Frequency of thrombocytopenia in severe COVID-19 pneumonia and its effects on clinical outcomes.

To aim of the study was to determine the frequency of thrombocytopenia and its effect on clinical outcomes in South Asian patients admitted with severe COVID-19. It was a cross-sectional study conducted at the COVID intensive care unit of tertiary care government hospital of Karachi, Pakistan. 190 patients admitted in five months from 1/2/2021 till 30/6/2021 were included in the study. Platelet counts were recorded at presentation and all patients were also followed to observe if they develop thrombocytopenia during the course of hospital stay. The patient outcome and need for mechanical ventilation was assessed 28 days after admission and compared with the frequency of thrombocytopenia. Thrombocytopenia was seen in 26.8% (n=51) admitted patients. Among these, 68.6% patients had thrombocytopenia at presentation and 31.4% patients developed thrombocytopenia during the course of hospital stay. The range of platelet count in thrombocytopenic patients was 11x109 - 150x109. Mean platelets count in thrombocytopenic patients was 110x109 (SD 33). Mortality in patients who developed thrombocytopenia was 73.6% and 56.9.2% in patients without thrombocytopenia (p 0.034). Patients with thrombocytopenia were more likely to require mechanical ventilation (p 0.024). Thrombocytopenia is frequently observed in patients with severe COVID-19 and can be used as a tool for risk stratification.

Spectrum of HRCT Scan Chest Findings in COVID-19 Patients as Categorized by Modified CO-RADS Classification

Objectives: The Dutch Radiological Society developed CO-RADS classification, a system for the classification of CT scan chest findings among suspected COVID-19 patients. However due to some important issues it was modified by authors and then applied on our study population. The objective was to study the spectrum of lungs involvement as concluded by HRCT scan chest finding and classifying it using the “Modified CO-RADS classification” Methods: This cross-sectional study was conducted jointly by the departments of Medicine and Radiology, JPMC from January 16, 2021 to April 30, 2021. This study includes suspected cases of COVID-19 patients aged between 18-80 years who came for HRCT chest. Their data variables were recorded. HRCT findings were classified using “Modified CO-RADS classification”. Patients’ results of real time PCR for COVID-19 were also followed. Results: A total of 78 patients presented to the study department during this study period. Of them 85.8% were male (n=67) and 14.2% were female (n=11). Out of the 78 patients, 58 were tested positive for COVID-19 on first RT-PCR on follow up. Among positive two patients (3.4%) had CO-RADS-1, 4 patients (7%) had CO-RADS-2, 19 patients (32.75%) had CO-RADS-3, 21 patients (36.2%) had CO-RADS-4 while 12 patients (20.7%) had CO-RADS-5 category. (CO-RAD-6 category was omitted). Of the patient who had negative results on RT-PCR, five patients had CO-RADS-4 while three patients had CO-RADS-5. On repeat RT-PCR all (8/8) patients of category IV and V proved Covid-19 positive. Conclusion: HRCT scan chest can be used for quicker diagnosis of COVID-19 patients in patients with respiratory complaints in whom prompt diagnosis is required and when RT-PCR investigation process would be taking prolonged time due to over burden during pandemic situation. “CO-RADS classification after modification” proved more effective communicative tool to label and understand the severity of lung involvement in Covid-19 disease.

Depletion of psychological, financial, and social resources in the hospitality sector during the pandemic.

This study details how psychological, financial, and social factors shape employee deviant interpersonal behaviors during a pandemic. Data were collected with a survey of 372 front-line employees of hotels and analyzed with PLS-SEM. The findings showed social disconnectedness and perceived risk of unemployment leads to perceived isolation, which further creates depression in employees. The findings also showed that depression is positively related to employee deviance. Financial strain is a major cause of perceived isolation, depression, and deviant behaviors among front-line employees. Results also proved that social support reduces fear of isolation, depression, and employee deviance. This study provides guidelines that hotels need to understand the psychological stance of employees and design policies to overcome employee perceived fears and psychological disorders.