Indian Journal of Critical Care Medicine

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 25 , ISSUE 9 ( September, 2021 ) > List of Articles


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

Parth Sudhendu Patel, Sudhendu Patel, Vidhi Shah, Varsha Aswani, Mahendra Narwaria

Keywords : COVID-19, Immune dysregulation, Immunomodulator, Mycobacterium w

Citation Information : 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.

DOI: 10.5005/jp-journals-10071-23963

License: CC BY-NC 4.0

Published Online: 08-09-2021

Copyright Statement:  Copyright © 2021; The Author(s).


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 O2 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 O2 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 FiO2 (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 O2 supplementation without any side effects in critically ill patients of COVID-19.

  1. Al-Rifai RH, Acuna J, Al Hossany FI, Aden B, Al Memari SA, Al Mazrouei SK, et al. Epidemiological characterization of symptomatic and asymptomatic COVID-19 cases and positivity in subsequent RT-PCR tests in the United Arab Emirates. medRxiv 2020.09.23.20200030. DOI: 10.1101/2020.09.23.20200030.
  2. Ren C, Yao RQ, Ren D, Li Y, Feng YW, Yao YM. Comparison of clinical laboratory tests between bacterial sepsis and SARS-CoV-2-associated viral sepsis. Mil Med Res 2020;7(1):36. DOI: 10.1186/s40779-020-00267-3.
  3. Yazdanpanah F, Hamblin MR, Rezaei N. The immune system and COVID-19: friend or foe? Life Sci 2020;256:117900. DOI: 10.1016/j.lfs.2020.117900.
  4. Yang L, Liu S, Liu J, Zhang Z, Wan X, Huang B, et al. COVID-19: immunopathogenesis and Immunotherapeutics. Signal Transduct Target Ther 2020;5(1):128. DOI: 10.1038/s41392-020-00243-2.
  5. Sepsivac [package insert]. Ahmedabad, India: Cadila Pharmaceuticals Limited; 2019.
  6. Sehgal IS, Basumatary NM, Dhooria S, Choudhuri R, Shah C, Agarwal R, et al. A randomized trial of Mycobacterium w in severe presumed gram-negative sepsis. Chest 2021;S0012–3692(21)00680–2. DOI: 10.1016/j.chest.2021.03.062.
  7. López-Collazo E, Avendaño-Ortiz J, Martín-Quirós A, Aguirre LA. Immune response and COVID-19: a mirror image of sepsis. Int J Biol Sci 2020;16(14):2479–2489. DOI: 10.7150/ijbs.48400.
  8. Sehgal IS, Bhalla A, Puri GD, Yaddanapudi LN, Singh M, Malhotra P, et al. Safety of an immunomodulator Mycobacterium w in COVID-19. Lung India 2020;37(3):279–281. DOI: 10.4103/lungindia.lungindia_242_20.
  9. Sehgal IS, Guleria R, Singh S, Siddiqui MS, Agarwal R. A randomised trial of Mycobacterium w in critically ill patients with COVID-19: ARMY-1. ERJ Open Res 2021;7(2):00059–2021. DOI: 10.1183/23120541.00059-2021.
  10. Ingale A, Ingale F, Kunwar B, Ahmed S, Salvi K, Chavan V, et al. Role of Mycobacterium w for the treatment of COVID-19: an observational study. J Assoc Physicians India 2021;69(1):19–22.
  11. Darrah PA, Zeppa JJ, Maiello P, Hackney JA, Wadsworth II MH, Hughes TK, et al. Prevention of tuberculosis in macaques after intravenous BCG immunization. Nature 2020;577:95–102. DOI: 10.1038/s41586-019-1817-8.
  12. Pant MC, Verma VP. Intravenous Cadi05: phase I single dose study. J Clin Oncol 2008;26(15_suppl):14019–14019. DOI: 10.1200/jco.2008.26.15_suppl.14019.
  13. Sudhalkar A, Khamar A, Khamar B. Outcomes of toll-like receptors’ antagonism in steroid-resistant optic neuritis; a pilot study. Graefes Arch Clin Exp Ophthalmol 2012;250(6):871–877. DOI: 10.1007/s00417-011-1896-1.
  14. Desai NM, Khamar BM. Immunotherapy for tuberculous pericarditis. N Engl J Med 2014;371(26):2533–2534. DOI: 10.1056/NEJMc1413185.
  15. Kharkar R. Immune recovery in HIV with Mycobacterium w. J Indian Med Assoc 2002;100(9):578–579. PMID: 12455393.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.