Comparison of thrombus burden in patients with COVID-19 presenting with ST-segment elevation myocardial infarction across the three waves of outbreak in the United Kingdom

Background: It has been previously reported during the first COVID outbreak that patients presenting with ST-Segment Elevation Myocardial Infarction (STEMI) and concurrent COVID-19 infection have increased thrombus burden and poorer outcomes [1]. Subsequently, there have been multiple further waves of the pandemic with the emergence of at least two new COVID-19 variants and the emergence of vaccinations. To-date, there have been no reports comparing the outcomes of COVID-19-positive STEMI patients across all waves of the pandemic. Purpose(s): The purpose of this study was to compare the baseline demographic, procedural and angiographic characteristics alongside the clinical outcomes of patients presenting with STEMI and concurrent COVID-19 infection across the COVID-19 pandemic in the UK. Method(s): This was a single-centre, observational study of 1250 consecutive patients admitted with confirmed STEMI treated with primary percutaneous coronary intervention (PCI) at Barts Heart Centre between 01/03/2020 and 10/03/2022. COVID +ve patients were split into 3 groups based upon the time course of the pandemic (Wave 1: March 2020-June 2020, Wave 2: Sept 2020-March 2021, Wave 3: October 2021-March 2022). Comparison was made between waves and with a control group of COVID-ve patients treated during the same timeframe. Result(s): A total of 135 COVID +ive patients with STEMI (1st Wave: 39 patients, 2nd Wave: 60 patients, 3rd wave 35 pts) were included in the present analysis;and compared with 1115 COVID negative patients. Significant changes in the baseline characteristics, angiographic features and clinical outcomes of COVID +ive patients occurred over time. Early during the pandemic (Wave 1 2020), STEMI patients presenting with concurrent COVID-19 infection had high rates of cardiac arrest, evidence of increased thrombus burden (higher rates of multi-vessel thrombosis, stent thrombosis, higher modified thrombus grade higher use of GP IIb/IIIa inhibitors and thrombus aspiration, coagulability (more heparin for therapeutic ACT), bigger infarcts (lower myocardial blush grade and left ventricular function) and worse outcomes (mortality). However, by wave 3 (late 2021/2022), no differences existed in clinical characteristics, thrombus burden, infarct size or outcomes between COVID +ive patients and those without concurrent COVID-19 infection with significant differences compared to earlier COVID +ve patients. Poor outcomes later in the study period were predominantly in unvaccinated individuals. Conclusion(s): Significant changes have occurred in the clinical characteristics, angiographic features and outcomes of STEMI patients with COVID- 19 infection treated by primary PCI during the course of the pandemic. Importantly it appears that angiographic features and outcomes of recent waves are no different to a non-COVID-19 population.

Persuasion Using Video Narratives: Case of Engagement with Videos on YouTube About COVID-19: An Abstract

Since November 2019, when the cases of COVID-19 were first reported, millions of people have been affected by the pandemic in some way. Social media has played a major role in generation and dissemination of information about the pandemic. This information on the social media has been posted by a wide range of individuals and organizations including government agencies, health organizations or professionals, news organizations or reporters, for profit and nonprofit organizations, and political, religious, corporate, or community leaders. Irrespective of the content or modality, the main objective of people/organizations posting information on social media is to spread their message to as many people as possible. The objective of this research is to examine the factors that contribute to user engagement with video content posted on YouTube on COVID-19 related topics. As such, the influence of YouTube videos about COVID-19 is examined within the context of narrative persuasion as compared with argument-based persuasion. This research is based on a unique approach to first analyze the content of YouTube videos in terms of having argument-based persuasive elements versus having narrative-based persuasive elements using text analysis. Content of videos is then related to user engagement metrics to assess which type of content (argument-based versus narrative-based) can generate greater user engagement. Data for the study were collected from YouTube videos about COVID-19 (N=831). Content of selected videos was extracted in the form of transcripts of posted videos and analyzed using Linguistic Inquiry and Word Count 2015 (LIWC2015) (Pennebaker et al., 2015a;Pennebaker et al., 2015b). Measures of argument-based content of videos (analytical thinking and clout) and narrative-based (authentic and emotional tone) were based on variables reported by LIWC2015. YouTube engagement metrics reflect how viewers interact with posted videos. Of the four publicly available engagement metrics three were used (number of likes, number of dislikes, and number of comments) as dependent variables. Overall, results indicate that narrative-based content in YouTube videos related to COVID-19 have stronger relationship with viewer engagement compared with argument-based content on the same platform. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Around the World in Eighty Days: Some Insights for Health Policies from Early Incidence, Fatality, and Recovery Data of Covid-19

Covid-19 is different from previous pandemics in many respects and singularly striking for an exceptionally unique phenomenon. Never before has an infection gone around the world to 216 countries in a short span of eighty days. This paper compares the incidence, fatality and recovery from Covid-19 data to discern patterns, examine differences in approach and draw lessons for health policy and health systems with data of first eighty days from the first infection in each country. The purpose of this paper is threefold: first, to compare responses of high income and low income countries from the perspective of spread, control measures, containment, tracing and treatment;second, to examine whether greater societal development or prosperity is associated with better outcomes for recovery of infected patients or lower fatality;and thirdly, to consider institutional differences that may explain differences in outcomes. For the study, we included countries with high infection rates [United States of America (USA), United Kingdom (UK), Italy, China, and Saudi Arabia] and also those with low infection rates (Vietnam, Japan, South Korea, New Zealand, and India). We conclude that health systems in high-income countries can learn to be resilient from the experience of other high income countries and also from low-income countries. Timely interventions and administrative initiatives can bring about an enormous difference in outcomes. © 2022 Adani Institute of Infrastructure.

Donation after circulatory death liver transplants are higher and unevenly distributed in the United States after the implementation of the acuity circle allocation policy

Background: This study aimed to assess the impact of the recently (02/2020) implemented Acuity Circles (AC) liver allograft allocation policy on MELD at transplant and Donation after Circulatory Death (DCD) rates. Methods: Study period: 01/2016- 08/2021. Data retrieved from SRTR database. Inclusion criteria: All DCD liver transplants (LT). The cohort was dichotomized into a pre- and post-AC era. DCD rate (defined as DCD/ 50k population/year) was calculated for each State. The change (Δ) on the DCD rate (ΔDCD) and the MELD (ΔMELD) between the two periods was also calculated. Results: 1. Total LT increased in the post-AC era (26%/50k vs. 15%/50k, p=0.0567). 2. DCD LT increased in the post-AC era (15%/50k vs.10%/50k, p=0.0885). 3. MELD increased in the post-AC era in nearly all States (ΔMELD, fig.1, 2 & 3). 4. Uneven distribution of pre- & post-AC DCD activity, with a few States driving DCD LT in the US (fig.4 & 5). 5. Arizona and Louisiana had the highest pre-AC DCD rates (58%/50k & 31%/50k, respectively;fig.3). 6. The top post-AC DCD rate was reached in Arizona (78%/50k, fig.5). 7. Top post-AC ΔDCD was noted in Arkansas & Arizona (fig.6). 8. The highest ΔMELD was noted in low DCD/ negative ΔDCD areas (fig.7). 9. The lowest ΔMELD was noted in areas with the highest DCD rate (fig.7) 10. The State with the highest DCD rates pre-AC had the highest ΔDCD (fig.5). 11. 10/11 States with negative ΔDCD were located North of the 35o. Conclusions: AC implementation coincided with an increase in the overall LT & DCD LT activity. However, causation remains to be clarified, given the concurrent opioid crisis and SARS-CoV-2 pandemic. There was remarkable DCD rate variation. States with high DCD rates/ΔDCD demonstrated greater adaptability in the allocation change, maintaining low ΔMELD across eras. (Figure Presented).

Resuming Elective Laparoscopic Surgery during COVID-19 Pandemic: Our Experience and Challenges Faced

Background: SARS-CoV-2 virus infection was detected and discovered in Wuhan, China, in December 2019, and it was declared a pandemic by WHO in March 2020. Since then a lot of changes were noticed in surgical practice. Various recommendations were released by eminent surgical associations all over the world. This study was designed to study and analyze the findings and experience after resuming elective minimal invasive surgery during the pandemic. Materials and methods: This observational study was conducted at St Joseph’s Hospital, Ghaziabad, from May 2020 to May 2021. Various preoperative and postoperative findings were noticed and analyzed. The presence of SARS-CoV-2 virus was also analyzed in endotracheal aspirate and surgical smoke. Observation and results: A total of 287 cases underwent surgery. Most commonly performed surgery was laparoscopic cholecystectomy. The positivity rate for SARS-CoV-2 during preoperative work-up was 2.87%. Slightly more than 5% of cases in postoperative period had COVID-19-like symptoms. None of those patients were found positive on RT-PCR, and X-ray/CT findings were also suggestive of early postoperative changes only. Presence of SARS-CoV-2 virus was not detected in either endotracheal aspirate or surgical smoke. Neither surgery team nor OT staff had infection during this period. There was no mortality, and only 1 patient was found to be infected 2 weeks after discharge. Conclusion: Minimal invasive surgery for elective cases can be safely performed by taking precautions like PPE and smoke evacuation system during the COVID-19 pandemic. There is no evidence of transmission of infection through endotracheal aspirate or surgical smoke.

Air Quality Decrement after Lockdown in Major Cities of Rajasthan, India

The lockdown restrictions during the COVID-19 pandemic provided a 'path' of reinstatement of the air quality globally. Despite several financial challenges, air quality improvement positively impacted the environment due to lockdown in the worst pandemic situations. The present study assessed the air pollution scenario in the post lockdown phase in the seven major metropolises of Rajasthan, namely, Jodhpur, Alwar, Jaipur, Kota, Pali, Ajmer, and Udaipur) in the recent pandemic year 2020. The air pollution scenario is determined with the help of the Air Quality Index (AQI) and the concentration level of PM2.5 PM10, NO2, and SO2. This study reveals that Most Cities of Rajasthan are violating India's national ambient air quality standards (NAAQS). It is found that Jodhpur is on rank first in terms of pollution levels, followed by Alwar, Jaipur, Pali, and Udaipur. The pollution level was higher before the lockdown period then reduced to a certain level due to restricted activities in lockdown. The pollution level is not rapidly increased after lockdown due to rainfall occurred in Rainy season from Southwest monsoon. Winter Season consists of higher concentration levels of pollutant and higher than Before Lockdown Period. The study shows the Significant impact of lockdown in reducing air pollution levels in cities. But imposing lockdown in a city or country is not a permanent solution to curb air pollution. So, regulating agencies and stakeholders should implement better control and reduction technologies for Indian cities. © The Electrochemical Society

Variation in NO2 Concentrations Associated With COVID-19 for Kota City, Rajasthan, India

This study focuses on how the covid-19 pandemic impacts NO2 concentration in Kota City, Rajasthan (India), under different metrological conditions (Temperature, Precipitation, Relative Humidity, and Wind speed and direction). A reduction in NO2 concentration (-55%) was observed due to the Lockdown in Kota city. A sharp decrease of -37% in NO2 levels was observed in lockdown compared to the same period of 2019. However, a massive increase of 57% in NO2 levels was also seen in 2021 compared to the 2020 lockdown period. This study shows the lockdown effect on atmospheric composition, mainly through massive traffic and anthropogenic emissions reduction, significantly reducing NO2 concentrations. The findings can give confidence to stakeholders involved in air quality policy that if better pollution control plans are put in place and strictly implemented, pollution prevention can be done well. The natural environment and air quality have greatly improved due to lockdown. © The Electrochemical Society

Ensuring Social Distancing using Artificial Intelligence: Distancia-the new normal

COVID-19 has impacted the lifestyle worldwide. Health, economy, daily routines, work culture, research, mode of communications etc. all have been adversely affected and a new normal has been defined. Until an effective and reliable vaccine is developed, social distancing is one of the key solutions to prevent the virus from affecting the community as lockdown is never a permanent solution to this problem. In order to ensure proper social distancing at any organization, a system is developed that is able to detect whether the people are following social distancing norms by using the proposed 'Distancia-the new normal Algorithm'. The system is designed such that it gives an alert whenever the social distancing norms are violated. It can be deployed with a CCTV camera, so that the live footage fetched by the CCTV can be directly used by the system for checking that the social distancing is being followed or not. Any organization regardless of the number of employees can use this system. Existing mobile applications designed for this purpose cannot be used at schools, educational institutes or any other organization where the use of mobile phones is prohibited. Also, since the effect of rain is not considered in any of the existing system, therefore the present applications can only be deployed at limited places where there is no hindrance caused by rain/snow etc. Thus, the proposed system can prove to be of great importance for organizations where keeping a check of the social distancing is difficult. © 2021 IEEE.

Challenges in contact tracing and sampling in three districts of western Rajasthan during the COVID-19 pandemic

Introduction: Contact tracing commenced in districts of Western Rajasthan in March 2020 to control the spread of Covid-19.It was an ongoing process involving isolation and sampling of contacts. Multi department Quick and Rapid response teams (Q/RRT) worked continuously as the pandemic passed through different stages. The objectives of the study was to compare the challenges faced during contact tracing and document good practices in place. Methods: A cross –sectional study was done among contact tracers using a semi structured questionnaire in Google forms in three districts of Pali, Jodhpur and Barmer. Keeping power of study at 80%, 5% error and 95% confidence interval, assuming 50% prevalence of effective contact tracing and 10 % non-response total 400, i.e 133 participants from each district. Results: Major challenges faced by tracers were resistance to contact sampling (64%)lack of training (49%), and random sampling workload (47%). Overall 36% of contacts had downloaded the Aarogya setu app but among them only 68% were using the app. Trainings, workload distribution and inter-sectoral coordination was best in Jodhpur, Barmer and Pali respectively. Conclusions: Trainings helped in better field management of resistance to sampling among contacts. Excessive workload of lab technicians lead to errors in reporting. Transport for sampling of contacts was a challenge in remote areas. The Aarogya setu app was not used by all contacts. Regular feedback meetings by local administration helped in effective contact tracing.

The impact of the COVID-19 pandemic on the delivery of primary percutaneous coronary intervention in STEMI

Objectives: The clinical environment has been forced to adapt to meet the unprecedented challenges posed by the COVID-19 pandemic. Intensive care facilities were expanded in anticipation of the pandemic where the consequences include severe delays in elective procedures. Emergent procedures such as Percutaneous Coronary Intervention (PCI) in acute myocardial infarction (AMI) in which delays in timely delivery have well established ad-verse prognostic effects must also be explored in the context of changes in procedure and public behaviour as-sociated with the COVID-19 pandemic. The aim for this single centre retrospective cohort study is to determine if door-to-balloon (D2B) times in PCI for ST Elevation Myocardial Infarction (STEMI) during the United Kingdom's first wave of the COVID-19 pandemic differed from pre-COVID-19 populations. Methods: Data was extracted from our single centre PCI database for all patients that underwent pPCI for STEMI. The reference (Pre-COVID-19) cohort was collected over the period 01-03-2019 to 31-05-2019 and the exposure group (COVID-19) over the period 01-03-2020 to 31-05-2020. Baseline patient characteristics for both populations were extracted. The primary outcome measurement was D2B times. Secondary outcome measurements included: time of symptom onset to call for help, transfer time to first hospital, transfer time from non-PCI to PCI centre, time from call-to-help to PCI centre, time to table and onset of symptoms to balloon time. Categorical and continuous variables were assessed with Chi squared and Mann-Whitney U analysis respectively. Procedural times were calculated and compared in the context of het-erogeneity findings. Results: 4 baseline patient characteristics were unbalanced between populations with statisti-cal significance (P<0.05). The pre-covid-19 cohort was more likely to have suffered out of hospital cardiac arrest (OHCA) and had left circumflex disease, whereas the 1st wave cohort were more likely to have been investigated with left ventriculography and be of Afro-Caribbean origin. No statistically significant difference in in-hospital procedural times was found with D2B, C2B, O2B times comparable between groups. Pre-hospital delays were the greatest contributors in missed target times: the 1st wave group had significantly longer delayed time of symptom onset to call for help (Control: 31 mins;IQR [82.5] vs 1st wave: 60 mins;IQR [90.0], P=0.001) and time taken from call for help to arrival at the PCI hospital (control: 72 mins;IQR [23] vs 1st wave: 80 mins;IQR [66.5], P=0.042). Conclusion: Enhanced infection prevention and control procedures considering the COVID-19 pandemic did not impede the delivery of pPCI in our single centre cohort. The public health impact of the pandemic has been demonstrated with times being significantly impacted by patient related delays. The recovery of public engagement in emergency medi-cal services must become the focus for public health initiatives as we emerge from the height of COVID-19 disease burden in the UK.

Interplay of shared leadership practices of principals, teachers' soft skills and learners' competitiveness in covid 19 era: Implications to economics of educational leadership

The COVID 19 pandemic had a significant impact on both the administration and instructional delivery. A close partnership between administrators and teachers is essential to students' overall growth, particularly in this COVID 19 era. This study employed a descriptive correlational research design. A survey was done using online to selected schools in South East Asian countries. From the study, it can be inferred that the highly positive results are seen on the level of principal shared leadership practices are manifested by the school heads, teachers' soft skills enhancement, and learners' competitiveness. The school heads are capable of exuding shared leadership aspects on effective communication, proper coordination, direction, and influence. Test of relationship showed a positive interplay between principals' shared leadership with the selected variables on teachers' soft skills and learners' competitiveness. Research on the comparative impacts of leadership styles will assist policymakers and practitioners in better understand which leadership techniques are most successful for specific elements of school reform efforts, in our view. Further, the implications of this study will help teachers better their interpersonal and administrative abilities while administrators are urged to continue to improve their leadership techniques. The result of this present study will provide a way for policymakers and other stakeholders to fund allocation and develop a plan of action to strengthen principal leadership in the COVID 19 era. © 2021 Ascociacion Internacional de Economia Aplicada. All Rights Reserved.

The management of severe aortic stenosis during the COVID-19 pandemic: An observational study comparing TAVI and SAVR

Introduction: Outcomes and characteristics of patients with severe aortic stenosis (AS) treated during the COVID-19 pandemic is unknown. Methods: This was a single-centre observational study of patients undergoing AS treatment with transcatheter (TAVI) or surgical (SAVR) therapy during the first-wave of the UK COVID-19 pandemic compared to a control cohort undergoing treatment in 2019. Demographics, baseline echocardiogram, CT, procedural characteristics and outcome data were collated. The primary outcome was 30-day allcause mortality. The secondary endpoint was duration of post-procedural hospitalisation. Results: 319 patients were recruited - 122 underwent intervention during the pandemic [73 TAVI;49 SAVR] and 197 in 2019 [127 TAVI;70 SAVR]. In 2020, TAVI patients had a higher Euroscore II (p<0.001) but there were no differences in procedural complications or mortality [p=0.16] compared to TAVI 2019 cases. Duration from TAVI to discharge was shorter in 2020 (p<0.001). SAVR 2020 patients had similar baseline profile [p=0.48], surgical characteristics, mortality (p=0.68) and duration from SAVR to discharge compared to those in 2019. During the pandemic, TAVI patients were older (p<0.001) and had a higher Euroscore II (p<0.001) than SAVR counterparts. TAVI patients had reduced 30-day mortality [0 (0%) vs 3 (6%);p=0.06] and were discharged more rapidly post-intervention than SAVR patients [median 1 [1] vs 7 [4] days;p<0.001) translating into shorter hospitalization (p<0.001). Conclusions: TAVI and SAVR can be safely delivered with predictable resource utilisation during a pandemic. Despite the TAVI cohort incorporating higher risk, older patients, outcomes were at least as good as SAVR with a shorter length of post-procedural hospitalisation.

Natural infection of Delta mutant of SARS-CoV-2 in Asiatic lions of India.

The current pandemic caused by a novel coronavirus (SARS-CoV-2) has underlined the importance of emerging diseases of zoonotic importance. Along with human beings, several species of wild and pet animals have been demonstrated to be infected by SARS-CoV-2, both naturally and experimentally. In addition, with constant emergence of new variants, the species susceptibility might further change which warrants intensified screening efforts. India is a vast and second most populated country, with a habitat of a very diverse range of animal species. In this study we place on record of SARS-CoV-2 infections in three captive Asiatic lions. Detailed genomic characterization revealed involvement of Delta mutant (Pango lineage B.1.617.2) of SARS-CoV-2 at two different locations. Interestingly, no other feline species enclosed in the zoo/park were found infected. The epidemiological and molecular analysis will contribute to the understanding of the emerging mutants of SARS-CoV-2 in wild and domestic animals.

SARS Covid-19- Call of Threat: Attributes and Current Approach

COVID -19 disease (Coronavirus) is a contemporary strain of coronavirus species which has initially appeared in Wuhan city, China. Over the few months it has spread to various regions of the world. It is observed that COVID-19 is able to get transmitted from human to human contact, by means of droplets sustained in the air as aerosols, fomites etc. WHO (World Health Organization) has declared the current outbreak to be a public health emergency globally. Asthe disease is life threatening, there is a crucial need for effective drugs. Optimistic nurture remains the backbone of the therapy. Despite the COVID-19 patients having benign or mild courses, up to 5% -10% can have serious;probably life alarming courses, there is a crucial need for effective drugs. There have been several clinical trials persisting, various immune regulating and antiviral agents for assessments of COVID-19 in those investigations and some of them would be reported in later couple of days. Although the critical need to find an efficient antiviral medication for COVID-19 through randomized controlled investigation, certain agents are being utilized all over the world, established on either envisioned evidence, in vitro or experimental studies. Presently, the research investigation on SARS COVID-2 is in the initial stages. Based on ongoing published information, this review article consistently summarizes the pathological analysis, clinical symptoms, prevention and treatment of COVID-19. Generally, maximum used therapeutic agents in India and all over the world includes hydroxychloroquine, chloroquine, remdesivir, favipiravir, lopinavir and Nitazoxanide. This review reports about Ivermectin to have an activity against SARS-COVID-19 in vitro, which is permitted for some other treatments of human diseases. It is assumed that this review willencourage the nation to recognize and handle COVID-19 and contribute for prospective studies.

SARS patients: Use of convalescent plasma therapy in rural area

Aims & Objectives: Aim and Objective- In order to evaluate the efficacy of convalescent plasma therapy in the treatment of patients with severe acute respiratory syndrome (SARS), Patients/Materials & Methods: Patients- 38 patients. Material and method- After the assessment of the donor, 200600 mL plasma can be collected with apheresis devices. Donor eligibility, Predonation evaluation of donors, Donor recruitment, Collection of convalescent plasma at apheresis centers. Results: Results 37 SARS patients were given convalescent plasma at K.D MEDICAL COLLEGE MATHURA UP, between 09 SEPTEMBER and 13 OCTOBER 2020. Good outcome was defined as patient responded to plasma therapy in 24 to 48 h after infusion. Poor outcome was defined as no response or death after 48 h of infusion. Discussion & Conclusion: Conclusion- CP seems to be a safe and probably effective treatment for critically ill patients with COVID19. It could also be used for prophylactic purposes but the safety and effectiveness of this approach should be tested in randomized prospective clinical trials.

Emotional analysis using twitter data during pandemic situation: Covid-19

During the crisis situation caused due to COVID-19 disease, managing mental health and psychological well-being is as important as physical health of people. As web based life is broadly utilized by individuals to communicate their feeling and supposition, our framework utilizes Twitter information posted by individuals during this emergency circumstance to dissect the feelings of individuals. For processing the cleaned data NRC Word-Emotion Association Lexicon (have aka EmoLex) is used. NRC Word-Emotion Association Lexicon is a list of English with real-valued scores of intensity for eight basic emotion words ns (anger, anticipation, disgust, fear, joy, sadness, surprise, and trust). The text content of tweeter dataset created by fetching tweets across the world have classified into basic emotions like anger, anticipation, disgust, fear, joy, sadness, surprise and trust. This analysis can be used by authorities to understand the mental health of the people and can take necessary measures to decide on policies to fight against coronavirus which is affecting the social well-being as well as economy of the whole world. © 2020 IEEE.

An institutional based study on imaging conundrum of newly diagnosed coronavirus disease 2019 (Covid-19) – a retrospective analysis in India population

Introduction: Coronavirus disease-2019 (COVID-19) was announced as a pandemic by the World Health Organization (WHO) on March 11, 2020. According to a WHO report on COVID-19, the disease has nospecific manifestation and the patient's pres-entation can range from completely asymptomatic to severe pneumonia and death. Objective: To retrospectively characterize and interpret the spectrum of chest computed tomography (CT) imaging features of Coronavirus disease-19 (COVID-19) in infected Indian population and to correlate CT total severity score with clinical classification and study extra-pulmonary manifestation of Corona-virus disease 2019 (COVID-19). Methods: A retrospective single-centre study was conducted on patients with COVID-19 from May 10, 2020, to July 13, 2020, in tertiary care Max super specialty hospital, Delhi, India. A total of 532 patients either laboratory-confirmed or strongly suspected of having COVID-19 underwent CT chest and their imaging features were analyzed and interpreted in detail and studied for extra-pulmonary manifestation of COVID-19. The consistency of observers was evaluated for CT total severity score (TSS) and TSS was compared with clinical classification. Result: This study included 532 patients, 10 patients were excluded from the study. Among a total of 522 patients in the study, 362 (69.3%) were males and 160 (30.7%) were females with a mean age of 52.75 years (range 14-88). According to the clinical subtype classification there were mild 17 (3.3%), common 355 (68.0%), severe 105 (20.1%) and critical 45 (8.6%) cases. 57 (10.9%) patients died and 37 (7.08%) patients showed extra-pulmonary manifestation of COVID-19. There were 17 patients with normal CT chest. Only 2 cases had unilateral lung disease and the rest of 503 cases showed bilateral lung involvement with multiple opacities and multiple lobe involvement. Diffuse lung involvement i.e. white lung noted in 10 cases and none of the patient had single lesion. Opacities on CT imaging tended to be both peripheral and central in most cases, followed by purely peripheral and rarely are with the purely central distribution. According to CT attenuation of opacity, Ground glass opacity (GGO), and the mixture of Ground glass opacity & consolidative opacities and consolidative opacities was the dominant abnormality founded almost in all cases. Perilesional or intralesional, thickened small vessel was observed in almost all cases. Accompany-ing signs were crazy paving (40.6%), reverse halo sign (10.9 %), subpleural lines (47.9%), air bronchogram (28.4%), bronchiec-tasis (18.6%), pleural effusion (5.6%) and mediastinal lymphadenopathy (4.8%). Follow up scanning was obtained in 28 cases, showed no change in 2 cases, turned better in 12 cases, and became worse in 14 cases on follow up imaging studies. Conclusions: The typical pattern of COVID-19 pneumonia in Delhi, India, was ground glass opacity in the form of pure ground glass opacity, ground glass opacity with superimposed crazy paving pattern or Ground glass opacity admixed with consolidation with intralesional vascular enlargement were the most dominant lung parenchymal abnormalities with the peripheral and pos-terior distribution encountered in most of the cases. In the short term follow-up, more patients had disease progression rather than absorption. Proportion of patients [17 (3.2%)] with normal CT chest in laboratory-confirmed COVID-19 was relatively low;hence chest CT may play a complementary role in the early detection of COVID-19 pneumonia and could be regarded as a diagnotic standard of COVID-19. COVID-19 is progressive viral pneumonia with broad spectrum of clinical manifestations and can also present with extra-pulmonary manifestations . © IJCRR.