Abstract Background: To access the effect of Intravenous immunoglobulin ‎‎(IVIG) in critically ill corona virus disease 2019 (COVID-19) patients. Method: In this retrospective matched cohort study, records of three tertiary centers with large number of COVID-19 admissions were evaluated and used. Based on treatment options, ‎patients were divided into two groups, standard COVID-19 treatment (109 patients) and IVIG treatment (74 patients) patients. Also, the effect of IVIG in different dosages was evaluated. Patients with IVIG treatment were divided into three groups of ‎low (0.25 gr/kg), medium (0.5 gr/kg), and high (1 gr/kg) dose. Data analysis was performed using independent t-test and ‎One-way analysis of variance (ANOVA) to compare the ‎outcomes between two groups, including duration of hospitalization, intensive care unit (ICU) length of stay, and mortality rate.‎ Result: The duration of hospitalization in the IVIG group ‎were significantly longer than standard treatment (13.74 days vs. 11.10 days, p<0.05). There was not a significant difference between the two groups in ICU length of stay, number of intubated patients and duration of mechanical ventilation (P>0.05).‎ Also initial ‎outcomes in IVIG subgroups were compared separately with the standard ‎treatment group. The results indicated that only the duration of hospitalization ‎in the IVIG subgroup with medium dose is significantly longer than the standard ‎treatment group (P<0.01). Conclusion: Using IVIG is not beneficial for COVID-19 patients based on no remarkable differences in duration of hospitalization, ICU length of stay, duration of mechanical ventilation and even mortality rate.

The first case of sever pneumonia caused by coronavirus (COVID-19) was detected in Wuhan, China in December 2019 and spread rapidly around the world. Pneumothorax has been reported as an uncommon complication following COVID-19 infection which caused by alveolar rupture, air leakage and interstitial emphysema after alveolar damages. Bilateral pneumothorax is also an uncommon life threatening complication induced by COVID-19 which has to be considered in patients present with late sudden dyspnea after Coronavirus infection. In this case report, we are presenting a patient with mild COVID-19 pneumonia with a left massive pneumothorax following a late sudden dyspnea in third week of the disease, during the hospitalization, in addition to aggravating the respiratory condition, right pneumothorax was also added.

Bilateral spontaneous pneumothorax can occur as a late complication in patients with COVID-19 even without any history of mechanical ventilation. Here, we are presenting a patient with mild COVID-19 pneumonia with a left massive pneumothorax in the third week of the hospitalization, and the addition of right pneumothorax as well.

In this case report, we are presenting a man with intermittent fever for three months with a history of aortic and pulmonary valve replacement and also recurrent blood culture-negative endocarditis. After several evaluations based on endemic epidemiology, the Real-time PCR and IFA (indirect immunofluorescence assay) were positive for Q fever.

Objectives Possibility of reinfection with SARS-CoV-2 changes our view on herd immunity and vaccination, and can impact worldwide quarantine policies. We performed RT-PCR follow-up studies on recovered patients to assess possible development of reinfections and re-positivity. Method During a 6-month period, 202 PCR-confirmed recovering COVID-19 patients entered this study. Follow-up RT-PCR tests and symptoms assessment were performed one month after the initial Positive results. patients who tested negative were tested again one and three months later. The Serum IgG and IgM levels were measured in the last follow-up session. Results In the first two follow-up sessions, 82 patients continued their participation, of which four patients tasted positive. In the second follow-up 44 patients participated, three of whom tested positive. None of the patients who tested positive in the first and second follow-up session were symptomatic. In the last session, 32 patients were tested and four patients were positive, three of them were mildly symptomatic and all of them were positive for IgG. Conclusion A positive RT-PCR in a recovering patient may represent reinfection. While we did not have the resources to prove reinfection by genetic sequencing of the infective viruses, we believe presence of mild symptoms in the three patients who tested positive over 100 days after becoming asymptomatic, can be diagnosed as reinfection. The IgG may have abated the symptoms of the reinfection, without providing complete protection.