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Clinical efficacy of immunoglobulin in pediatric patients with severe respiratory syncytial virus pneumonia: a retrospective clinical analysis

Zhiyuan Zhong, Rui Pu, Ran Yao, Xiao-Yu Li, Yu-Qing Ou, Liangkang Lin, Wenqi Yu, Junfeng Xie et al.

Frontiers in Medicine, 2026

157 participants

Abstract

Background The effectiveness of intravenous immunoglobulin (IVIG) in the treatment of severe respiratory syncytial virus pneumonia (SRSVP) remains a topic of ongoing debate. This study aimed to evaluate the association of IVIG on the duration of hospitalization and the use of corticosteroids in pediatric cases of SRSVP. Methods To minimize confounding by indication, a 1:1 propensity score matching (PSM) was performed with a caliper width of 0.02. Multivariate logistic regression analysis was conducted for the entire cohort (n = 157), while generalized estimating equations (GEE) /generalized linear models (GZLM) were utilized within the matched cohort to evaluate the independent association between IVIG use and clinical outcomes (hospitalization duration and corticosteroid use). Results Results showed that intravenous immunoglobulin (IVIG) treatment failed to reduce the duration of corticosteroid use, corticosteroid dosage, or length of hospital stay (OR = 4.634; OR = 4.667; OR = 2.566). Propensity score matching (PSM) successfully generated 41 well-balanced pairs. In the GEE/GZLM analysis (which further corrected for residual baseline imbalances in alanine aminotransferase (ALT), aspartate aminotransferase (AST), and creatinine), IVIG treatment still failed to reduce the duration of glucocorticoid use (OR = 3.229, 95% CI: 1.267–8.232), reduce glucocorticoid dosage (OR = 2.653, 95% CI: 1.063–6.619), or shorten the length of hospital stay (OR = 4.375, 95% CI: 1.581–12.108).…

How strong is the evidence?

Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 157 participants or records.

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