Among the 80 pneumonia patients, 17 patients showed severe respiratory distress with hypoxemia at presentation (12 cases) and during their hospital stay (5 cases). Arterial blood gas analysis was done in 15 patients, and 12 patients showed hypoxemia (PO 2 < 60 mmHg in the room air). These patients received additional corticosteroids as soon as possible when indicated; 12 patients received intravenous MP (10 mg/kg/day, divided two doses, at presentation, 5 mg/kg/day at next day and then tapered off within a week) and 5 patients received oral prednisolone (1 mg/kg/day, divided 3 doses, for 3 days tapered off within a week). Six patients received early MP with osetalmivir which is recommended early use, before the positive RT-PCR results. Interestingly, all patients except one (age 4 years) were among the 5-9 years age group, and male patients were predominant (13/17). We performed serial chest radiographs of some cases in these patients. A 6-year-old male patient complained of one day fever and cough, and his initial chest radiograph showed few pulmonary infiltrations. On the following morning, he complained of severe dyspnea and showed chest radiographic infiltrations on right lower lung and left hilar regions. He had received two doses of oseltamivir before the MP treatment ( Figure 3A -C). A 7 year-old male patient was presented with a day fever and severe cough and had a rapidly progressive pneumonia in which initial patchy infiltrates on left upper lobe progressed to total left lung consolidation within 12 h after admission. He was given three doses of oseltamivir before the MP treatment ( Figure 4A-G) . These two patients showed dramatic improvements in their clinical symptoms and radiographic findings within 24 h after MP treatment. A 7-year-old male patient with lobar pneumonia was treated with oseltamivir, MP and intravenous immunoglobulin (IVIG) treatment. He was admitted with fever, cough and progressive dyspnea of 2 days, and after MP (10 mg/ kg/day, divided 2 doses) infusion, he showed persistent dyspnea and slightly aggravated pneumonic consolidation ( Figure 5C ). On the following morning, high-dose IVIG (1 g/kg) was infused for 6 hours. At the time of termination of IVIG, his clinical symptoms disappeared and a dramatic improvement of radiographic findings was observed within 6 hours after IVIG termination ( Figure  5A-F) . There was no adverse or rebound reaction in any patient treated with corticosteroids. The clinical symptoms of all patients improved within a day and their pneumonic infiltrations, regardless of severity, ceased immediately after corticosteroid treatment and disappeared within several days without adverse reactions.