Foliar application of Silicon and Salicylic acid improves growth, leaf pigments and yield of maize (Zea mays L.) under nutrient deficient sandy soil (preprint)

Purpose The individual benefits of Salicylic acid (SA) and Silicon (Si) on plant growth have been studied independently but there is limited research exploring the interactive effects of SA and Si on plant growth. Therefore, the objective of this current study is to evaluate the combined impact of SA and Si on the growth, chlorophyll content, and yield of maize. Method The effect of foliar application of Si and SA was estimated in maize in the year 2021–2022. Treatments were of two levels of varieties i.e., V1:PMH13 and V2:TA5084 and four levels of foliar application of Si and SA along with RDF i.e., T1:RDF (Control), T2:RDF + Salicylic acid (150ppm), T3:RDF + Silicon (40ppm) and T4:RDF + Salicylic acid (150ppm) + Silicon (40ppm) replicated thrice laying out in a randomized block design with a factorial arrangement (FRBD). Results T4recorded higher chlorophyll content (15.64 mg g− 1 FW) and growth in seedling tray experiment. It also had the highest plant height, leaf area index (LAI), total dry matter (TDM), and SPAD values in field trial. This resulted in a significant increase in grain yield (39.97%) compared to T1. Additionally, T3 and T4, which received silicon foliar application, had the least insect infestation during early crop stages compared to T1. Conclusion The results showed that application of Si would have increased synthesis of structural components in plant cells and enhanced resistance to environmental stresses and SA induced System Acquired Resistance (SAR) and promoted nutrient uptake. The results were further verified by principal component analysis (PCA).

Impact of COVID 19 on bacterial respiratory isolates (2018-2021) from a UK tertiary cardio-thoracic ICU

Aim: To study the impact of COVID-19 admissions during 1st and 2nd surges on bacteriology of ICU respiratory isolates. Method(s): Retrospective time trend analysis of bacterial respiratory isolates from a single centre, tertiary cardiothoracic ICU (CT-ICU) from patients admitted from Jan 2018- June 2021. We compared pre-COVID-19 (January 2018- March 2020) and COVID-19 periods (April 2020- June 2021) and surge periods (surge 1: March 2020- June 2020, surge 2: January- March 2021) to similar time frames in previous years. Chi-square test used to compare proportions. Result(s): 4974 respiratory isolates (Sputum-4230, BAL-563, ET secretions-181) included. During surge 2, culture positivity and gram-negative rates tripled from baseline (20% to 75%;p<0.05). Comparing the pre- pandemic to pandemic period, rates of Klebsiella sp, Acinetobacter sp and Stenotrophomonas sp increased from 12% to 21.3%, 2.4% to 6.2% and 10.5% to 14.3% respectively, while Pseudomonas sp dropped from 30.7% to 23.1% (all p<0.05). MDR Pseudomonas increased significantly from 38.9% to 47.9% (p<0.05), with a non-significant increase in MRSA (5.2% to 9.3%;p=0.34) and MDR enterobacterales (22.6% to 23%;p=0.48). Conclusion(s): This is the first report from a UK CTICU showing a marked epidemiological shift in the bacteriology of respiratory isolates in terms of organism profile, increase in culture positivity and MDR Pseudomonas rates during the pandemic. Analyzing trends on longevity of the findings will help guide changes to infection control and antibiotic policies. This emphasizes the importance of unit specific ecology in choosing appropriate timely antimicrobial therapy and therefore improving patient outcome.

Allogeneic transplant following CAR T-cell therapy for large B-cell lymphoma.

Allogeneic hematopoietic cell transplantation (alloHCT) can potentially salvage large B-cell lymphoma (LBCL) patients experiencing treatment failure after chimeric antigen receptor T-cell therapy (CAR-T). Nonetheless, data on the efficacy and toxicities of alloHCT after receipt of CAR-T are limited. We report a multicenter retrospective study assessing the safety, toxicities, and outcomes of alloHCT in LBCL patients following CAR-T failure. Eighty-eight patients with relapsed, refractory LBCL received an alloHCT following anti-CD19 CAR-T failure. The median number of lines of therapy between CAR-T infusion and alloHCT was 1 (range 0-7). Low intensity conditioning was used in 77% (n=68) and peripheral blood was the most common graft source (86%, n=76). The most common donor types were matched unrelated donor (39%), followed by haploidentical (30%) and matched related donor (26%). Median follow-up of survivors was 15 months (range 1-72). One-year overall survival, progression-free survival, and graft-versus-host disease-free relapse-free survival were 59%, 45%, and 39% respectively. One-year non-relapse mortality and progression/relapse were 22% and 33% respectively. On multivariate analysis.

The positive impact of the COVID- 19 Pandemic on Organ Utilisation in Liver Transplantation

Background As the world recovers from the aftermath of devastating waves of an outbreak, the ongoing Coronavirus disease 2019 pandemic has presented a unique perspective to the transplantation community of ‘'organ utilisation'' in liver transplantation, a poorly defined term and ongoing hurdle in this field. To this end, we report the key metrics of transplantation activity from a high-volume liver transplantation centre in the United Kingdom over the past two years. Methods Between March 2019 and February 2021, details of donor liver offers received by our centre from National Health Service Blood & Transplant, and of transplantation were reviewed. Differences in the activity before and after the outbreak of the pandemic, including short term post-transplant survival, have been reported. Results The pandemic year at our centre witnessed a higher utilisation of Donation after Cardiac Death livers (80.4% vs. 58.3%, p=0.016) with preserved United Kingdom donor liver indices and median donor age (2.12 vs. 2.02, p=0.638;55 vs. 57 years, p=0.541) when compared to the pre-pandemic year. The 1- year patient survival rates for recipients in both the periods were comparable. The pandemic year, that was associated with increased utilisation of Donation after Cardiac Death livers, had an ischemic cholangiopathy rate of 6%. Conclusions The pressures imposed by the pandemic led to increased utilisation of specific donor livers to meet patient needs and minimise the risk of death on the waiting list, with apparently preserved early post-transplant survival. Optimum organ utilisation is a balancing act between risk and benefit for the potential recipient, and technologies like machine perfusion may allow surgeons to increase utilisation without compromising patient outcomes.

Impact of Inpatient Tele-Nephrology Treatment Outcomes in Rural Alabama

Background: Access to nephrology care including dialysis in rural Alabama (AL) hospitals is lacking. The University of Alabama at Birmingham (UAB) with Sanderling Inc. started inpatient tele-nephrology (TN) services in 2019 and currently serves 3 rural AL hospitals. Since the COVID-19 pandemic, transfer to TN-equipped hospitals in AL played a pivotal role for patients needing nephrology services when primary referral centers were at capacity. Method(s): TN services were 100% virtual and video-based. Consults were completed by UAB nephrology faculty. Home hemodialysis machine (HHD) was used to provide kidney replacement therapy (KRT) in the hospital, with aid of inpatient dialysis technicians supervised remotely by TN dialysis nurses. TN consults were evaluated from Jun 2019 to Dec 2021. Retrospective chart review for pre-defined outcomes was performed and analyzed. Result(s): There were 694 inpatient TN encounters. Mean age was 64 (18-96) yr. 74% of consultations involved black patients. Mean stay was 6 d. 44% were ICU patients;18% were COVID-19 positive. AKI and known ESKD patients contributed to 48% and 44% consults, respectively. 11% had AKI necessitating KRT. 20% and 13% of consults involved hyperkalemia and dysnatremias, respectively. 792 dialysis treatments were performed with 11% complicated by intradialytic hypotension (IDH). Patients were discharged 64% and transferred to higher level of care 18% of the time. 90 patients expired. 66% of deaths were attributable to COVID-19. Preliminary economics analysis at the hospital with the most consults showed increase in case-mix index and higher census since implementation of TN services. Conclusion(s): Inpatient TN in community hospitals in rural AL provided essential nephrology care to underserved populations amidst a pandemic limiting transfer to nephrology-staffed medical centers at capacity. Most patient encounters resulted in discharge without need for transfer to bigger centers thus saving vital time and resources. Dialysis safety was favorable with low IDH prevalence likely given HHD use. TN services can be beneficial for nephrology care in remote community hospitals with further studies warranted.

A Retrospective Study of Microbiological Profile and Resistance Pattern in Early- and Late-onset Ventilator-associated Pneumonia Among COVID-19 Patients of a Tertiary Care ICU

Aim and objectives: To compare the microbiological profile, resistance pattern, and outcome in early- and late-onset ventilatorassociated pneumonia (VAP) among severe COVID-19 patients in a tertiary care ICU. Materials and methods: It is a retrospective study conducted in the Department of Critical Care Medicine, Fortis Hospitals Pvt ltd, Bangalore over a period of 15 months (April 2020 to June 2021). It included all patients who had a first episode of VAP confirmed by positive tracheal aspirate culture. Patients on mechanical ventilation for <4 days (48-96 hours) were included in the early-onset VAP group and 5 days or more were included in the late-onset VAP group. Data collected from case records including demographic and clinical characteristics of the patients at ICU admission, data related to the disease course, ICU treatments (prior antibiotic exposure and immunomodulatory therapy), mortality and, finally, data related to each VAP episode (date of sampling, implicated germs and their detailed biochemical testing identified any significant growth, and antibiotic sensitivity testing report). Results: We analysed a total of 404 patients, out of which 149 patients had VAP. The incidence of VAP was found to be 36.8%, out of which 59 (39.5%) had early-onset VAP and 90 (60.5%) had late-onset VAP. The most common organisms isolated from early- and late-onset VAP was Klebsiella pneumoniae. Among earlyonset VAP, 42% of Klebsiella pneumoniae were extended-spectrum beta-lactamase (ESBL) with carbapenemase-producing strains and in late-onset VAP 85% of Klebsiella pneumoniae strains were ESBL with carbapenemase-producing strains. The overall mortality in our study was 65.7%. Conclusion: VAP is one of the most common complications in critically ill mechanically ventilated COVID-19 patients. The underlying immune nature of the virus and the various immunomodulating therapies used for the same has contributed towards a high incidence of VAP in COVID-19 pneumonia patients. Knowledge of your local microbial flora can help in initiating the appropriate therapy at the correct time and hence improve clinical outcomes.

Acute Occipital Stroke in Young COVID-19 Patient Presenting as Bilateral Visual Loss: A Rare Presentation

Case report: COVID-19 infection though mainly presents as a respiratory disease it can also present as secondary stroke due to thrombotic complications. We report a case of a 28-year lean male with no underlying comorbidities and addiction who had a history of fever, cough, and neck weakness of 10 days duration and presented to us with sudden painless loss of vision in both eyes. On the evaluation of his d-dimers, serum LDH was raised. HRCT showed a CTSI of 17/25. His MRI brain showed hyperintense foci of diffusion restriction in the occipital lobe suggestive of acute infarct within the territory of a respective posterior cerebral artery. Conclusion: Stroke in COVID-19 is seen more among patients with severe respiratory disease due to thrombotic complications. Though elderly age and co-morbidities are a risk factor for increased disease severity and complications, severe disease can occur in young healthy individuals. Thus, COVID-19 disease is an independent risk factor for stroke.

Detection of Pathological Artifacts Caused by COVID-19 Using U-Net

SARS-COV-2 disease also known as (COVID-19) is a newly discovered viral disease that can be fatal. The majority of patients will experience mild to severe respiratory problems and will improve without need for special treatment. Deep learning (DL) has proven beneficial in medical imaging, and several research have begun to study Deep Learning based solutions for the aided detection of lung disorders in the aftermath of the recent COVID19 epidemic. While previous research has focused on Chest Tomography scans, this study investigates the use of DL approaches to analyse lung ultrasound data. We provide a new completely annotated dataset of LUS pictures gathered from multiple Italian hospitals, with labels reflecting the severity of illness at the frame and pixel levels. In the proposed system, a deep network named Convolutional Neural Networks (CNN) based transfer learning (Mobile-Net) is used, developed from Spatial Transformer Networks (STN) that which predicts the disease from the given image. Once after the disease prediction, we will use UNet for the segmentation of the predicted disease part from the given image. © 2022 IEEE.

The Moderating Effect of COVID-19 on the Promotion, Distribution and Sales of Dairy Products in Western India: An Exploratory Study

Purpose: This study aims at exploring and understanding the effect of four independent variables related to dairy retail marketing and distribution (deep freezers, promotions, company support and distributor-retailer relationship) and one moderating variable Covid-19 lockdown on sales of dairy product during the Covid 19 pandemic situation. Research design and methodology: Personal interviews and door-to-door surveys and promotional tools were designed to publicise and collect data from the retailers. The sale data before, during and after promotion activity were all recorded and evaluated to draw an inferential conclusion. Factor analysis and multiple regression methods were adopted to analyses the data collected. Results: The research shows that four out of the five factors studied was found having significant impact on dairy retail sales. The highest impact on sales was contributed by promotions, secondly by the deep freezer impact followed by distributor-retailer relationship during the study period and lastly but not the least due to influence of Covid-19 lockdown. Conclusions: The study contributes to the body of knowledge in cold chain distribution process through utilization of right mix of tools and tactics for effective marketing and distribution of dairy products in developing countries especially during a pandemic situation. © Copyright: The Author(s) This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://Creat¡vecommons.org/l¡censes/by-nc/4.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

COVID VACCINES-AN UPDATE

From the time COVID-19 infection was first reported from Wuhan, China by the end of December 2019, vaccine production and trials geared up globally and have been successful in bringing out vaccines for use in the community in a year’s time. This was made possible as the genome of the SARS-CoV-2 was released by Chinese researchers on 11th January 2020. The scientific advancements and lessons learnt from the previous pandemics due to H1N1(Spanish flu), H2N2(Asian flu), H3N3 (Hong Kong Flu) and SARS outbreak also helped in this regard. This article highlights conventional and newer technologies used in the development of vaccines and the types of vaccines available. © 2021, Indian Academy of Pediatrics. All rights reserved.

Role of a multidisciplinary team assisted, technology enabled education program in empowering people with type 1 diabetes

Introduction: Carbohydrate counting (CC)-a meal planning tool is an integral part of type 1 diabetes (T1D) management. CC have been evidenced to have positive effects on glycemic control. Objectives: We investigated and analyzed the effect of a multidisciplinary team (MDT) assisted, technology enabled education program in empowering T1D to meticulously use carb counting. Methods: T1D (n=50;age: 5-35 years;HbA1c>8 % at baseline;55% females) during their initial visit to the center were invited to participate in a MDT assisted technology enabled program. Group I (G1) received continuous assistance from a MDT along with trimonthly education and the use of technologies (n=25) and Group II (G2) opted for performing CC on their own based on the trimonthly education and used technologies at their convenience. Both the groups were trained on CC trimonthly and virtually during the Covid pandemic. Individual WhatsApp group was created for G1 comprising of the patient/caretaker and the MDT, for reporting their BG values, and sharing photos of their meals so that MDT can assist them continuously. Patients were encouraged to use a connected glucometer to monitor the BG values to improve MDT engagement. 66% of the patients were on MDI and 34% were on CSII. 8% of the participants belong to the 5-9 age group and rest of them were 10-35 years of age. Results: A significant improvement in HbA1c (Baseline 9.53 ± 1.65 to 7.50 ± 0.68) was observed in G1 Compared to G2. CC in Indian foods is challenging given the hidden carbs in the traditional meals. The greater ability to count carbs accurately led to better A1c reduction. Conclusions: Counting carbohydrates with the help of a MDT assisted technology enabled education program was found to be of significant benefit in the management of T1D.

Novel Drug Discovery Using Generative Model for COVID-19

Drug discoveries often need expertise knowledge and insanely complex biochemical tests for the discovery of molecular chemical properties. In recent years, there has been an increasing trend of using AI and deep learning-based tools which aid the domain expect to speed up the process of drug design. The use of dynamically un-supervised deep learning systems is used to identify certain properties of atoms of molecules that could have aided the pharmaceutical scientist at many times. The drug discovery comes under sixth goal of millennium development goals which is used as a standard procedure to combat diseases such as HIV, AIDS, dengue, malaria, and another global pandemic. In this paper, we propose a new un-supervised molecular embedding procedure, which provides a continuous vector of molecule in their latent space. These molecules in their latent space can aide in generation of new atoms or a combination of atoms which have relevant chemical nature and can be used as a direct and effective replacement for the existing molecules. The model proposed in this paper is an LSTM autoencoder (long short-term memory) to model the sequence to sequence approach since the molecule input is taken a string format called simplified molecular-input line-entry system (SMILES). © 2021, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Robust Protective Effect of COVID-19 Vaccination in India-Results of Survey in the Midst of Pandemic's Second Wave.

Introduction Our objective was to document the incidence of COVID-19 in vaccinated health care professionals and related personnel. Method We conducted an online survey to ascertain the incidence of COVID-19 symptoms, reverse transcriptase polymerase chain reaction (RT-PCR) positivity, effect on normal activity, need for anti-COVID-19 medication, hospitalization, and death among individuals who had completed both doses of COVID vaccination at least 2 weeks earlier. Results A total of 351 unique valid responses were received. Among the 340 people who had been vaccinated in India, 5% (17/340) had COVID-19 symptoms, 4.7% (16) became COVID-19 RT-PCR positive, 12 (3.5%) had sickness preventing normal daily activity, 2.65% (9) required anti-COVID-19 medication, and 1.18% (4) required hospitalization. Among family members living with the survey responders, the corresponding incidence was even lower. There was one death in this group. Discussion Being health care professionals, the responders would be at higher risk of daily exposure to COVID-19. Even in this high risk group, the vaccine efficacy is good. Vulture journalists should stop spreading fake news and misinformation that makes people hesitate taking the vaccine or be afflicted analysis paralysis. Every person who chooses to remain unvaccinated increases the risk for our entire community. We also need to follow universal precautions (wearing mask, physical distancing, handwashing) diligently without letting down our guard.

Lack of correlation between the SARS-CoV-2 cycle threshold (Ct ) value and clinical outcomes in patients with COVID-19.

PROBLEM: The utility of the polymerase chain reaction (PCR) cycle threshold (Ct ) values in the management of patients with coronavirus disease 2019 (COVID-19) remains controversial. METHODS: We assessed the correlation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Ct values in nasopharyngeal swab samples with the oxygen requirements at the time of sample collection. Specimens were tested with the Simplexa PCR platform, which targets the SARS-CoV-2 ORF1ab and S genes. RESULTS: We identified 23 COVID-19 patients with 49 Ct values available. While Ct values from ORF1ab and S genes were highly correlated for a given specimen, there was no correlation between Ct values for any of these target genes and the oxygen requirements of the patient at the time of sample collection. We found no differences in the initial nor the nadir Ct values between survivors and non-survivors or mild/moderate versus severe/critical illness at the maximum point of illness. CONCLUSION: SARS-CoV-2 Ct values have limited value in the management of COVID-19.

Evolving Paradigm of Prothrombin Time Diagnostics with Its Growing Clinical Relevance towards Cardio-Compromised and COVID-19 Affected Population

Prothrombin time (PT) is a significant coagulation (hemostasis) biomarker used to diagnose several thromboembolic and hemorrhagic complications based on its direct correlation with the physiological blood clotting time. Among the entire set of PT dependents, candidates with cardiovascular ailments are the major set of the population requiring lifelong anticoagulation therapy and supervised PT administration. Additionally, the increasing incidence of COVID affected by complications in coagulation dynamics has been strikingly evident. Prolonged PT along with sepsis-induced coagulopathy (SIC score > 3) has been found to be very common in critical COVID or CAC-affected cases. Considering the growing significance of an efficient point-of-care PT assaying platform to counter the increasing fatalities associated with cardio-compromised and coagulation aberrations propping up from CAC cases, the following review discusses the evolution of lab-based PT to point of care (PoC) PT assays. Recent advances in the field of PoC PT devices utilizing optics, acoustics, and mechanical and electrochemical methods in microsensors to detect blood coagulation are further elaborated. Thus, the following review holistically aims to motivate the future PT assay designers/researchers by detailing the relevance of PT and associated protocols for cardio compromised and COVID affected along with the intricacies of previously engineered PoC PT diagnostics.

Clinical presentation and outcomes of COVID-19 following hematopoietic cell transplantation and cellular therapy.

BACKGROUND: One year into the pandemic, published data on hematopoietic cell transplantation (HCT) recipients with coronavirus disease 2019 (COVID-19) remain limited. METHODS: Single-center retrospective cohort study of adult HCT recipients with polymerase chain reaction (PCR)-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. RESULTS: Twenty-eight consecutive transplantation and cellular therapy patients (autologous, n = 12; allogeneic, n = 15; chimeric antigen receptor T-cell therapy [CAR-T], n = 1) with COVID-19 were identified. The median age was 57 years. The median time from HCT to COVID-19 diagnosis was 656 days (interquartile range [IQR], 33-1274). Patients were followed for a median of 59 days (IQR, 40-88). Among assessable patients (n = 19), 10 (53%) had documented virological clearance; median time to clearance was 34 days (range, 21-56). Out of 28, 12 (43%), 6 (21%), and 10 (36%) patients had mild, moderate, and severe/critical disease, respectively. Overall mortality was 25%, nearly identical for autologous and allogeneic HCT, and exclusively seen in hospitalized patients, older than 50 years of age with severe COVID-19. None of the patients with mild (n = 12) or moderate (n = 6) COVID-19 died whereas 7/10 patients (70%) with severe/critical COVID-19 died (P = .0001). Patients diagnosed with COVID-19 within 12 months of HCT exhibited higher mortality (57% vs 14%; P = .04). All-cause 30-day mortality (n = 4) was 14%. A higher proportion of patients who died within 30 days of COVID-19 diagnosis (3/4) were receiving ≥2 immunosuppressants, compared with patients who survived beyond 30 days after COVID-19 diagnosis (2/24; 75% vs. 8%; P = .01). CONCLUSIONS: Mortality in COVID-19 HCT patients is higher than that of the age-comparable general population and largely dependent on age, disease severity, timing from HCT, and intensity of immunosuppression.

Magnetic-Nanosensor-Based Virus and Pathogen Detection Strategies before and during COVID-19. LID - acsanm.0c02048

The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), is a threat to the global healthcare system and economic security. As of July 2020, no specific drugs or vaccines are yet available for COVID-19;a fast and accurate diagnosis for SARS-CoV-2 is essential in slowing the spread of COVID-19 and for efficient implementation of control and containment strategies. Magnetic nanosensing is an emerging topic representing the frontiers of current biosensing and magnetic areas. The past decade has seen rapid growth in applying magnetic tools for biological and biomedical applications. Recent advances in magnetic nanomaterials and nanotechnologies have transformed current diagnostic methods to nanoscale and pushed the detection limit to early-stage disease diagnosis. Herein, this review covers the literature of magnetic nanosensors for virus and pathogen detection before COVID-19. We review popular magnetic nanosensing techniques including magnetoresistance, magnetic particle spectroscopy, and nuclear magnetic resonance. Magnetic point-of-care diagnostic kits are also reviewed aiming at developing plug-and-play diagnostics to manage the SARS-CoV-2 outbreak as well as preventing future epidemics. In addition, other platforms that use magnetic nanomaterials as auxiliary tools for enhanced pathogen and virus detection are also covered. The goal of this review is to inform the researchers of diagnostic and surveillance platforms for SARS-CoV-2 and their performances. FAU - Wu, Kai

Trinational Study Exploring the Early Impact of the COVID-19 Pandemic on Organ Donation and Liver Transplantation at National and Unit Levels.

BACKGROUND: The coronavirus disease (COVID-19) pandemic is stressing healthcare services to an unprecedented extent. There is anecdotal evidence of reduction in organ donation and transplantation activity across the world. METHODS: The weekly organ donation and liver transplant numbers over a 3-month period (Feb 17, 2020, till May 17, 2020) for the United States, United Kingdom, and India were compared with their previous year's activity. Liver transplant activity in 6 centers from these countries with varying local COVID-19 caseload was also compared. RESULTS: The COVID-19 pandemic has led to a significant contraction in organ donation and liver transplantation in all 3 countries. Peak reduction ranged from 25% in the United States to over 80% in the United Kingdom and India. The reduction was different for deceased donor and living donor liver transplantation and varied between centers within a country. There was early evidence of recovery of deceased donation in the United States and United Kingdom and resumption of living donor liver transplantation activity in India toward the end of the study period. A number of policy changes were undertaken at national and transplant center levels to ensure safe transplantation despite significant redirection of resources to combat the pandemic. CONCLUSIONS: There was a substantial reduction in organ donation and liver transplantation activity across the 3 countries with signs of recovery toward the end of the study period. Multiple factors including COVID-19 severity, stress on resources and influence of regulatory agencies and local factors are responsible for the reduction and recovery.