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Medical Journal of Dr. D.Y. Patil Vidyapeeth ; 15(3):406-408, 2022.
Article in English | Scopus | ID: covidwho-1835274


The severe acute respiratory syndrome coronavirus 2 disease (COVID-19) pandemic is not just about medical management in intensive care units (ICUs). The old population and those with severe comorbidities and chronic illnesses are more prone to die due to COVID-19 infection and integrating palliative care support in ICUs is the need of the hour. However, during this pandemic, there is a clear lack of palliative care in ICUs due to several barriers which we will discuss in this particular case. © 2021 Medical Journal of Dr. D.Y. Patil Vidyapeeth ;Published by Wolters Kluwer - Medknow

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


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.

Medical Journal of Dr. D.Y. Patil University ; 14(2):128-133, 2021.
Article in English | Scopus | ID: covidwho-1151773
Medical Journal of Dr. D.Y. Patil University ; 13(3):195-196, 2020.
Article in English | Scopus | ID: covidwho-1151770