Welsh immunodeficient individuals who were at high risk for developing severe COVID-19 were instructed to take protective measures while receiving immunoglobulin replacement therapy (IgRT). As a result, patients receiving intravenous immunoglobulin (IVIg) at a hospital swiftly switched to subcutaneous immunoglobulin (SCIg) administered at home. For a study, researchers sought to evaluate how patients perceived and experienced the emergency IgRT changeover during COVID-19, as well as the laboratory results.
It was possible to switch quickly from in-hospital IVIg to home-based rapid push SCIg, but outside of emergency shielding measures, the patient choice for IgRT administration still mattered a lot.
Patients’ pre/post-IgRT switch subjective self-reported experiences (n = 23) and objective immunoglobulin G (IgG) concentration tests (n = 28) were prospectively gathered. All of the patients who switched from IVIg to fast push SCIg (41/55; 75% of the patients) were trained to self-administer subcutaneously in less than a month. Six weeks after the transfer, 22% (n = 5) of patients preferred SCIg and 35% (n = 8) wished to go back to hospital-based IVIg. Pre- and post-SCIg switch mean IgG levels were comparable (10.3 g/l and 10.6 g/l, respectively). During COVID-19, patients expressed increased infection concern and changed their behavior to reduce risk. Although a third of patients wanted to go back to IVIg when shielding stopped, over time, the number choosing to stay on SCIg increased from 22% to 59%.