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1.
Aerosol and Air Quality Research ; 23(5), 2023.
Article in English | Web of Science | ID: covidwho-2308201

ABSTRACT

Air quality is a global concern, with particulate matter receiving considerable attention due to its impact on human health and climate change. Recent advances in low-cost sensors allow their deployment in large number to measure spatio-temporal and real-time air quality data. Low-cost sensors need careful evaluation with both regulatory approved methods and other data sets to understand their efficacy. In this work, PM concentrations measured by deploying low-cost sensors at four regional sites are evaluated through comparison with satellite-based model MERRA-2 and the SASS reference instrument. Daily PM2.5 mass concentration variation was analyzed at four regional sites of India from January 2020 to July 2020, including pre-lockdown and six different lockdown periods. Higher PM2.5 concentration was observed at Rohtak (119 mu g m-3) compared to Mahabaleshwar (33 mu g m-3), Bhopal (45 mu g m-3) and Kashmir sites during the pre-lock down period. During the lockdown period, the PM2.5 mass concentration was reduced significantly compared to the pre-lockdown period at every location, although the PM2.5 concentration was different at each location. The air quality trend was quite similar in both the measurements, however, MERRA-2 reconstructed PM2.5 was significantly lower in the pre-lockdown period compared to the lockdown periods. Significant differences were observed between low-cost sensor measurements and MERRA-2 reanalysis data. These are attributed to the MERRA-2 modelling analysis that measures less PM2.5 concentration as compared to ground-based measurements, whereas low-cost sensor are and biases.

2.
Coronaviruses ; 2(10) (no pagination), 2021.
Article in English | EMBASE | ID: covidwho-2254441

ABSTRACT

Background: In December 2019, a large number of patients with a novel coronavirus were identified in Wuhan, China. The novel coronavirus (COVID-19) is highly contagious and in-creasing the rate of mortality day by day. The World Health Organization declared COVID-19 as a worldwide pandemic on March 11, 2020. Early diagnosis of SARS-CoV-2 can restrict the COVID-19 pandemic. Objective(s): We aim to study the currently available diagnostic methods for COVID-19. Method(s): World Health Organisation portal, Centre for Disease Control and Prevention portal, Indian Council of Medical Research portal, Chinese Centre for Disease Control and Prevention por-tal, Science Direct, Google Scholar, Research Gate, etc. were searched for obtaining data. Result(s): Rapid diagnosis and prompt treatment can reduce the number of prospective cases. The diagnostic strategy encompasses the screening of the virus with nucleic acid amplification test (NAAT) such as real-time reverse-transcription polymerase chain reaction (RT-PCR) assays. Sero-logical testing is a diagnostic procedure used for identifying the presence of immune responses. Radiological findings in individuals with COVID-19 are characterised by multiple areas of consolida-tion in the chest. Rapid antigen tests are in-vitro diagnostics that have been designed to give results within 10-20 min. Conclusion(s): Rapid, simple, and safe diagnosis of COVID-19 has a great impact on deciding clinical and epidemiological factors. RT-PCR results often require 5 to 6 hours. Diagnosis by serologi-cal testing is not suitable but important epidemiologically. At present, the best radiological strategy remains undefined. Rapid antigen tests have limitations on sensitivity.Copyright © 2021 Bentham Science Publishers.

3.
Coronaviruses ; 2(6):1-6, 2021.
Article in English | EMBASE | ID: covidwho-2252296

ABSTRACT

Background: Today, the world is facing COVID-19 mutant, which was declared as a pandemic disease by the World Health Organization. COVID-19 has spread rapidly to 203 countries and up to 31st March 2020, 36405 people had lost their lives. We aimed to study the impact of three parameters, i.e., weather, life expectancy, and travel, either due to tourism or business purpos-es on the transmission of the COVID-19. Method(s): The data of infected cases and deaths of different countries and territories related to the 2019-nCoV are studied. These data are collected from the situation reports issued by WHO. Result(s): The Temperature-Time trajectory shows that the dissemination of coronavirus has a high tendency in cold climate countries. Most of the cases are observed in the temperature range of 40degreeF to 60degreeF. Also, we analyzed the dependence of 2019-nCoV transmission and death cases on life ex-pectancy. Most of the cases related to COVID-19 in the entire world were adult and old patients. The global connectivity between China as a "Manufacturing Hub" and other counties also plays a vital role in the transmission of COVID-19. Conclusion(s): The spread pattern of COVID-19 cases is in good agreement with our study, but this does not mean that it will not spread in warm areas. The precautionary measure provided by WHO and health departments of various countries should be followed to slow down the transmission rate of COVID-19.Copyright © 2021 Bentham Science Publishers.

4.
Medical Mycology ; 60(Supplement 1):112-113, 2022.
Article in English | EMBASE | ID: covidwho-2189364

ABSTRACT

Objective: Multipleinfections canoccur after2009, pandemicinfluenza, includingfungal andbacterial infections, but data from India are limited.To our knowledge, this is the first reported case of influenza-associated invasive pulmonary aspergillosis (IAPA), caused by Aspergillus tamarii, after infection with pandemic (H1N1) 2009 which was preceded by COVID-19,20 months before. Methods andResults: A33-year-oldmale, knownasthmatic, hadbeen hospitalizedelsewhere inAugust 2020with COVID-19 pneumonia for 50 days and had been on mechanical ventilation for 37 days. He had no residual respiratory symptoms 3 months after recovery from COVID-19. He was admitted to Jupiter Hospital in April 2022 with fever, cough, and dyspnea for 8 days, which developed after a cold bath in a temple. HRCT (chest) showed ground glass opacities (GGOs), crazy paving, nodules, and traction bronchiectasis. Review of previous HRCT showed that only GGOs were present (Fig. 1). At admission, the nasopharyngeal swab was positive for pandemic (H1N1) 2009 in the filmarray respiratory panel and no other pathogen was detected. He was treated with oseltamivir. Expectorated sputum examination showed a heavy load of thin septate hyphae, with acute angle branching, resembling Aspergilllus species (Fig. 2). Serum galactomannan was positive (1.8).Based on these features he was diagnosed as a case of probable IAPA and initiated posaconazole (PCZ) treatment.Sputum fungal culture was positive and was identified by MALDI T OF MS as A. tamarii. A. tamarii has been rarely encountered as a human pathogen. Case reports of its involvement in eyelid infection, keratitis, invasive sinonasal infection, and onychomycosis exist. Sensititre MICs were 0.0625 mcg/ml, 0.125 mcg/ml, 0.0625 mcg/ml, and 0.125 mcg/mL for itraconazole, voriconazole, PCZ, and for isavuconazole (ISVCZ) respectively. The usually obtained PCZ trough level with standard dose is 1.2 mg/l which generates AUC of 200R.The usually obtained ISVC) trough level with standard dose is 3 mg/l which generates AUC of 100R. The PKPD index, AUC/MIC of 100, is needed with both these azoles for a therapeutic effectR. Therefore, it would be possible to treat this infection with any of these azoles. PCZ was continued in view of the easy availability of therapeutic drug monitoring (TDM) to assure adequate drug expo-sure, lower cost, and clinical improvement which had already occurred. Conclusion(s): An infection due to a rare Aspergillus species needs correct identification, MIC determination, and PKPD consideration for appropriate drug selection and management.

5.
Medical Journal of Dr DY Patil Vidyapeeth ; 15(8):143-145, 2022.
Article in English | Scopus | ID: covidwho-2202079
6.
South Eastern European Journal of Public Health ; 19, 2022.
Article in English | Scopus | ID: covidwho-2120595

ABSTRACT

Aim: Frontline Health Care Workers (FLHCWs) are the key workforce in the fight against ongoing COVID-19 pandemic. They hail from the community and are responsible for supporting the health system in generating awareness, implementing preventive strategies, contact tracing and isolating potential cases. In their job responsibilities, FLHCWs thus may perceive heightened risk of exposure to the virus, leading to overwhelming emotional response and psychological distress. The objective of this study was to investigate risk perception, cognitive awareness and emotional responses among FLHCWs trained to deal with Covid 19, to identify unmet needs of this training in India. Methods: A cross-sectional study was conducted in a total of 131 frontline workers selected by a multistage sampling process from two states (Odisha and Himachal Pradesh) of India. The FLHCWs were interviewed personally (when feasible) with the help of a predesigned pretested semi-structured questionnaire. Results: The findings suggested that majority (90%) of the FLHCWs perceived that they are susceptible to nCoV-19 infection and 77.1% of FLHCWs felt high probability of them getting infected with the nCoV-19. Almost 90% of them responded that it is something they think about all the time and 41% of FLHCWs admitted that they feel helpless in the situation. About 63% of FLHCWs perceived that the nCoV-19 infection was a severe illness and 35% perceived it to be very severe and life threatening. Although most of them had received some unstructured and non-uniform training on preventive measures against COVID-19, yet only 38% felt that the knowledge was adequate to protect themselves from the nCoV-19 infection. The training sessions lacked psychological component for capacitating them with coping skills to address their emotional and psychological responses. Conclusion: The FLHCWs experienced heightened risk perception and symptoms of emotional distress in significant numbers even after trainings. A more inclusive public health policy dialogue to address the emotional and psychological coping skills is needed for capacitation of these frontline workers to address the challenges of Pandemic response now and in future. © 2022 Dobe et al;This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

8.
Indian Journal of Forensic Medicine and Toxicology ; 16(1):76-82, 2022.
Article in English | EMBASE | ID: covidwho-1998193

ABSTRACT

Sudden death due to cardiac cause is considered as a major health problem worldwide accounting for 15–20% of all deaths and cardiomyopathies account for 10–15% of the cases.According to the 2016 WHO classification, angiomatous meningioma is a rare subtype of meningioma classified as Grade I. It is an aggressive variety with a fair prognosis, with typical symptoms including headache and seizures. We present a case of a 60-year-old man brought to the morgue for autopsy with a history of progressive left-sided weakness and headache for several months with no prior diagnosis or treatment for the same because of current pandemic of COVID-19.On conducting medicolegal autopsy significant pathologies in heart and brain were found which could have contributed to the cause of death.

9.
Journal of Clinical Urology ; 15(1):55-56, 2022.
Article in English | EMBASE | ID: covidwho-1957029

ABSTRACT

Introduction: The objective was to investigate the feasibility, safety, efficacy, and patient acceptability of performing mini-PCNL as a day case procedure. To our knowledge, this is the first reported series in the UK. Method Mini-PCNL data was prospectively collected between April- December 2021. Renal access was achieved by the operating surgeon under fluoroscopic guidance in the prone position. The MIP-M system (Karl Storz, Germany) was used. Stones were fragmented using holmium LASER and retrieved by the Vortex effect and basket. Drainage was via a 6 Fr antegrade stent or 10 Fr nephrostomy tube. Patients suitable for same day discharge were identified using defined preoperative selection criteria. Stone related outcomes, duration of surgery, length of stay, readmission rate and complications were recorded. Results: Fifty patients underwent mini-PCNL (34 male,16 female) with a mean age of 60 years. Mean stone size was 24 mm with a mean operating time of 90 minutes. Twenty patients were suitable for same day discharge. Thirty patients stayed overnight (15 for social reasons, 13 for medical comorbidities and 2 for complications). We recorded 1 case of post-operative sepsis and bleeding requiring embolization. The readmission rate was 0% and 85% were stone free on post-operative CT KUB. Conclusion: Our study shows that day case mini-PCNL is safe, feasible and acceptable in selected group of patients. With the ever-rising pressures on stone services to drive efficiency particularly pertinent with the COVID pandemic, day case mini-PCNL represents an ideal therapeutic option in suitable cases.

10.
Journal of Digestive Endoscopy ; 13(2):70-76, 2022.
Article in English | EMBASE | ID: covidwho-1956438

ABSTRACT

Background and Study Aims In the coronavirus disease 2019 (COVID-19) pandemic, patients undergoing esophagogastroduodenoscopy (EGD) and colonoscopy on the same day (bidirectional endoscopy [BDE]) have increased. The aims of the study were to compare the procedure times, benefits, and safety of same-day BDE and conventional serial endoscopic examination (SEE). Patients and Methods All the patients undergoing evaluation with either BDE or SEE were prospectively enrolled at Ramaiah Medical College and Hospitals, Bangalore, from 1st December 2020 to 31st May 2021. EGD was immediately followed by colonoscopy in BDE. In SEE, EGD was followed by colonoscopy in 1 or 2 days. Clinical data and results were collected and evaluated. Results Two hundred consecutive patients who consented for BDE were enrolled in the study. The mean ± standard deviation (range) age of the patients was 45 ± 14.5 (22-60) years. Majority (124 [62%]) were men. The outcome measures of Boston Bowel Preparation Scale with the excellent/good preparation score and polyp detection rate were similar in both groups (p = 0.4). The total procedure time was significantly higher in the SEE group than in the BDE (p < 0.001). There were no adverse events noted in the study. The overall patient experience and satisfaction were higher in BDE than in SEE without any difference in the quality of the procedures (p < 0.001). Patients with weight loss and anemia were more likely to have a positive test result than the patients with abdominal pain and diarrhea. Conclusions In conclusion, same-day BDE is advised for patients with anemia and weight loss which can reduce the number of hospital visits and improve patient satisfaction in COVID times.

11.
International Journal of Early Childhood Special Education ; 14(3):16-20, 2022.
Article in English | Web of Science | ID: covidwho-1928883

ABSTRACT

This research note is prepared to present an overview of the effectiveness of the Government's decision to open the activities of the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA) in the non-lockdown zones during the second phase of the restrictions of lockdown imposed by COVID-19 in April 2020. Providing employment opportunities to the rural workers, seasonally migrated workers from the urban areas and strengthen rural economy in the midst of COVID-19 pandemic. The matter of interest is to identify how the Government decision helped migrants to secure a share of their loss of income. Our study reveals that close to 0.75 million seasonal migrant workers are refugees under the MGNREGA for the state of Odisha.

12.
Natural Volatiles & Essential Oils ; 8(5):1344-1352, 2021.
Article in English | GIM | ID: covidwho-1812987

ABSTRACT

AKI has been observed as a common problem of coronavirus disease 2019 (COVID-19) on frequent occasions in patients with moderate to severe disease. These patients showed presence of proteinuria and microscopic hematuria. Outcomes of such patients are bad with higher mortality and many of those surviving have become dialysis dependent. Kidney biopsy features show variety of tubular and glomerular involvement with acute tubular injury being a common finding.

13.
Journal of Indian Academy of Forensic Medicine ; 43(2):185-187, 2021.
Article in English | Scopus | ID: covidwho-1744701

ABSTRACT

A 35-year-old male was referred for autopsy from a District Headquarter hospital, where he was admitted to the COVID isolation ward with suspicion of being infected. His clinical history was a day of fever with chills and abdominal pain. He was alone overnight in the isolation ward post collection of his nasal swabs for screening and blood for routine laboratory tests. However, he was found lying dead on the floor within 18 hours of hospitalization © 2021. Journal of Indian Academy of Forensic Medicine. All rights reserved.

14.
Journal of the Practice of Cardiovascular Sciences ; 7(2):142-148, 2021.
Article in English | Web of Science | ID: covidwho-1702063

ABSTRACT

Background: COVID-19 pandemic has caused havoc and many deaths around the world. Coronavirus is highly contagious and spreads like wildfire in the community. The nurses and other frontline health-care workers (HCWs) bore the brunt of this pandemic with maximum effect because they all worked with infected patients. Direct exposure has caused stress, anxiety, and physical cum mental discomfort among them. Objective: This study aimed to assess stress among nurses and family members related to COVID-19 outbreak. Methodology: In this study, mixed method of prospective approach was used. The study was conducted virtually using social media platforms by online questionnaire. It included 150 participants and information was collected on demographic data, change in relationship with family, spouse, children, self-concept, and perceived stress among themselves and their family members. Results: All the nurses were involved in the direct care of COVID-infected patients. Many participants (47%) became anxious and worried about themselves. More than half (56.7%) respondents had no change in relationship, while 40.7% experienced change in relationship with their family. Majority of the participants (88%) had long travel hours and accommodation issues. Although the nurses working for COVID patients were stressed, frightened, and anxious, most of them took pride in their work as a contribution toward the nation during this current pandemic. Conclusion: This study demonstrated that frontline HCWs were at increased risk of mental health consequences such as stress, anxiety, and frustration. Their children developed behavioral changes such as agitation and aggressiveness. Many nurses got more family support than before for their contribution during COVID-19 pandemic.

15.
Journal of the Practice of Cardiovascular Sciences ; 7(2):135-141, 2021.
Article in English | Web of Science | ID: covidwho-1701570

ABSTRACT

Objective: The objective is to assess the clinical course and outcomes of heart transplant (HTx) recipients affected by COVID-19 disease in a tertiary care health care institution. Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) is a contagious illness with alarming morbidity and mortality. The HTx recipients are chronically immunosuppressed and thus COVID-19 infection in them may result in an unpredictable clinical course. Materials and Methods: HTx recipients in a tertiary care transplant center in North India were retrospectively reviewed from January 2020 to January 2021. Case records of 28 patients of HTx were reviewed, and four (14%) were found to have developed Covid-19 infection. Clinical parameters and outcomes of these four HTx recipients with confirmed SARS-CoV-2 infection are described. Results: Fourteen percent of our HTx patients (4 out of 28 patients under follow-up) developed COVID-19 in the first infection wave. The study population consisted of 3 males and 1 female patient with a median age of 28 years (range 15-39). The most common presenting symptoms were fever (100%), myalgia (100%) and cough (75%). There was no mortality observed in this study. None required intensive care admission or mechanical ventilatory support. Three were managed with hospital admission while one was subjected to home isolation. The mean hospital stay was 13.5 days (12-17 days). Immunosuppressants were modified by reducing tacrolimus and mycophenolate, however, corticosteroids were continued. Conclusion: The dose modification rather than discontinuation of immunomodulatory agents should be established as standard of care for transplant recipients. Steroids may provide added benefit and should be continued. The morbidity and mortality in such cases may be lower than anticipated;however, this needs to be substantiated with larger multicentric studies.

16.
Pacific Business Review International ; 14(3):66-76, 2021.
Article in English | Web of Science | ID: covidwho-1619288

ABSTRACT

The world has emerged dramatically after the outbreak of the influenza virus (Covid-19) with the new normal that has triggered many social and psychological challenges and changes. The present paper conceptualizes and identifies a few questions like;whether human social values change with a crisis like covid-19. Does, social value orientation intensifies cooperation and helping behaviour among people. Whether such changes are temporary and apparent in case of disasters or crisis like a pandemic. The study highlighted some perspectives based on previous studies relating to social and behavioural aspects during a crisis and provided a conceptual framework on how the social value orientation has been influenced by different factors like Social Norms, Social Discrimination and Inequality, Trust, Leadership, Sense of Connection and Empathy. Finally, as a policy implication, it gives enough scope for an empirical investigation into the various factors influencing social value orientation and its impact on behavioural changes during a crisis. An insight into the social value and behavioural changes in humans help the policymakers to devise appropriate strategies for crisis management.

17.
British Journal of Surgery ; 108(SUPPL 6):vi223, 2021.
Article in English | EMBASE | ID: covidwho-1569628

ABSTRACT

Introduction: Surgical conferences are invaluable events for healthcare professionals;they provide opportunities to engage with upcoming scientific discoveries, network professionally with peers as well as expand learning through lectures and workshops. For medical students, conferences provide an opportunity to expand understanding beyond the undergraduate curriculum in an interactive manner. COVID-19 has caused disruption to the organisation and attendance of in-person conferences (IPCs). Virtual conferences (VCs) offer a viable solution, allowing delegates to attend from the comfort of their own homes. Method: The aim of our study was to evaluate an organised VC and explore the perceived benefits and limitations of VCs compared to IPCs. A virtual one-day trauma & orthopaedics (T&O) conference was organised involving lectures, workshops, poster, and oral presentations. Anonymous questionnaire forms were distributed to delegates following the conference to assess the aims of our paper. Results: From 106 responses, 96.2% rated the conference as 'Excellent' or 'Good' with 92.5% stating that it increased their passion for T&O surgery. Based on a five-point Likert scale (5= strongly agree, 1= strongly disagree), mean score of agreement for preferring VCs to IPCs was 3.30(± 1.24). Key advantages of the VC were a lower cost (70.8%) and not having to travel (77.4%), whereas the main limitation was the inability to participate in hands-on workshops (84.9%). Conclusions: Despite the success of our VC, delegate feedback indicates a mixed response comparing VCs to IPCs. We share our findings to encourage similar events to be organised and for other specialties.

18.
British Journal of Surgery ; 108:1, 2021.
Article in English | Web of Science | ID: covidwho-1539368
19.
Hepatology ; 74(SUPPL 1):319A-320A, 2021.
Article in English | EMBASE | ID: covidwho-1508699

ABSTRACT

Background: Liver Transplant recipients have an increased susceptibility to SARS CoV2 infection with a possible more severe disease course. There is paucity of data of SARSCoV2 infection in this cohort from Asia. We report on the data of an on-going APCOLIS-1 (APASL Liver Injury Spectrum, APCOLIS) registry with the aim to define the profile, risk factors for severity and predictors of survival among the liver transplant recipients. Methods: In a multinational study, data was recorded between April 2020 to May 2021 across 13 countries in Asia. The data was compiled on a survey monkey under the APASL COVID-19 study task force [NCT04345640]. We performed multivariate logistic regression to identify independent predictors of severity and all cause mortality among the liver transplant (LT) recipients suffering from COVID-19. Results: Altogether, 130 LT recipients were enrolled [mean age 53 ± 12 years, median post-transplant period, 54 months (range 2-77 months)]. Majority (92, 71% ) of the patients had undergone live-donor transplant. Severe COVID was seen in 21/130 (16%) and 17/130 (13%) required ICU care. COVID related organ failures (OF) were seen in 17 patients (13%), predominantly as respiratory (16/21, 76.2%) followed by renal (9/21, 42.8%) and circulatory (5/21, 23.8%) with ventilatory requirement in 12/21 (57.1%) of the severe cases. Among the baseline parameters age [HR=1.08, 95CI 1.01-1.16, p=0.03], presentation with dyspnea [HR=6.34, 95CI 1.78-22.9, p=0.004] and Neutrophil to Lymphocyte ratio (NLR) [HR=1.08, 95CI 1.01-1.17, p=0.04] independently predicted a severe course of the COVID-19 among LT recipients. The baseline NLR of 8.47 ± 1.45 peaked to 17.94 ± 3.68 in median of 15 days (range 1-37) among severe cases [p<0.001] indicating rapid progression of disease. Age above 55 years increased the disease severity with AUROC of 0.78, sensitivity of 72.7% and specificity of 74.8%. Time from LT, immunosuppression dosage or presence of co-morbidities did not influence the outcome. Graft dysfunction was seen in 21/130 (16%);predominantly as acute cellular rejection in 13/130 (10%) and graft failure 7/130 (5%). The all cause mortality was 8% (11/130). Among non-survivors, the baseline NLR of 4.88 ± 1.63 increased to a peak value of 25.14 ± 5.49 [p<0.001] i.e 5 folds. The baseline NLR [HR=1.17, 95CI 1.03-1.34, p=0.02], development of graft injury [HR=27.21, 95CI 2.55-290., p=0.006] and COVID related OF [ HR=21.87, 95CI 2.39-203.85, p=0.007] independently predicted mortality due to SARSCoV2 infection. Conclusion: COVID-19 infection precipitates a severe disease course in one fifth of the liver transplant recipients, leading to graft dysfunction and early mortality. LT recipients above 55 years of age, presenting with dyspnea and high NLR need to be specifically watched for a progressive disease course. Dynamic NLR determination can help in early stratification and referral to a specialized liver unit to improve outcomes.

20.
Hepatology ; 74(SUPPL 1):334A-335A, 2021.
Article in English | EMBASE | ID: covidwho-1508698

ABSTRACT

Background: COVID-19 among liver transplant (LT) recipients varies with symptoms, severity, time from LT and with treatment from region to region. Here-with we report the clinical presentation, spectrum of disease and outcome from the Asia Pacific region. Methods: In this multinational study, data was recorded between April 2020 to May 2021 across 13 countries in Asia. The data was compiled on survey monkey under the APASL COVID-19 study task force [NCT04345640]. Severity of COVID infection was defined as per WHO guidelines. We analysed symptoms, demography, treatment, clinical course and treatment among LT patients with COVID-19. Results: Among a total 130 LT patients, males were 117 with mean age of 53±12 years and majority were live donor transplant (92,71%). The most common etiology of liver disease was ethanol (37, 28%) followed by NASH (28,22%) and cryptogenic(21,16%). Median post LT period was 54 months. Co-morbidity was present in 101 patients (78%), the most common being obesity (61,47%),followed by Diabetes (56,43%) and hypertension(30,23%). The presenting complaints were fever(82%), cough(61%), dyspnoea(29%) and diarrhoea(7%);8% were asymptomatic. Respiratory distress was seen in 29 (22%) cases;17 received only oxygen and 12 needed ventilator support. Prior to illness, only CNI was used as immunosuppressant in 30% (39), CNI & MMF in 31% (40) and in another 31% (40) mTOR inhibitors alone or with a CNI and triple regimen in 9%. During COVID, only low dose steroid was used in 50% (64), low dose CNI in mild to moderate ( 32%,41), complete avoidance of MMF in 4% cases where as low dose CNI and MMF in 16% (20) patients. Immunosuppression reintroduction done in 68% to pre-COVID dose and 28% were maintained on low dose CNI with steroids with close monitoring of LFT and pre-COVID dose was restarted after 14 days of recovery .4% had graft dysfunction leading to early augmentation of immunosuppression. Any antiviral was received by 36%, convalescent plasma by 26% and immunomodulators like tocilizumab or bevacizumab in 13%. Home care offered to 46% cases while those admitted, 41% were managed in ward only and 13% needed ICU admission. Graft function was unaffected in majority (109, 84%) but Acute Cellular Rejection was noted in 10% cases and DILI or other causes in 6%. Liver injury in the form of raised transaminases or bilirubin was noted in 19% at hospital stay and in 40% at presentation. Severe COVID was in 16% (21) cases with mortality in 8% (11). Conclusion: Compared to general population post-LT patients have an increased mortality due to COVID. Home based care could be feasible in only half of the patients.

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