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1.
Thyroid ; JOUR:A47-A48, 32(Supplement 1).
Article in English | EMBASE | ID: covidwho-2097289

ABSTRACT

OBJECTIVE: Angiotensin-converting enzyme 2 (ACE2) and neuropilin 1 (NRP1) were essential molecules mediating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The effects of typical cytokines in autoimmune thyroid diseases (AITDs), such as IFN-gamma, TNF-alpha, IL-4 on the expression of SARSCoV-2 infection-mediating molecules remained unclear. Hydrogen sulfide (H2S) had the effects of anti-virus in literatures. The purpose of our study was to explore whether IFN-gamma, TNF-alpha or IL-4 regulated ACE2 and NRP1 levels and whether H2S exerted protective roles in thyroid on SARS-CoV-2 infection by regulating these molecules. METHOD(S): Thyroid sections from the patients with HT (n = 18), GD (n = 18) and normal thyroid tissues (n = 18) were collected. Immunohistochemistry was used to detect the expression of ACE2 and NRP1. Human primary thyrocytes were stimulated with different concentrations of IFN-gamma, TNF-alpha and IL-4, respectively. Thyrocytes were further cultured with IFN-gamma, TNF-alpha or NaHS + IFN-gamma / TNF-alpha in vitro. ACE2 and NRP1 expression levels were examined by realtime PCR and Western blot. RESULT(S): Both ACE2 and NRP1 were expressed on human thyrocytes. ACE2 expressions in thyroid tissues were higher in HT group than normal thyroid group (P < 0.001) and staining scores for ACE2 had no relationship with serum levels of thyroid autoantibodies. NRP1 expressions in HT and GD thyroid tissues were higher than those in normal thyroid tissues (P < 0.0001) and the staining scores for NRP1 were positively correlated with serum levels of TgAb (r = 0.4627, P = 0.0024) and TPOAb (r = 0.3633, P = 0.0181). The mRNA levels of ACE2 and NRP1 were upregulated in a concentration-dependent manner for IFN-gamma and TNF-alpha in human primary thyrocytes (P < 0.05). IL-4 rarely had effects on ACE2 or NRP1 mRNA levels. After pre-treating with NaHS, we found that ACE2 and NRP1 protein expressions were downregulated compared to IFN-gamma or TNF-alpha treatment (P < 0.01). CONCLUSION(S): ACE2 and NRP1 expressions were more abundant in thyroid tissues from AITDs than normal thyroid tissues. ACE2 and NRP1 expressions were upregulated by IFN-gamma and TNF-alpha. H2S might exert a protective role against SARS-CoV-2 infection by downregulating ACE2 and NRP1 levels.

2.
6th International Conference on Big Data and Internet of Things, BDIOT 2022 ; JOUR: 64-69,
Article in English | Scopus | ID: covidwho-2088939

ABSTRACT

In recent years, the use of the Internet of Things (IoT) has become more widespread, which has had a great impact on the animal health system. In the context of the COVID-19 pandemic, interactions between people and pets have been of great help in the regulation of mood and spirit. And in modern society, more and more people regard pets as their emotional sustenance, it can be said that pets are no longer just living in the family as animals, but also a kind of "loved ones", so the health and care of pets is particularly important. IoT devices come in the form of wearables for tracking human activity. Now wearables can also be used to monitor animal activity. Novel Pet Collaborative Care (NPCC) uses biosensors and corresponding software to monitor and maintain animal health records, as well as supports remote virtual interactions with pets or virtual pets. The main purpose of this article is to review the latest advances in the field of animal health, and to improve and strengthen them on this basis, with the aim of conducting research and development in the hope of bringing more benefits to pets. © 2022 ACM.

3.
Annals of the Rheumatic Diseases ; JOUR:675-675, 81.
Article in English | Web of Science | ID: covidwho-2088692
4.
IEEE Journal on Selected Areas in Communications ; JOUR: 1-1,
Article in English | Scopus | ID: covidwho-2088060

ABSTRACT

To fight against infectious diseases (e.g., SARS, COVID-19, Ebola, etc.), government agencies, technology companies and health institutes have launched various contact tracing approaches to identify and notify the people exposed to infection sources. However, existing tracing approaches can lead to severe privacy and security concerns, thereby preventing their secure and widespread use among communities. To tackle these problems, this paper proposes CoAvoid, an edge-based, privacy-preserved contact tracing system that features good dependability and usability. CoAvoid leverages the Google/Apple Exposure Notification (GAEN) API to achieve decent device compatibility and operating efficiency. It utilizes Bluetooth Low Energy (BLE) to detect close contact with other people and leverages GPS with fine-grained matching algorithms to verify user information. In addition, to enhance privacy protection, CoAvoid applies fuzzification and obfuscation measures to shelter sensitive data, making both servers and users agnostic to information of both low and high-risk populations. The evaluation demonstrates good efficacy and security of CoAvoid. Compared with four state-of-the-art contact tracing applications, CoAvoid can reduce the size of upload data by at least 90% and reduce the verification time by 92%. More importantly, CoAvoid can preserve user privacy and resist replay and wormhole attacks in all analysis scenarios. IEEE

5.
International Journal of Information and Education Technology ; 12(11):1221-1228, 2022.
Article in English | Scopus | ID: covidwho-2081172

ABSTRACT

Due to the COVID-19 pandemic, majority of the Biomedical Science students were not able to undergo their clinical internship at diagnostic laboratories and this has created an impact on students’ skills and the future of the Malaysian healthcare system. Hence, our objective was to implement arevolutionized Biomedical Science practicum completely in a virtual environment, without compromising the learning outcomes during the pandemic in 2021. To achieve the intended learning outcomes, various online teaching-learning and assessment activities were carefully curated in accordance to standard program guidelines, learning outcomes, student learning time and thorough analysis of actual student logbooks. Learning materials were reinforced with various initiatives such as actual engagements with real-life scenarios via synchronous meetings with external panelists from hospitals. Online video-log (Vlog) and a logbook of daily activities were used as part of the assessment to ensure that students were able to learn and reflect on the activities performed. The study showed that all students displayed increased confidence levels in medical laboratory skills. They were also able to apply them in real-life situations due to the clear instructions and realistic experience via the virtual learning activities. Therefore, students who participated in the virtual practicum demonstrated almost similar levels of performance when compared to the students who went for physical practicums in the year 2020. Our virtual practicum has achieved its intended outcomes of empowering students with similar skills as those who underwent physical clinical placements in diagnostic laboratories. Those skills include successful acquisition of discipline-specific knowledge, collaborative and communication skills, as well as solid experimental methods and good laboratory practices. © 2022 by the authors.

6.
Annals of Agricultural and Environmental Medicine ; 29(3):375-382, 2022.
Article in English | EMBASE | ID: covidwho-2067567

ABSTRACT

Introduction and Objective. From March 2022, China has been in the rapid progressing stage of the Omicron outbreak. However, the mental status of clinical nurses against infection by the Omicron variant of COVID-19 has been not explored. Therefore, a nationwide online investigation with a larger sample size was conducted to explore the mental status of Chinese frontline clinical nurses, and its influencing factors using sound validated and reliable measurements. Materials and method. A cross-sectional study was conducted, and 1,204 clinical nurses fighting the Omicron outbreak were recruited across various provinces of China. Results. The mean age of the nurses was 30.43 (SD=6.59) years. The majority were female. The rates of these nurses with depression, anxiety, stress, and insomnia symptoms were 29.2%, 37.2%, 19.1%, and 48.8%, respectively. The variables of department, insomnia, fear with COVID-19, turnover intention, job burnout, work coping style, and public recognition of nursing, were significant factors influencing the mental status of clinical nurses. Conclusions. The Chinese clinical nurses fighting the Omicron variant of COVID-19 had a similar level of depression and anxiety, a higher level of insomnia, and a lower level of stress, in comparison with nurses globally who experienced the initial period of the pandemic. Targeted investigation and interventions are urgently needed for Chinese frontline clinical nurses with high levels of anxiety, depression and insomnia, who fought against infection by Omicron. Much more professional advocacy is strongly recommended during control of the pandemic and recovery to consolidate the role and influence of nurses. The contribution and visibility of nursing should be recognized not only by the medical professionals, but by the public in general. Copyright © 2022, Institute of Agricultural Medicine. All rights reserved.

7.
American Journal of Clinical Oncology: Cancer Clinical Trials ; 45(9):S7-S8, 2022.
Article in English | EMBASE | ID: covidwho-2063020

ABSTRACT

Background: Traditionally procedural training requires in-person and hands-on education. However, only about 50% of residents express confidence to develop a brachytherapy practice (Marcrom SR, et al. Int J Radiat Oncol Biol Phys 2019). The COVID-19 pandemic demonstrated the need to develop distributed educational tools for procedural experiences. Virtual reality (VR) platform has been shown to improves resident confidence and proficiencies (Taunk NK. et al. Brachytherapy 2021). Objective(s): We hypothesize that a low-cost cardboard viewer VR (CVVR) has similar educational effectiveness as commercially available integrated headset VR (IHVR). Method(s): We created a VR video of an intracavitary brachytherapy case. Radiation oncology residents from a single ACGME-accredited training program were recruited and randomized to IHVR or CVVR. Both groups were given unlimited access to their randomized technology. Each resident performed a timed intracavitary procedure on a simulator while 5 implant quality metrics were recorded. A pre- and post-simulation questionnaire assessed self-confidence, procedural knowledge, and perceived usefulness of VR technology. Result(s): There were 13 residents, including four post-graduate year (PGY)-2, three PGY-3, two PGY-4, and four PGY-5, in the study. Both VR technologies improved self-perceived overall confidence. Average time required for implant (mean: CVVR-200 seconds vs. IHVR-235 seconds, P=0.38) and median objective proficiencies of implant quality (5/5 in both group, P=0.56) were similar. There was no difference between CVVR and IHVR as useful, enjoyable and engaging educational tool. Both groups would recommend the technology to another trainee. IHVR-based program would cost ~33x more than CVVR-based program based on an assessment of US-based programs. Conclusion(s): CVVR is a cost-effective alternative to a IHVR as a virtual education tool (Figs. 1-3). (Table Presented).

8.
22nd COTA International Conference of Transportation Professionals, CICTP 2022 ; : 887-898, 2022.
Article in English | Scopus | ID: covidwho-2062366

ABSTRACT

The outbreak of COVID-19 and the unprecedented policies issued by the government have compelled citizens to reshape their daily travel behavior. Questionnaires were designed to obtain three main related indicators of socio-economic and demographic characteristics, primary travel purposes and patterns, and factors influencing mode choice to explore the impact of the pandemic on travel behavior and mode preferences of urban residents. By applying the online survey method with Snowball sampling techniques, a total of 591 valid questionnaire responses from Hong Kong residents were received in the designated time period. Then, the non-parametric test methods (e.g., McNemar-Bowker test and Mann-Whitney U test) were employed to implement the statistical analysis. Traffic administrators can use the survey findings to adjust current policies or delineate new policies to align with the passenger travel behavior. This will ensure more fluid and safer transportation. © ASCE.

9.
Annals of Emergency Medicine ; 78(4 Suppl):S123-S124, 2021.
Article in English | GIM | ID: covidwho-2035735

ABSTRACT

Background: Fluid boluses are amongst the strongest recommendations for the management of septic patients, and they are generally administered with the goal increasing cardiac output and improving tissue perfusion. Early identification of volume responsiveness is challenging and dependent on many patient factors, but it may prevent the harmful consequences of hypervolemia. Left ventricular outflow tract (LVOT) velocity time integral (VTI) has been used as a predictor of volume responsiveness. Study Objectives: The purpose of this study was to determine whether lack of volume responsiveness, defined as =15% change in LVOT VTI, is associated with increased risk of mortality, admission to an intensive care unit (ICU), or rapid response team activation within 24 hours of hospital arrival (composite outcome measure). We hypothesize that septic patients who are not volume responders will be more critically ill and therefore at greater risk of experiencing the composite outcome.

11.
2022 International Conference on Blockchain Technology and Information Security, ICBCTIS 2022 ; : 246-254, 2022.
Article in English | Scopus | ID: covidwho-2029226

ABSTRACT

The COVID-19 pandemic has led to a worldwide surge in demand for masks, protective clothing, and other epidemic prevention materials. The lack of epidemic prevention materials has put the lives of frontline health care workers at serious risk. However, epidemic prevention materials are not being distributed fairly and efficiently. This, coupled with the occasional scramble for scarce materials, makes epidemic prevention materials scarcer. The traditional centralized donation model makes it difficult to obtain the demand for materials in a timely manner, and the existing blockchain-based donation systems have not improved the efficiency of material donation. Moreover, most of the donation systems do not consider privacy and security issues. In this paper, we propose a blockchain-based material donation platform designed and implemented through the Ethereum platform. We solve the difficulty of demand acquisition and improve the transparency of the donation process through blockchain;reduce the possibility of a second disaster and improve the efficiency of material distribution through smart contracts;and protect the privacy and security of the donation process through zero-knowledge proof. We validate the security and efficiency of the proposed epidemic donation platform. © 2022 IEEE.

12.
Engineering, Construction and Architectural Management ; 2022.
Article in English | Scopus | ID: covidwho-2018452

ABSTRACT

Purpose: This paper aims to analyze Hangzhou Urban Brain in responding to COVID-19, including systematically sorting out the development mode, capabilities, composition and application of Urban Brain and exploring its role and effect. This paper tries to provide a reference for other cities' digital infrastructure construction through case analysis. Design/methodology/approach: The authors took Hangzhou Urban Brain as a typical case in urban digital infrastructure construction, and they conducted thorough research on its practice in facing COVID-19. The authors analyzed the key elements of Urban Brain, the application and the evaluation of Urban Brain through literature review, field investigation, questionnaire and interviews. Findings: Hangzhou Urban Brain has been deeply applied in urban management and has a good foundation. Therefore, when the COVID-19 occurred, the Urban Brain played an important role. The detailed practices facing COVID-19 are mainly in five aspects: information collection and analysis, ensuring material supply by government–enterprise collaboration, using AI and Big Data to “Visualize” COVID-19, etc. Moreover, Urban Brain has won high evaluation. However, Hangzhou Urban Brain still has problems like data privacy and security, technical issues, etc. Originality/value: This case study shows that Hangzhou's experience in Urban Brain construction is worthy of reference and promotion. Firstly, it can strengthen the understanding of digital infrastructure in responding to public health emergencies. Furthermore, it provides a reference for other urban governance worldwide by excavating the role and effect of digital infrastructure in preventing and controlling COVID-19. Thirdly, it explores how to improve the digital infrastructure construction to support public health challenges, which will help the cities grasp the actual value of data and make progress in this field. By this, it can provide references for cities in the world, especially in Asia to achieve sustainable city development. © 2022, Emerald Publishing Limited.

13.
Annals of the Rheumatic Diseases ; 81:440, 2022.
Article in English | EMBASE | ID: covidwho-2009122

ABSTRACT

Background: Patients with systemic lupus erythematosus (SLE) are at increased risk of severe COVID-19 due to the underlying disease, comorbidities and use of immuno-suppressants (IS). An alternative option would be to adopt telemedicine (TM) to maintain medical care while minimizing exposure. Despite being widely adopted during the pandemic, the evidence supporting the use of TM in rheumatology has been limited. Objectives: We primarily aimed to evaluate the effectiveness to maintain disease activity control using TM delivered care compared to conventional in-person follow-up in patients with lupus nephritis (LN). The secondary objectives were to compare the patient reported outcomes, safety and cost-of-illness from the patient's perspective between the 2 modes of health care delivery. Methods: This was a 1-year, single-center, RCT conducted at a regional hospital in Hong Kong. From May 2020, consecutive adult patients with a SLE according to the 2019 EULAR/ACR classifcation criteria followed up at the LN clinic were invited to participate in the study. Participants were randomized 1:1 to either TM (TM group) or standard FU (SF group). Patients randomized to receive TM FU were scheduled for a video consultation via a commerical software ZOOM. Patients in the SF group received standard in-person outpatient care. SLE disease activity at each consultation was assessed by SLEDAI-2k and physician global assessment (PGA). Results: A total of 144 patients with LN were randomized and 3 patients self-withdrew from the study. The mean age was 44.5±11.4 years and the median time from diagnosis to randomization was 168 months (range: 1-528). Most of the patients had class III, IV or V LN (87.2%) and were on prednisolone (89.4%, median dose 5mg daily). Many of them (68.1%) were on IS. While 66.0% of the patients were in lupus low disease activity state (LLDAS), none had disease remission. There were no baseline differences, including demographics, SLEDAI-2k (TM: 3.8±2.3, SF: 3.2±2.2, p=0.13, PGA (TM: 6.2±6.5, SF: 4.6±5.9, p=0.13) and SLE damage index (TM: 1.1±1.3, SF: 0.8±1.1, p=0.10), between the 2 groups. At one year, 80.0% and 80.2% of the patients in the TM group and SF group were in LLDAS or remission respectively. SLE disease activity indices including SLEDAI-2k, PGA, proteinuria amount and serum anti-ds-DNA level remained similar between the 2 groups. Within the study period, 28 (40%) patients in the TM group and 21 (29.6%) patients in the SF group had disease fare (p=0.20). There were no differences in the SF-36, lupusQoL and HADS scores between the 2 groups at the end of the study. The overall patient satisfaction score was higher in the TM group with a signifcantly shorter waiting time before seeing doctors. At the end of the study, 67.9% of the overall participants agreed to (versus 15.0% who did not agree to) use TM as a mode of future FU. The mean indirect costs of illness (HKD26,681 vs HKD12,016, p=0.20) and the out-of-pocket costs for health care services were similar between the 2 groups (TM: HKD13,547 vs SF: HKD12,297, p=0.83) in one year. The total number of FU was similar (TM: 6.0±2.0, SF: 5.7±1.7, p=0.40). However, signifcantly more patients in the TM group (29/70, 41.4% vs 4/71, 5.6%;p<0.01) requested change mode of FU. The proportion of patients requiring hospitalization during the study period was also higher in the TM group (TM: 23/70, 32.9% vs 11/71, 15.5%;p=0.02). After adjusting for age and pred-nisolone dosage, not being in LLDAS at baseline was the predictor of hospitalization (OR 3.4, 95%CI 1.20-9.65). None of the participants was tested positive for COVID-19. Conclusion: TM FU resulted in similar 1-year disease activity control and better satisfaction in patients with LN compared to standard care. However, a signifcant proportion of patients cared by TM required in-person visits or were hospitalized. The results of the study suggest that TM delivered care could help minimizing exposure to COVID-19, but it needs to be complemented by physical visits, particularly in those with unstable d sease.

15.
Chinese Medical Ethics ; 35(6):692-697, 2022.
Article in Chinese | Scopus | ID: covidwho-1988523

ABSTRACT

In the fight against COVID-1 9, under the guidancc of medical professionalism, the majority of medical workers adhered to the scientific spirit of rigorous truth-seeking and innovation, and the humanitarian feelings of boundless love and dedication, and made outstanding contributions to prevention and control. However, the epidemic situation fluctuates repeatedly, the virus mutates frequently, and the risk of major public health emergencies has caused deep thinking on the cultivation of medical students’ professionalism. Medical students are the reserve force for the sustainable development of China’s medical and health undertakings. The times and society endow medical students with a more lofty and arduous historical mission, and also call for strengthening the cultivation of medical students’ professional spirit. Under the background of normalization of epidemic prevention and control, responding to the demands of the times, providing high-quality medical talents for the society, promoting building the doctor-patient desting community, and promoting the reality of the healthy China strategy, efforts to explore the path of cultivating medical students’ professionalism with “three combinations, two considerations and one emphasis”. © 2022, Editorial department of Chinese Medical Ethics. All rights reserved.

16.
Antimicrobial Stewardship and Healthcare Epidemiology ; 2(1), 2022.
Article in English | Scopus | ID: covidwho-1984306

ABSTRACT

In this prospective, longitudinal study, we examined the risk factors for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection among a cohort of chronic hemodialysis (HD) patients and healthcare personnel (HCPs) over a 6-month period. The risk of SARS-CoV-2 infection among HD patients and HCPs was consistently associated with a household member having SARS-CoV-2 infection. ©

17.
Journal of Semiconductors ; 43(7):7, 2022.
Article in English | Web of Science | ID: covidwho-1978193

ABSTRACT

With the epidemic of the coronavirus disease (COVID-19) infection, AlGaN-based ultraviolet-C light emitting diodes (UVC-LEDs) have attracted widespread attention for their sterilization application. However, the sterilization characters of high power integrated light sources (ILSs) haven't been widely investigated before utilizing in public sanitary security. In this work, by integrating up to 195 UVC-LED chips, high power UVC-LED ILSs with a light output power (LOP) of 1.88 W were demonstrated. The UVC-LED ILSs were verified to have efficient and rapid sterilization capability, which have achieved more than 99.9% inactivation rate of several common pathogenic microorganisms within 1 s. In addition, the corresponding air sterilization module based on them was also demonstrated to kill more than 97% of Staphylococcus albus in the air of 20 m(3) confined room within 30 min. This work demonstrates excellent sterilization ability of UVC-LED ILSs with high LOP, revealing great potential of UVC-LEDs in sterilization applications in the future.

18.
Pediatric Investigation ; 2022.
Article in English | EMBASE | ID: covidwho-1976763

ABSTRACT

Kawasaki disease (KD) is a systemic vasculitis of unknown etiology, which tends to involve coronary arteries and can lead to acquired heart disease in children. The immuno-inflammatory response and vascular endothelial dysfunction are important causes of coronary artery disease in patients with KD. Multisystem inflammatory syndrome in children (MIS-C) is a rare inflammatory disease in children identified in recent years, which is caused by severe acute respiratory syndrome coronavirus 2 infection;this disease overlaps with KD. This review examines research progress concerning the immuno-inflammatory response and vascular endothelial dysfunction associated with KD, as well as differences between KD and MIS-C.

19.
Radiology: Artificial Intelligence ; 4(4), 2022.
Article in English | EMBASE | ID: covidwho-1968372

ABSTRACT

Purpose: To conduct a prospective observational study across 12 U.S. hospitals to evaluate real-time performance of an interpretable artificial intelligence (AI) model to detect COVID-19 on chest radiographs. Materials and Methods: A total of 95 363 chest radiographs were included in model training, external validation, and real-time validation. The model was deployed as a clinical decision support system, and performance was prospectively evaluated. There were 5335 total real-time predictions and a COVID-19 prevalence of 4.8% (258 of 5335). Model performance was assessed with use of receiver operating characteristic analysis, precision-recall curves, and F1 score. Logistic regression was used to evaluate the association of race and sex with AI model diagnostic accuracy. To compare model accuracy with the performance of board-certified radiologists, a third dataset of 1638 images was read independently by two radiologists. Results: Participants positive for COVID-19 had higher COVID-19 diagnostic scores than participants negative for COVID-19 (me-dian, 0.1 [IQR, 0.0–0.8] vs 0.0 [IQR, 0.0–0.1], respectively;P, .001). Real-time model performance was unchanged over 19 weeks of implementation (area under the receiver operating characteristic curve, 0.70;95% CI: 0.66, 0.73). Model sensitivity was higher in men than women (P = .01), whereas model specificity was higher in women (P = .001). Sensitivity was higher for Asian (P = .002) and Black (P = .046) participants compared with White participants. The COVID-19 AI diagnostic system had worse accuracy (63.5% correct) compared with radiologist predictions (radiologist 1 = 67.8% correct, radiologist 2 = 68.6% correct;McNemar P, .001 for both). Conclusion: AI-based tools have not yet reached full diagnostic potential for COVID-19 and underperform compared with radiologist prediction.

20.
Gastroenterology ; 162(7):S-1248-S-1249, 2022.
Article in English | EMBASE | ID: covidwho-1967432

ABSTRACT

Introduction Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 virus (SARS-CoV-2), can commonly lead to abnormal liver tests, mostly transaminase elevation. Recently, a novel entity of cholangiopathy was discovered in patients who recovered from critical COVID-19 infection. However, understanding of this disease is limited due to its rarity. Methods We reviewed Pubmed, Embase, and Web of Science Core Collection databases from inception to Nov 30th, 2021, to identify studies reporting cholangiopathy after severe COVID-19 infection. “SARS-CoV-2” or “COVID-19” with “cholangiopathy” were used as keywords to search. Our study is to summarize the clinical features and characteristics of cholangiopathy after severe COVID-19 illness. Results Literature review identified 15 articles including 33 patients for reviews. Most studies were performed in the United States. The mean age of participants from all studies is 52.17 ± 13.98 years old. Among the 33 included patients, the majority are male (29, 88%) and the common medical histories include hypertension (n=11), obesity (n=8), and diabetes mellitus (n=8). The length of stay (LOS) during hospitalization was prolonged with a mean of 80.23 ± 33.14 days. All patients were intubated and put on mechanical ventilation during medical intensive care stay with 12 patients having a history of endotracheal cardiac output monitoring. The mean peak of serum alkaline phosphatase, aspartate aminotransferase, alanine transaminase and total bilirubin were 2106.96 (U/l) ± 784.04, 1456.09 (U/l) ± 2325.10, 983.57 (U/l) ± 1244.44 and 14.04 (mg/dl) ± 8.41, respectively. Cholangiopathy after severe COVID illness mimics secondary sclerosing cholangitis on magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography studies with ductal beading but the presence of unique severe cholangiocyte injury and intrahepatic microangiopathy is suggestive of direct hepatic injury due to COVID-19. In terms of outcome, 7 patients were documented as deceased. Eight patients underwent liver transplantation (Table 1). Discussion Cholangiopathy is a late complication of severe COVID-19 after prolonged ICU stay with potential for long-term liver morbidity and liver failure needing liver transplantation. Further studies are warranted to understand pathogenesis, natural history, therapeutic interventions, and prognostic indicators. (Table Presented)

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