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Currently, there is no availability of any proven specific treatment or prevention strategy to fight against COVID-19. Convalescent plasma (CP) therapy is expected to increase survival rates in COVID-19 as in the case of emerging viral infection (SARS-CoV and MERS-CoV). To collect all the studies relevant to CP therapy in critically ill or severe COVID-19 patients and summarize the findings. The systematic review was conducted according to the PRISMA consensus statement. A systematic search was performed in PubMed, Scopus, Web of Science, and Cochrane databases on April 25, 2020. A total of six studies (28 patients) relevant to CP therapy in severe or critical COVID-19 are considered for inclusion. Two authors extracted the data about study characteristics, demographics, symptoms, co-morbidities, clinical classification of COVID-19, drug therapies, oxygen therapy, laboratory results, chest CT, neutralizing antibody titer, SARS-CoV-2 RNA load, aal outcome. The review findings revealed that CP therapy increases lymphocyte count, reduced s serum inflammatory markers (CRP, IL-6, Procalcitonin) and liver enzyme levels (AST or ALT). There was a rise in serum neutralizing antibody titers in 10 of 14 patients after CP transfusion. In 4 of 14 patients, the titer levels remain unchanged after CP transfusion. All 28 cases (100%) achieved negative to the SARS-CoV-2 RNA after CP transfusion. The convalescent plasma transfusion can improve neutralizing antibody titers and reduces the viral load in severe/critical COVID-19 patients. The review recommends a well-controlled trial design is required to give a definite statement on the safety and efficacy of convalescent plasma therapy in severe/critical COVID-19.
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Introduction Covid‐19 is linked with the development of cardio‐metabolic disorders, including dyslipidemia, dysregulation of high‐density lipoprotein (HDL), and low‐density lipoprotein (LDL). Furthermore, SARS‐Co‐2 infection is associated with noteworthy changes in lipid profile, which is suggested as a possible biomarker to support the diagnosis and management of Covid‐19. Methods This paper adopts the literature review method to obtain information about how Covid‐19 affects high‐risk group patients and may cause severe and critical effects due to the development of acute lung injury and acute respiratory distress syndrome. A narrative and comprehensive review is presented. Results Reducing HDL in Covid‐19 is connected to the disease severity and poor clinical outcomes, suggesting that high HDL serum levels could benefit Covid‐19. SARS‐CoV‐2 binds HDL, and this complex is attached to the co‐localized receptors, facilitating viral entry. Therefore, SARS‐CoV‐2 infection may induce the development of dysfunctional HDL through different mechanisms, including induction of inflammatory and oxidative stress with activation of inflammatory signaling pathways. In turn, the induction of dysfunctional HDL induces the activation of inflammatory signaling pathways and oxidative stress, increasing Covid‐19 severity. Conclusions Covid‐19 is linked with the development of cardio‐metabolic disorders, including dyslipidemia in general and dysregulation of high‐density lipoprotein and low‐density lipoprotein. Therefore, the present study aimed to overview the causal relationship between dysfunctional high‐density lipoprotein and Covid‐19. While Covid‐19 is linked with the development of cardio‐metabolic disorders, including dyslipidemia and dysregulation of high‐density lipoprotein and low‐density lipoprotein, this study aimed to overview the causal relationship between dysfunctional high‐density lipoprotein and Covid‐19.
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The primary purpose of this study is to investigate the relationship between tail risk and systemic risk in financial technology (Fintech) companies. The study also analyzes the role of the tail and systemic risk in Fintech firms during the COVID-19 outbreak. The exponential increase in digital users of financial applications demonstrates the tremendous growth of the Fintech industry during COVID-19. Thus, the analysis of the association between tail risk, systemic risk, and Fintech is conducted on a deluxe sample of Fintech companies. From December 2019 to February 2022, the data of Fintech enterprises is compiled. The extreme value theory serves as the theoretical lens for determining the tail risk of based Fintech companies. The lower value of technology companies suggests a long tail for Fintech companies. The thicker tail suggests that Fintech firms grew dramatically throughout the COVID-19 timeframe. Few firms in our sample have the fattest tail, indicating that these enterprises were highly exposed to risk during COVID-19. Furthermore, the data indicate that the systemic risk of Fintech firms during COVID-19 depends on the global technology index. The likely explanation for these results is that during COVID-19, Fintech firms' clients grew faster than customers in other industries. During the COVID-19 epidemic, Fintech firms have raised their tails. This study is among the first and will aid regulators, financial professionals, and researchers in gaining a better grasp of the challenges surrounding tail risk and systemic risk in Fintech companies. © 2022, International Journal of Economics and Finance Studies. All Rights Reserved.
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Tokyo Summer Olympics and Paralympics have raised social issues regarding the potential rise in COVID-19 cases in Japan and risks associated with the safe organization of mega sporting events during the pandemic, such as the FIFA World Cup Qatar 2022. This study investigates the Tokyo Summer Olympics as a unique case study to clarify the drivers of infectivity and provide guidelines to host countries for the safe organization of subsequent international sporting events. The result here reveals that Tokyo and Japan did not experience a rise in confirmed cases of COVID-19 due to the hosting of the Summer Olympics. Still, transmission dynamics seems to be mainly driven by the high density of population (about 1.2%, p-value <0.001) like other larger cities in Japan (result confirmed with Mann-Whitney U test, significance at 0.05). Our study provided evidence that hosting mega sporting events during this COVID-19 pandemic is safe if strictly maintained the precautions with non-pharmaceutical (and pharmaceutical) measures of control of infections. The Tokyo Summer Olympics hosting will be exemplary for next international events due to the successful implementation of preventive measures during COVID-19 pandemic crisis.
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Coronavirus disease 2019 (COVID-19) is caused by a novel virus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). SARS-CoV-2-induced hyperinflammation together with alteration of plasma proteins, erythrocyte deformability, and platelet activation, may affect blood viscosity. Thus, this review aimed to study the link between SARS-CoV-2 infection and alteration of blood viscosity in COVID-19 patients. In order to review findings related to hyperviscosity in COVID-19, we suggested a protocol for narrative review of related published COVID-19 articles. Hyperviscosity syndrome is developed in different hematological disorders including multiple myeloma, sickle cell anemia, Waldenstorm macroglobulinemia, polycythemia, and leukemia. In COVID-19, SARS-CoV-2 may affect erythrocyte morphology via binding of membrane cluster of differentiation 147 (CD147) receptors, and B and 3 proteins on the erythrocyte membrane. Variations in erythrocyte fragility and deformability with endothelial dysfunction and oxidative stress in SARS-CoV-2 infection may cause hyperviscosity syndrome in COVID-19. Of interest, hyperviscosity syndrome in COVID-19 may cause poor tissue perfusion, peripheral vascular resistance, and thrombosis. Most of the COVID-19 patients with a blood viscosity more than 3.5 cp may develop coagulation disorders. Of interest, hyperviscosity syndrome is more commonly developed in vaccine recipients who had formerly received the COVID-19 vaccine due to higher underlying immunoglobulin concentrations, and only infrequently in those who have not received the COVID-19 vaccine. Taken together, these observations are untimely too early to give a final connotation between COVID-19 vaccination and the risk for development of hyperviscosity syndrome, consequently prospective and retrospective studies are necessary in this regard.
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The CAR-T cells are the genetically engineered T cells, designed to work specifically for the virus antigens (or other antigens, such as tumour specific antigens). The CAR-T cells work as the living drug and thus provides an adoptive immunotherapy strategy. The novel corona virus treatment and control designs are still under clinical trials. One of such techniques is the injection of CAR-T cells to fight against the COVID-19 infection. In this manuscript, the hypothesis is based on the CAR-T cells, that are suitably engineered towards SARS-2 viral antigen, by the N protein. The N protein binds to the SARS-2 viral RNA and is found in abundance in this virus, thus for the engineered cell research, this protein sequence is chosen as a potential target. The use of the sub-population of T-reg cells is also outlined. Mathematical modeling of such complex line of action can help to understand the dynamics. The modeling approach is inspired from the probabilistic rules, including the branching process, the Moran process and kinetic models. The Moran processes are well recognized in the fields of artificial intelligence and data science. The model depicts the infectious axis "virus-CAR-T cells-memory cells". The theoretical analysis provides a positive therapeutic action; the delay in viral production may have a significant impact on the early stages of infection. Although it is necessary to carefully evaluate the possible side effects of therapy. This work introduces the possibility of hypothesizing an antiviral use by CAR-T cells.
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Purpose This study aims to examine the factors influencing user satisfaction with unified payment interface (UPI)-based payment systems during the COVID-19 pandemic in India. The study also aimed to examine whether the user satisfaction with UPI-based payment systems during the COVID-19 pandemic will transform into their continuance intention post-COVID-19 pandemic. Design/methodology/approach The study was performed in three phases, i.e. pre-testing (for developing questionnaire), pilot study (using exploratory factor analysis to ensure unidimensionality) and the main study. The main study was based on the feedback from a sample of 369 internet users who first used the UPI-based payment system during the COVID-19 pandemic. Data generated were analysed using the structural equation modelling approach. Findings The study findings suggest that the users who are satisfied with UPI-based transactions during the COVID-19 pandemic are likely to continue their use of this payment mode in future. Factors such as post-adoption perceived value, perceived usefulness and post-adoption perceived risk were observed to be key constructs in explaining user satisfaction and continued intention for UPI-based payment systems. Originality/value The study is one of the pioneering studies, in the sense that it investigated the continuance intention of UPI-based payment systems, which, surprisingly, did not gain much attention from past researchers.
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Background: To determine the safety profile of Sinopharm COVID-19 vaccine and identify breakthrough infections. Method: The study design was analytical cross sectional. An online questionnaire was filled by 1033 respondents between 16th and 22nd April 2021. Adults who had received both doses of Sinopharm COVID-19 vaccine more th nd than a week ago or only a single dose with serious side effect were included in the study. The frequency and severity of vaccination related side effects were assessed and breakthrough infection identified. Results: The mean age of participants was 36.7 +/- 12.91(18 - 92) years. Ninety one percent of participants (n=946) were health care professionals. One fifth (n=225/1033, 21.8%) had suffered from COVID-19 infection prior to vaccination, confirmed using the nasal RT-PCR test. None of the participants reported serious (grade III) or life threatening (grade IV) adverse reactions after either of the two doses. The most common side effects after the first dose were pain at injection site (20.3%), fatigue (20.3%), headache (13.9%), myalgia (12.5%) and fever (9.3%) whereas after the second dose were fatigue (16.8%), pain at injection site (15.8%), myalgia (14%) and fever (6.7%). The side effects were more common in participants who had previous history of COVID-19 infection. Of 225 previously infected participants, 97(43.1%) (p value=0.020) and 90 (40%) (p value=0.001) participants had side effects after 1st and 2nd dose respectively. 16 participants (1.55%) developed PCR positive COVID-19 infection two weeks after the second dose while 3(0.29%) participants had a re-infection. There was one case of probable severe COVID-19 infection, 2 weeks after the second dose and recovered completely with treatment. Conclusion: Our study shows that Sinopharm COVID-19 vaccine is generally safe with no serious side effects. The side effects were however, more common in inviduals who already had COVID-19 infection. The COVID-19 breakthrough infection and reinfection could occur after the vaccination.
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COVID-19 pandemic-borne wastes imposed a severe threat to human lives as well as the total environment. Improper handling of these wastes increases the possibility of future transmission. Therefore, immediate actions are required from both local and international authorities to mitigate the amount of waste generation and ensure proper disposal of these wastes, especially for low-income and developing countries where solid waste management is challenging. In this study, an attempt is made to estimate healthcare waste generated during the COVID-19 pandemic in Bangladesh. This study includes infected, ICU, deceased, isolated and quarantined patients as the primary sources of medical waste. Results showed that COVID-19 medical waste from these patients was 658.08 tons in March 2020 and increased to 16,164.74 tons in April 2021. A top portion of these wastes was generated from infected and quarantined patients. Based on survey data, approximate daily usage of face masks and hand gloves is also determined. Probable waste generation from COVID-19 confirmatory tests and vaccination has been simulated. Finally, several guidelines are provided to ensure the country's proper disposal and management of COVID-related wastes.
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COVID-19 , Medical Waste Disposal , Medical Waste , Waste Management , Bangladesh/epidemiology , Delivery of Health Care , Humans , Pandemics , SARS-CoV-2ABSTRACT
Background : Cerebral venous sinus thrombosis (CVST) is rare in children. Its risk factors and outcome are largely unknown in low-middle income countries. Some case reports have shown presence of anemia in pediatric CVST as a probable risk factor. Aims : This study was done to determine the frequency of anemia in patients having pediatric CVST and to observe its association with the severity of disease. Methods : Patients between age 0 to 18 years of both genders diagnosed with sinus thrombosis during 2011 to 2020 were identified through international classification of diseases (ICD 9). Data was collected through in-house computerized system and SPSS version 19 was used for analysis. Results : Of 143492 patients who were admitted, 32 (21 males and 11 females) with a median (IQR) age of 4.5 years (0-16) had CVST. This is equivalent to 2.2 CVST events /10,000 pediatric admissions. Overall mortality was 3.4%. Primary underlying disorders were infections (59%), hematological neoplasms (12.5%), thrombotic thrombocytopenic purpura (3%) and antiphospholipid syndrome (3%). Significant laboratory findings were anemia (65%), low protein S (19%), low protein C (19%), low antithrombin III (6%) and activated protein C resistance (25%). Mean(±SD) hemoglobin in anemic patients was 9.0 g/dL (±2.3). SARS-COV2 was negative in patients tested in 2020. Regression analysis showed a positive association of anemia with multiple sinus involvement ( P 0.009) but anemia had no association with the duration of symptoms ( P 0.344), hospital stay ( P 0.466), age ( P 0.863) or gender ( P 0.542) of the patients. Conclusions : Low hemoglobin was observed in a significant proportion of patients with pediatric CVST. Anemia may be an important biomarker along with other clinical variables in the risk assessment of sinus thrombosis in children. Future studies may unveil the role of anemia in coagulopathy and more specifically in pediatric CVST.
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The CAR-T cells are the genetically engineered T cells, designed to work specifically for the virus antigens (or other antigens, such as tumour specific antigens). The CAR-T cells work as the living drug and thus provides an adoptive immunotherapy strategy. The novel corona virus treatment and control designs are still under clinical trials. One of such techniques is the injection of CAR-T cells to fight against the COVID-19 infection. In this manuscript, the hypothesis is based on the CAR-T cells, that are suitably engineered towards SARS-2 viral antigen, by the N protein. The N protein binds to the SARS-2 viral RNA and is found in abundance in this virus, thus for the engineered cell research, this protein sequence is chosen as a potential target. The use of the sub-population of T-reg cells is also outlined. Mathematical modeling of such complex line of action can help to understand the dynamics. The modeling approach is inspired from the probabilistic rules, including the branching process, the Moran process and kinetic models. The Moran processes are well recognized in the fields of artificial intelligence and data science. The model depicts the infectious axis “virus—CAR-T cells—memory cells”. The theoretical analysis provides a positive therapeutic action;the delay in viral production may have a significant impact on the early stages of infection. Although it is necessary to carefully evaluate the possible side effects of therapy. This work introduces the possibility of hypothesizing an antiviral use by CAR-T cells.
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Purpose The discourse aimed to investigate green finance practices under the assumptions of several notable climate advisors and speculators in Asia and particularly in Southeast Asia. The study intrigues by considering financial specialists to vent government spending on green restoration plans leading toward green bankable venture openings for the public and private sector. This section distinguishes a few of the green fund components and approaches that can be joined by national and neighborhood governments, essentially in Southeast Asia, into their post-COVID-19 techniques, but are too valuable inputs for domestic commercial banks and private corporates. Design/methodology/approach It can be defined as a functional type for Cobb Douglas development. ARDL technology is a way of calculating complex forces at the classification level at long-term and short-term stages. This ARDL approach has many advantages and can be implemented when incorporated in level I (0) and level I first (1) with the original variable. Still, it offers robust ability to the outcomes and standardizes the lag, considering the number and sample size used. Pooled mean group (PMG) method is becoming a convenient technique for monitoring data over the period and a good approach for energy impact panels - growth ties for creating links between energy emissions and environmental sustainability and businesses in the nation. Findings There is a positive partnership between creativity and a sustainable world. Corporations are recommended to uphold the principles of CSR in the development process by introducing environmentally friendly advanced technologies. The main objectives of corporate social responsibility (CSR) are economic growth, environmental sustainability and social justice. Several programs have been established to expand businesses' responsibilities to improve their confessions in sustainable growth. SMEs are a primary source of production of innovative products and technologies. The key concerns of stakeholders and politicians in the new competitive business climate are the protection of environmental sustainability and social responsibility, recognizing factors driving economic development for SMEs. Originality/value During the COVID-19 era, the prime responsibility of pandemic confronting governments is to spend on help activities (that have been started in earlier phase) and recovery endeavors (yet to start in the situation). Therefore, the governments may devise policies to pool resources from commercial, private, public-private partnerships and other capital market sources. With rising hazard recognitions particularly emerging from at-threat income projections, governments ought to make the correct mechanisms and instruments that can perform this catalytic part of derisking and drawing in such capital. This too can be an opportunity for governments to enhance and execute such financial instruments that offer assistance, quicken their commitments to climate alter beneath the Paris Agreement and the sustainable development goals (SDGs), and thus "build back better" is being progressively voiced over the world.
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Objective: To determine the impact of COVID-19 pandemic on vaccination of the children under two years of age. Study Design: An analytical cross-sectional study. Place and Duration of Study: A multi-center study conducted at the Children’s Hospital Lahore, Allama Iqbal Teaching Hospital, Sialkot and Idress Teaching Hospital, Sialkot over a period of 2 weeks. Material and Methods: We used a structured questionnaire to interview 345 participants, selected through non-probability convenience sampling. Results: A total of 345 children were enrolled, mean age was 7.74 ± 4.48 (range 1-24) months. In 158 (45.8%) children, vaccination during pandemic was complete, It was delayed in 117 (33.9%) and 70 (20.3%) children missed their vaccination. 14 (4%) participants missed BCG and OPV at birth, 31 (9%) missed first and 21 (6%) missed second dose of pneumococcal, pentavalent, rotavirus vaccine and oral polio vaccine (OPV). Whereas 19 (5.5 %) missed third dose of pneumococcal, pentavalent and OPV as well lPV, while 16(4.6 %) and 12 (3.4 %) missed first and second dose of measles vaccine. Fear of getting infected with COVID-19 was the major reason for missing and a transportation issue during lockdown was the commonest reason for delaying vaccination. Univariate analysis showed lower educational status of father, low monthly income and distance from vaccination center had significant impact on missing the vaccination. Conclusion: The COVID-19 pandemic had a negative impact on routine immunization in Pakistan with a delay in one third and missed vaccination in 20% of children less than 2 years of age. The major factors responsible were the fear of getting COVID-19 infection and logistic issues.
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Face masks are playing an essential role in preventing the spread of COVID-19. Face masks such as N95, and surgical masks, contain a considerable portion of non-recyclable plastic material. Marine plastic pollution is likely to increase due to the rapid use and improper dispensing of face masks, but until now, no extensive quantitative estimation exists for coastal regions. Linking behaviour dataset on face mask usage and solid waste management dataset, this study estimates annual face mask utilization and plastic pollution from mismanaged face masks in coastal regions of 46 countries. It is estimated that approximately 0.15 million tons to 0.39 million tons of plastic debris could end up in global oceans within a year. With lower waste management facilities, the number of plastic debris entering the ocean will rise. Significant investments are required from global communities in improving the waste management facilities for better disposal of masks and solid waste.
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COVID-19 , Plastics , Humans , Masks , Oceans and Seas , SARS-CoV-2ABSTRACT
Objective: To find out the association of ABO blood groups with severity and outcome of Corona Virus Disease 2019 (COVID-19) infection in children presenting to a single tertiary care hospital. Study Design: Descriptive cross-sectional study. Place and Duration of Study: The study was conducted inThe Children's Hospital & ICH Lahore from March 2020 to September, 2020. Material and Methods: This study included all the laboratory-confirmed cases of COVID-19 and post-COVID (MIS-C)/Kawasaki like illness admitted to Corona Isolation ward. The blood groups were recorded and the disease course was followed. Results: Of a total of 74 admitted children, 66 children in which blood group was available were included. Of these, 45 (68%) were COVID-19 and 21(32%) MIS-C/ Kawasaki like illness temporally associated with SARS-C0V2. The mean age was 7.9 ± 4.1 years with a male preponderance 38/66 (57%). Majority 62 (94%) had Rh-positive blood, O blood group was the predominant group 25 (38%) followed by B in 23 (35%) and A in 17 (26%). Majority of children had mild to moderate illness 38 (58%), while 23 (35%) had severe or critical disease. Among all patients 24(36%) had some underlying comorbidity. Blood group A was significantly associated with severe and critical disease (p=0.030). Our case fatality rate was 7.6% and underlying comorbid conditions were significantly associated with a fatal outcome (p=0.035). Conclusion: COVID-19 in children has generally a good outcome but children with blood group A are more susceptible to severe/critical disease. The presence of an underlying comorbid conditions is also a risk factor for poor outcome. .
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Objective: To determine the spectrum of clinical presentation, multisystem involvement and treatment outcome in children with MIS-C. Study Design: A descriptive cohort study Place and Duration of Study: Conducted at The Children's Hospital and Institute of Child Health, Lahore from May 15, 2020 to November 22, 2020. Material and Methods: Children (aged 0-16 years) with features of this new inflammatory syndrome who fulfilled the WHO criteria for MIS-C and required admission to hospital were prospectively identified. Demographic and clinical data were collected from patient records and entered on a predesigned proforma and results were analyzed on SPSS 20. Results: A total of 24 patients were enrolled in the study. Majority were males (17/24, 70%). Mean age of presentation was 7.3 years. Six patients (25%) had a positive PCR for SARS CoV-2 but none of the patients had been symptomatic with classic COVID-19 respiratory symptoms in the 6 weeks prior to admission. Comorbid conditions were present in only 2 patients (8%). SARS-CoV-2 antibodies were positive for 23/24 patients (96%). Despite being clinically unwell, with laboratory evidence of elevated C-reactive protein, ferritin, and D-dimers, no pathological organism was isolated in any of the 24 children. There were two major presentations: one as atypical or typical Kawasaki disease (18 of 24, 75%) and a more severe second one with shock or low cardiac output (6 of 24, 25%). Common presenting features were fever, body aches, and abdominal pain. Four out of 24 (16%) patients had sufficient criteria for typical Kawasaki disease, whereas 18 children (75%) presented more sub acutely with presentation resembling Kawasaki disease;all had at least two features of classic Kawasaki. Myocardial dysfunction seen in 3 patients (12%) and pericardial effusion was observed in 5 patients (20%). Coronary artery dilatation was seen in 12 (50%) patients. All 6 children with shock-like presentation had coronary artery involvement. Twenty children (83%) received intravenous immunoglobulin within the first 2 days of their stay. Thirteen (54%) patients received therapeutic anticoagulation (enoxaparin) on the basis of the high risk of thromboembolism and number of D-dimers. There was one death (4%). Conclusion: The SARS-COV 19 pandemic led to the identification of a new and potentially life-threating childhood disease, referred to as MIS-C. Prompt diagnosis and early treatment with IVIGs has shown a good early outcome. .
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Objectives: To describe the epidemiological characteristics, clinical presentation, severity of the disease, and early outcomes of children with COVID-19 in Pakistan with special reference to underlying comorbid conditions. Study Design: Descriptive cross-sectional study. Place and Duration of Study: The Children’s Hospital and The Institute of Child Health, Lahore, from March 15 to July 31, 2020. Material and Methods: We analyzed data on all laboratory-confirmed cases of severe acute respiratory syndrome coronavirus 2 (SARC-COV-2) infection in children admitted to a single tertiary care center including patient characteristics, clinical course and hospital outcomes with special reference to underlying comorbidity. Results: Of 42 symptomatic children, 19 (45%) had a pre-existing comorbidity, the most common of which was chronic kidney disease (7/19-37%). The median age was 7.75 years (IQR: 1.3–11.2) with a slight female preponderance (55%). Fever (79%), respiratory symptoms (52%), and gastrointestinal symptoms (14%) were the most common symptoms. No direct or indirect contact with COVID-19 positive person was identified in 12 patients (29%). Patients with pre-existing comorbidity required mechanical ventilation and prolonged intensive care monitoring than those without. There were three fatalities in the groups of 42 (7%) patients, and underlying comorbid conditions were significantly associated with a fatal outcome (p=0.032). Conclusion: COVID-19 in children is generally mild with good outcome. Chronic kidney disease was the commonest co-morbidity and the presence of an underlying co-morbid condition is a risk factor for prolonged hospital stay and a poor outcome. © 2020, Pakistan Pediatric Journal. All rights reserved.
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We report a 10-year-old girl who presented with fever, unilateral redness of eye, strawberry tongue, cheilitis, acralmaculopapularrash and erythematous swelling of hands and feet followed by desquamation. Her father had COVID-19 almost a month back and her SARS-CoV-2 antibodies were raised. She had normal inflammatory markers, normal echocardiogram and a benign self-resolving rash. Though skin and mucosal lesions resembled Kawasaki disease like syndrome, these were isolated cutaneous manifestation most likely immune mediated and temporally related to SARS-CoV-2 infection. © 2020, Pakistan Pediatric Journal. All rights reserved.
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Objective: To identify the Psychosocial effects of COVID-19 pandemic on health care workers of a tertiary level pediatric hospital. Methodology: This is a cross-sectional study done at The Children's Hospital and the Institute of Child Health, Lahore from 1st April to 15th April 2020. A questionnaire was circulated among health care workers of the hospital and responses were analyzed with SPSS V. 23. Results: The questionnaire was filled by 989 hospital employees but 914 forms with complete were analyzed. Most participants (75%) were younger than 40 years of age. The male to female ratio was 1:1.5. There was almost equal participation of married and unmarried medical personnel (52% vs 48%). Regarding concerns about personal and family health, 544 (59.5%) were deeply concerned about their health, but the concern was far greater about their families (672, 73.5%). The fear of going home was expressed by 629 (69%) participants. Regarding employee protection using personal protective equipment (PPE), 680 (74.4%) hospital workers were dissatisfied. Wearing a protective suit and gloves were the precautions frequently cited as most bothersome (38.8%). Over 65% of workers felt anxiety while dealing with febrile patients. Over 60% of health care workers cited religion as their main source of coping with psychological impact. Conclusions: Health care workers experience a great deal of psychological implications of the COVID-19 pandemic related to the uncertainty of the disease behavior, associated comorbidities and risk factors in the health care workers, and healthcare-related local policies.