University of Medical Science, Isfahan, Iran 2025 02 10 Objectives: Acute respiratory distress syndrome (ARDS) is one of the life-threatening complications of COVID-19. The occurrence of ARDS is due to over activation of the host immune response to the virus. The purpose of this study is to investigate whether administration of intravenous immunoglobulins (IVIG) could enhance the outcomes of sever ill COVID-19 patients with ARDS. Methods: In this randomized controlled trial in Milad Hospital of Isfahan, Iran, 88 patients randomly were assigned between May to October 2020. The patients had no significant differences in age and sex. The patients divided in two groups: the group who received IVIG and routine treatment (n=44, 50%) and the control group who just treated with routine treatment (n=44, 50%). The outcomes of patients including hospitalization duration, ICU admission period and total death occurrence besides clinical and laboratory parameters were fallowed and compared between two groups. Results: Primary outcomes of patients including hospitalization duration (P=0.18), ICU admission period (P= 0.35), and mortality (P=0.621) had no significant difference between IVIG group and the control group. At day 3 and day 5 of IVIG administration, clinical and laboratory outcomes had been screened. The clinical parameter that improved was oxygen saturation compared to the control group (87.56 ± 6.72 vs. 86.72 ± 7.52). In cardiovascular system IVIG significantly decreased the diastolic blood pressure (P= 0.02). In terms of coagulation parameters IVIG treatment decreased PTT while it increased D-dimer but no effect on platelet count and PT have been seen. The inflammatory parameters include ESR, CRP, and IL6 had no superior changes between IVIG group and the control group.  Conclusion: Our study demonstrated that there were no superior advantages in COVID-19 patients with ARDS who treated with IVIG.  https://abi.tums.ac.ir/index.php/abi/article/view/103 https://abi.tums.ac.ir/index.php/abi/article/download/103/60