Intravenous immunoglobulin in severe Crimean-Congo hemorrhagic fever: A retrospective study

Abstract

Objective: To assess the effectiveness of intravenous immunoglobulin (IVIg) therapy in patients diagnosed with Crimean-Congo hemorrhagic fever (CCHF) disease.

Methods: A single-center retrospective cohort study was conducted on hospitalized patients with confirmed severe CCHF at a tertiary care hospital in Turkey between 2010 and 2022. Cases were categorized into two groups based on whether they received IVIg therapy, with the treatment plan determined by the primary healthcare provider. The clinical, epidemiological, and laboratory parameters of these patients were evaluated. Demographic, laboratory findings, platelet counts on the day of IVIg indication and the third day, bleeding status during follow-up beyond 24 hours after IVIg administration, and prognosis recorded in patient information forms were retrieved.

Results: 72 patients were included in the analysis, with IVIg administered to 42 cases (58.3%) and not given to 30 cases (41.7%). Among the patients, 37 (51.4%) were female. Fever (65.3%) was the most common clinical presentation. The overall mortality rate was 19.4%, and IVIg administration did not significantly impact overall survival outcomes (P=0.48). On Day 3 following IVIg administration or indication, the platelet count was higher in the IVIg-treated group compared to the non-treated group (P=0.02). Furthermore, during follow-up beyond 24 hours after IVIg administration, bleeding was observed in 19.0% of the IVIg-treated group, compared to 46.6% in the non-treated group (P=0.01).

Conclusions: This study underscores the potential advantages of IVIg therapy in managing severe CCHF. Although IVIg administration did not significantly affect overall survival, it was associated with earlier improvement in platelet counts and a notable reduction in bleeding complications. These findings indicate that IVIg may serve as an adjunctive treatment in CCHF, particularly for addressing hemorrhagic manifestations.

Keywords

Intravenous immunoglobulin / Crimean-Congo hemorrhagic fever / Treatment / Clinical improvement

Conflict of interest statement

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Ethical approval and informed consent

This study was conducted in accordance with the principles of the Declaration of Helsinki and was approved by the Clinical Research Ethics Committee of Karadeniz Technical University (approval number: 2025/24, dated on 3 March 2025). Informed consent was waived due to the retrospective nature of the study, and anonymous clinical data were used in the analysis.

Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

Authors’ contributions

Conceptualization: FA; Methodology: FA, HNKP; Software: HNKP; Formal analysis: HNKP, GY; Investigation: FA and DCY, FAK; Data curation: DCY, FAK; Writing-original draft preparation: FA and HNKP; Writing-review and editing: GY; Visualization: HNKP; Supervision: GY. All authors have read and approved the final version of the manuscript.

Publisher’s note

The Publisher of the Journal remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Edited by Pan Y, Lei Y, Zhang Q

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