ABSTRACT
This report explores the agrologistics challenges and opportunities faced by agri-food systems in three countries in Northern Central America, namely El Salvador, Guatemala and Honduras, with a specific focus on the impacts on family farming systems. As an overarching principle guiding the analysis, the report adopts the World Bank's framework of Green, Resilient, and Inclusive Development (GRID), which recognizes that the challenges of poverty, inequality, climate change, and systemic shocks such as COVID-19 are strongly interrelated, and thus need to be addressed simultaneously and systematically. As such, the study seeks to highlight ways in which enhancing agrologistics systems can drive food system efficiency, environmental sustainability, resilience and inclusion in Northern Central America, thus contributing to wellbeing and overall economic performance. In this study, the term agrologistics is used to refer to the infrastructure, machinery, related services, and information systems that allow agri-food products to move from the original point of production to the final point of consumption. The analysis follows the five key components of agrologistics value chain, namely: (a) on-farm post-harvest management;(b) storage and handling, including cold storage;(c) processing and packaging;(d) transport from the farm to collection and processing centers, and onwards to distribution networks;and (e) distribution by wholesalers, retailers and exporters, which in the case of exports involves customs and other border crossing processes.
ABSTRACT
SESSION TITLE: Post-COVID-19 Outcomes SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/19/2022 11:15 am - 12:15 pm PURPOSE: Organizing pneumonia (OP) is well known complication of severe viral infections. Recent reviews of postmortem biopsies and CT imaging suggest that a subset of patients develop secondary organizing pneumonia following infection with SAR-COV2. High dose steroids have previously been proven efficacious in post viral OP following infections such as H1N1, severe acute respiratory syndrome and MERS. This study aims to discover the incidence and impact of high dose steroids in treatment of Covid 19 patients who have characteristics of OP following initial infection. METHODS: We reviewed records of adult patients over age 18 hospitalized with respiratory failure due to COVID-19 pneumonia between 3/1/20 and 6/30/21 in our institution. We isolated patients who survived initial presentation but developed persistent hypoxia and CT evidence of progression to OP. Of these, we reviewed those treated with high dose prednisone, the usual dexamethasone, or no steroid treatment. We documented age, gender, timing of initiation of steroids, timing of steroid tapering, oxygen requirements at initiation, at day 30, and day 90, and overall outcomes. RESULTS: We identified 881 patients with COVID of which 46 patients met the criteria of having OP. Age ranged from 18-73, median age of 60.5. 52% were male. 3 patients had lung biopsy to confirm OP. All other patients were diagnosed based on CT and clinical presentation. 23 patients were treated with Prednisone after the initial 10-day course of dexamethasone. 24 patients were treated with just 10 days of dexamethasone. 5 patients were not treated with steroids. CONCLUSIONS: The incidence of post-covid OP appears to be lower than anticipated, with an incidence rate of roughly 0.05% in our study population. A significant proportion of patients had at least 2 underlying medical conditions. Patients on lower supplemental oxygen requirement (<2 L NC) were not continued on steroids and did well with only 2 of the 23 requiring oxygen at 30 days with mortality. Patients on higher supplemental oxygen at 10 days (>2L NC) were continued on steroids and the mortality rate was high, ~40%. We would conclude the incidence of post-Covid associated OP seems to be low in this small cohort of patients, and the decision to continue steroids should be based on individual patient characteristics such as supplemental oxygen requirements at 10 days, rather than CT findings of OP and that they seem to have higher mortality. In the future, larger multicenter cohort studies would help to understand further treatment. CLINICAL IMPLICATIONS: Although our incidence of post-covid OP is low, the mortality and morbidity in select patients appears to be high. Anticipating specific populations who may be at higher risk and starting treatment earlier could help reduce mortality. Larger cohort studies are needed to help develop better treatment strategies. DISCLOSURES: No relevant relationships by Hajra Channa No relevant relationships by Cesar Davila-Chapa No relevant relationships by Prathik Krishnan No relevant relationships by uzoamaka ogbonnah No relevant relationships by arunima sharma no disclosure on file for Diana Song;No relevant relationships by Fereshteh Yazdi