Severe acute respiratory syndrome coronavirus 2 has infected and caused the death of an alarming number of individuals worldwide. No specific treatment has been internationally standardized for coronavirus disease 2019 (COVID-19); however, in some cases, intravenous immunoglobulin (IVIG) has been used as adjuvant treatment in critically ill patients with COVID-19 pneumonia. We report a case of a 50-year-old man with severe COVID-19 pneumonia who received 5 days course of IVIG as adjuvant therapy. Invasive respiratory support was avoided. The patient had a successful recovery and was discharged without supplemental oxygen. A high dose of IVIG may improve survival in patients with severe COVID-19 pneumonia. In the current report, we reviewed literature on how IVIG use may improve the early stages of the disease.
Background: Children with Sickle-Cell Anemia (SCA) are at high risk for
obstructive sleep apnea (OSA). Screening for OSA is therefore
recommended by current guidelines but no specific method described. The
Pediatric Sleep Questionnaire (PSQ) is a validated detection tool for
OSA in children. We assessed the utility of PSQ to screen for OSA in
snoring children with SCA. Methods: A prospective study in children with
SCA, aged 4 - 18 years. Subjects were assessed for snoring and PSQ
administered at the same visit. All snoring children were then referred
for polysomnography (PSG). Results: A total of 106 subjects were
screened. Mean age was 10.5 years and 47.2% male. Snoring prevalence
was 51/106 (48.1%). In the snoring group, OSA was detected in 83.9%
(AHI ≥ 1.0/h) and 22.6% (AHI ≥ 5.0/h), respectively. Sensitivity and
specificity of PSQ in snoring children was 46.2% and 20.0% (AHI ≥
1.0/h), and 57.1% and 50.0% (AHI ≥ 5.0/h), respectively. Physician
assessment of snoring had a high sensitivity of 70.3% but low
specificity of 58.4% (AHI ≥1.0/h), and 87.5% and 41.5% (AHI ≥ 5.0/h),
respectively. Conclusion: PSQ is a poor screening tool for detection of
OSA in snoring children with SCA. Physician assessment of snoring
however could be an initial approach prior to polysomnography.
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