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.

Objective: We aimed to arouse awareness of the medical staff and surgeons of possible complications, especially lethal and rare complications, of pectus excavatum (PE) surgery. Summary background data: PE is the most common deformity of the chest wall, characterized by a sternal depression. Patients with PE typically present with cosmetic concerns due to their abnormal appearance, but some patients also report exercise intolerance and shortness of breath. The prevalence and type of life-threatening complications related to the surgical repair of PE are unknown and underreported. We presented a case of lethal cardiac event following the PE surgery. We also systematically reviewed the published case reports. Methods: We described a case of lethal complication of ventricular-fibrillation and cardiac arrest following Ravitch procedure for correction of PE in a 10-year-old boy. We also systematically reviewed relevant cases of PE surgery complications. Results: From the 506 initial records that was retrieved from databases search, 95 case reports form 88 articles were identified over the 23 years. Among them, 79 patients were male, and 17 cases were female. The average age of patients was 18.9 ± 7.7 years (range: 5-53). Complications had occurred up to 37 years from the time of surgery, with most of the cases (23%) occurred during the operation. The most common complications experienced were cardiothoracic complications and displacement of the implanted steel bar. Complications resulted in death in eight cases. Conclusion: We recommend that surgeons should be aware of rare and lethal complications of PE surgery, particularly for cosmetic indications.