Early Experience of High-dose Intravenous Mycobacterium w in Critically Ill Patients of COVID-19

BACKGROUND: Immune dysregulation is one of the main reasons for mortality and morbidity in coronavirus disease 2019 (COVID-19). Mycobacterium w (Mw) is recently approved for gram-negative sepsis. Moreover, it is also found effective in COVID-19 patients in previous studies. The traditional route of administration for Mw is intradermal, which has a limitation of administering 0.1 mL per injection and local injection site reaction. Intravenous (IV) administration of Mw has not been explored in COVID-19. We report the retrospective analysis of six critically ill COVID-19 patients who received Mw (IV). PATIENTS AND METHODS: At baseline, all patients in this case series required O(2) supplementation, and their inflammatory biomarkers were elevated. All patients received 0.6 mL Mw (high-dose) in normal saline along with the standard-of-care treatment. RESULTS: After Mw administration, gradual improvement in O(2) requirement was observed and patients were discharged from the hospital with no mortality. A reduction in mean C-reactive protein (CRP) (51.48–18.52 mg/dL), interleukin-6 (IL-6) (260.22–14.47 pg/mL), and FiO(2) (81.67–43.33) was also observed. No side effects were observed with the use of Mw by IV route. CONCLUSION: Use of 0.6 mL Mw by IV route in this case series was associated with decreased O(2) supplementation without any side effects in critically ill patients of COVID-19. HOW TO CITE THIS ARTICLE: Patel PS, Patel S, Shah V, Aswani V, Narwaria M. Early Experience of High-dose Intravenous Mycobacterium w in Critically Ill Patients of COVID-19. Indian J Crit Care Med 2021;25(9):1066–1068.