Medical Specialties Commons^™

Likely Community Transmission Of Covid-19 Infections Between Neighboring, Persistent Hotspots In Ontario, Canada, Ben C. Shirley, Eliseos J. Mucaki, Peter Rogan

Biochemistry Publications

Introduction: This study aimed to produce community-level geo-spatial mapping of confirmed COVID-19 cases in Ontario Canada in near real-time to support decision-making. This was accomplished by area-to-area geostatistical analysis, space-time integration, and spatial interpolation of COVID-19 positive individuals.
Methods: COVID-19 cases and locations were curated for geostatistical analyses from March 2020 through June 2021, corresponding to the first, second, and third waves of infections. Daily cases were aggregated according to designated forward sortation area (FSA), and postal codes (PC) in municipal regions Hamilton, Kitchener/Waterloo, London, Ottawa, Toronto, and Windsor/Essex county. Hotspots were identified with area-to-area tests including Getis-Ord Gi*, Global …

The Mystery Of Covid-19 Reinfections: A Global Systematic Review And Meta-Analysis, Rubaid Azhar Dhillon, Mohammad Aadil Qamar, Jaleed Ahmed Gilani, Omar Irfan, Usama Waqar, Mir Ibrahim Sajid, Syed Faisal Mahmood

Department of Medicine

Background: As the COVID-19 pandemic rages on, reports on disparities in vaccine roll out alongside COVID-19 reinfection have been emerging. We conducted a systematic review to assess the determinants and disease spectrum of COVID-19 reinfection.
Materials and methods: A comprehensive search covering relevant databases was conducted for observational studies reporting Polymerase Chain Reaction (PCR) confirmed infection and reinfection cases. A quality assessment tool developed by the National Institute of Health (NIH) for the assessment of case series was utilized. Meta-analyses were performed using RevMan 5.3 for pooled proportions of findings in first infection and reinfection with a 95% confidence interval …

Adverse Reactions Following Covid-19 Vaccination: An Ecuadorian Experience, Emanuel Vanegas, Karla Robles-Velasco, María F. Osorio, María José Farfán Bajaña, Zouina Sarfraz, Azza Sarfraz, Juan Carlos Fernández Cadena, Derly Madeleiny Andrade Molina, Matias Panchana Lascano, Ivan Cherrez-Ojeda

Department of Paediatrics and Child Health

Background: Limited large-scale studies have been conducted to investigate the adverse effects of COVID-19 vaccine in Latin America, particularly among the healthcare worker (HCW) population in Ecuador. The objective of this study was to assess a cohort of Ecuadorian healthcare workers for adverse reactions following vaccination with the Pfizer-BioNTech vaccine.
Methods: We conducted an observational cross-sectional study to assess the potential adverse reactions to the Pfizer-BioNTech COVID-19 vaccine among a sample of healthcare workers (HCWs) in the city of Guayaquil, Ecuador, from March to May 2021.
Results: The sample comprised 1291 patients, with a mean age of 39.3 years (SD, …

Upregulated Type I Interferon Responses In Asymptomatic Covid-19 Infection Are Associated With Improved Clinical Outcome, Kiran I. Masood, Maliha Yameen, Javeria Ashraf, Saba Shahid, Syed Faisal Mahmood, Asghar Nasir, Nosheen Nasir, Bushra Jamil, Najia Karim Ghanchi, Iffat Khanum, Safina Abdul Razzak, Akber Kanji, Rabia Hussain, Martin E. Rottenberg, Zahra Hasan

Department of Pathology and Laboratory Medicine

Understanding key host protective mechanisms against SARS-CoV-2 infection can help improve treatment modalities for COVID-19. We used a blood transcriptome approach to study biomarkers associated with differing severity of COVID-19, comparing severe and mild Symptomatic disease with Asymptomatic COVID-19 and uninfected Controls. There was suppression of antigen presentation but upregulation of inflammatory and viral mRNA translation associated pathways in Symptomatic as compared with Asymptomatic cases. In severe COVID-19, CD177 a neutrophil marker, was upregulated while interferon stimulated genes (ISGs) were downregulated. Asymptomatic COVID-19 cases displayed upregulation of ISGs and humoral response genes with downregulation of ICAM3 and TLR8. Compared across …

Which Outcomes Are Most Important To Measure In Patients With Covid-19 And How And When Should These Be Measured? Development Of An International Standard Set Of Outcomes Measures For Clinical Use In Patients With Covid-19: A Report Of The International Consortium For Health Outcomes Measurement (Ichom) Covid-19 Working Group, William H. Seligman, Luz Fialho, Nick Sillett, Christina Nielsen, Farhala Mari Baloch, Philip Collis, Ingel K M. Demedts, Marcelo P. Fleck, Maiara A. Floriani, Nasreen Muhammad

Section of Cardiology

Objectives: The COVID-19 pandemic has resulted in widespread morbidity and mortality with the consequences expected to be felt for many years. Significant variation exists in the care even of similar patients with COVID-19, including treatment practices within and between institutions. Outcome measures vary among clinical trials on the same therapies. Understanding which therapies are of most value is not possible unless consensus can be reached on which outcomes are most important to measure. Furthermore, consensus on the most important outcomes may enable patients to monitor and track their care, and may help providers to improve the care they offer through …

Atypical St-Segment-Elevation Myocardial Infarction Presentation In Patients With Covid-19 At A High-Volume Center In New York City, Miguel A Alvarez Villela, Ahmad Alkhalil, Michael A Weinreich, Jonathan Koslowsky, Shunsuke Aoi, M Azeem Latib

The Texas Heart Institute Journal

Atypical presentations of ST-segment-elevation myocardial infarction (STEMI) have been reported in patients who have COVID-19. We have seen this occurrence in our center in Bronx, New York, where multitudes of patients sought treatment for the coronavirus. We studied the prevalence of atypical STEMI findings among patients with COVID-19 who presented during the first 2 months of the pandemic.

Consistent with previous reports, 4 of our 10 patients with COVID-19 and STEMI had no identifiable culprit coronary lesion; rather, they often had diffuse ST-segment elevations on surface electrocardiograms along with higher levels of D-dimer and inflammatory markers. In contrast, 32 of …

Is Covid-19 Impacting Cancer Screening In Pakistan? An Observational Study Of Cancer Screening Test Requests During The Pandemic, Sibtain Ahmed, Muhammad Abbas Abid, Noureen Niaz Ali, Junaid Ahmed, Imran Siddiqui

Department of Pathology and Laboratory Medicine

Background: The purpose of this study is to assess how the COVID-19 pandemic affected cancer screening at a large tertiary care setting in the city of Karachi, the third largest city in the world, and to identify if there has been any decrease in cancer screening during the ongoing pandemic.
Methods: A retrospective observational study was conducted at the clinical chemistry laboratory at the Department of Pathology & Laboratory Medicine, Aga Khan University Hospital (AKUH), Karachi Pakistan. Data for test volumes was extracted from the Integrated Laboratory Management System (ILMS) for the following tumor markers: CA19 Carbohydrate Antigen 19-9 (CA …

The Radiological Presentation Of Rasmussen Aneurysm Secondary To Pulmonary Tuberculosis And Covid-19: A Case Report, Adnan Arif, Khurram Khaliq Bhinder, Azza Sarfraz, Zouina Sarfraz, Miguel Felix, Ivan Chérrez-Ojeda

Department of Paediatrics and Child Health

Rasmussen aneurysm is rare diagnosis occurring in patients with long-standing tuberculosis. TB-COVID-19 co-infection in the context of Rasmussen aneurysm is a rare occurrence, yet new cases are emerging. An elderly male was recently diagnosed with TB-COVID-19 co-infection and presented with sudden onset massive hemoptysis. The patient was diagnosed with Rasmussen aneurysm after being evaluated by computed tomography pulmonary angiogram due to a suggestive clinical presentation. Interventional radiologists planned for embolization of pulmonary artery, with an unidentifiable source. It was suspected that the patient's source of bleeding was hampered due to local tamponade effect or thrombosis of the aneurysm. The patient …

Non-Compliance To Social Distancing During Covid-19 Pandemic: A Comparative Cross-Sectional Study Between The Developed And Developing Countries, Faiqa Binte Aamir, Syeda Maria Ahmad Zaidi, Saadia Abbas, Syed Roohan Aamir, Syed Nauman Ahmad Zaidi, Karishma Kanhya Lal, Syeda Sadia Fatima

Medical College Documents

Background: Despite mass vaccination campaigns, the world has seen a steady rise in the number of SARS-CoV-2 cases, with 178,765,626 cases and 3,869,994 COVID-19 related deaths by June 19^th, 2021. Therefore, it is important to enforce social distancing to control its spread. With the variation observed in the severity of the pandemic in different countries, it is also imperative to study the social distancing behaviors amongst the population in developed and developing countries.
Design and Methods: In this cross-sectional study, a total of 384 participants from 14 different countries were surveyed via an online REDCap form.
Results: In …

Colchicine, Covid-19 And Hematological Parameters: A Meta-Analysis, Musharraf Sarwar, Zahid Ali, Mahnoor Fatima, Zouina Sarfraz, Azza Sarfraz, Ivan Cherrez-Ojeda

Department of Paediatrics and Child Health

Introduction: Colchicine has the potential in reducing patient morbidity and mortality in COVID-19 infection owing to its anti-inflammatory properties. This study aims to determine the efficacy of colchicine in optimizing inflammatory hematological biomarker levels among COVID-19 patients.
Methods: In accordance to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement guidelines, a systematic search was conducted using the following keywords: Colchicine, covid*, SARS-CoV-2, anti-inflammatory, trials, clinical, hematological, laboratory. Databases were searched from December 2019 until August 26, 2021: MEDLINE/PubMed, Web of Science, Cochrane, Scopus, and EMBASE. Other sources were located through ClinicalTrials.Gov, manually searching SAGE, Science Direct, Elsevier, …

Role Of Gut Microbiome In Covid-19: An Insight Into Pathogenesis And Therapeutic Potential, Ikram Hussain, Gabriel Liu Yuan Cher, Muhammad Abbas Abid, Muhammad Bilal Abid

Department of Pathology and Laboratory Medicine

Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), resulted in an unprecedented global crisis. Although primarily a respiratory illness, dysregulated immune responses may lead to multi-organ dysfunction. Prior data showed that the resident microbial communities of gastrointestinal and respiratory tracts act as modulators of local and systemic inflammatory activity (the gut-lung axis). Evolving evidence now signals an alteration in the gut microbiome, brought upon either by cytokines from the infected respiratory tract or from direct infection of the gut, or both. Dysbiosis leads to a "leaky gut". The intestinal permeability then allows access to …

Chronic Long-Covid Syndrome: A Protracted Covid-19 Illness With Neurological Dysfunctions, Abdul Mannan Baig

Department of Biological & Biomedical Sciences

After almost a year of COVID-19, the chronic long-COVID syndrome has been recognized as an entity in 2021. The patients with the long-COVID are presenting with ominous neurological deficits that with time are becoming persistent and are causing disabilities in the affected individuals. The mechanisms underlying the neurological syndrome in long-COVID have remained obscure and need to be actively researched to find a resolution for the patients with long-COVID. Here, the factors like site of viral load, the differential immune response, neurodegenerative changes, and inflammation as possible causative factors are debated to understand and investigate the pathogenesis of neuro-COVID in …

Covid-19 Vaccination In Sindh Province, Pakistan: A Modelling Study Of Health Impact And Cost-Effectiveness, Carl A B. Pearson, Fiammetta Bozzani, Simon R. Procter, Nicholas G. Davies, Maryam Huda, Henning Tarp Jensen, Marcus Keogh-Brown, Muhammad Khalid, Sedona Sweeney, Sergio Torres-Rueda

Community Health Sciences

Background: Multiple Coronavirus Disease 2019 (COVID-19) vaccines appear to be safe and efficacious, but only high-income countries have the resources to procure sufficient vaccine doses for most of their eligible populations. The World Health Organization has published guidelines for vaccine prioritisation, but most vaccine impact projections have focused on high-income countries, and few incorporate economic considerations. To address this evidence gap, we projected the health and economic impact of different vaccination scenarios in Sindh Province, Pakistan (population: 48 million).
Methods and findings: We fitted a compartmental transmission model to COVID-19 cases and deaths in Sindh from 30 April to 15 …

Relative Risk Of Anxiety And Depression Among Covid-19 Survivor Healthcare Workers From A Tertiary Care Hospital In Pakistan: A Pilot Cohort Study, Farnaz Zahoor, Zahid Nazar, Sarwat Masud, Rehana Rahim

Department of Emergency Medicine

Longitudinal studies for determining the risk of anxiety and depression among COVID-19 survivor healthcare workers are lacking. This study aimed to determine the risk of anxiety and depression among healthcare workers that survived COVID-19 infection through a six-month post-recovery follow-up. This was a cohort study conducted at the Department of Obstetrics and Gynecology, Lady Reading Hospital, Peshawar, from 1st March to 30th August 2020. A total of 64 subjects participated. Hospital Anxiety and Depression Scale (HADS) was used for assessing the anxiety and depression symptoms. HADS has three score cutoff as normal, borderline abnormal and, abnormal anxiety/depression. For the purpose …

Impact Of Covid-19 On The Pre And Post Analytical Clinical Laboratory Testing Processes- A Performance Evaluation Study Using Six Sigma, Sibtain Ahmed, Farhat Jahan, Muhammad Umer Naeem Effendi, Farooq Ghani

Department of Pathology and Laboratory Medicine

Background: The aim of this study was to determine the impact of COVID-19 pandemic on the total testing process using six sigma metrics based on a comparison of pre and during pandemic periods.
Material & methods: The study duration was over 12 months, 6 months before and 6 months after the COVID-19 onset in Pakistan in March 2020 after the recognition of the first case, using quality indicators (QIs). QIs were chosen from a model of QIs recommended by the CAP. Analysis was performed using Six Sigma calculators and QIs were expressed in percentage (%) and Sigma value were computed. …

Persistence Of Post-Covid Lung Parenchymal Abnormalities During The Three-Month Follow-Up, Ali Bin Sarwar Zubairi, Anjiya Shaikh, Syed Muhammad Zubair, Akbar Shoukat Ali, Safia Awan, Muhammad Irfan

Section of Pulmonary & Critical Care

Introduction: COVID-19-associated pulmonary sequalae have been increasingly reported after recovery from acute infection. Therefore, we aim to explore the charactersitics of persistent lung parenchymal abnormalities in patients with COVID-19.
Material and methods: An observational study was conducted in patients with post-COVID lung parenchymal abnormalities from April till September 2020. Patients ≥18 years of age with COVID-19 who were diagnosed as post-COVID lung parenchymal abnormality based on respiratory symptoms and HRCT chest imaging after the recovery of acute infection. Data was recorded on a structured pro forma, and descriptive analysis was performed using Stata version 12.1.
Results: A total of 30 …

Covid-19 And Family Planning In The Eastern Mediterranean Region, Azza Sarfraz, Zouina Sarfraz, Sameer Saleem Tebha, Namrata Hange, Kuchalambal Agadi, Alanna Barrios, Manish Kc, Gaurav Patel

Department of Paediatrics and Child Health

No abstract provided.

Comparative Analysis Of N95 Respirators Fit Testing With Commercially Available And In House Reagent, Erum Khan, Joveria Farooqi, Humaira Shafaq, Kaleem Ullah Khushik, Syed Shamim Raza, Sara Khan, Zohra Rafiq, Bushra Ahmed, Shazia Chisti, Kehkashan Imtiaz, Hasnain Zafar, Afia Zafar

Department of Pathology and Laboratory Medicine

Background: Due to COVID-19, thousands of healthcare workers have been affected and have lost their lives in the line of duty. For the protection of healthcare workers, WHO and CDC have made standard guidelines and requirements for PPE use. N95 masks are amongst the most readily used PPE by healthcare professionals and it is highly recommended by OSHA that every make and model of N95 should go through a fit test at least once in a year.
Method: A total of 30 randomly selected healthcare professionals (who were a regular user of N95 respiratory masks) were subjected to assess in-house …

Avoidance Of St-Segment-Elevation Myocardial Infarction Treatment For >1 Week Due To Covid-19 Fears, Rahul V Annabathula, Gregory J Sinner, Talal S Alnabelsi, Rachel P Goodwin, Vincent L Sorrell

The Texas Heart Institute Journal

During the coronavirus disease 2019 (COVID-19) pandemic, social distancing guidelines have negatively affected the care-seeking behavior of patients with chronic medical conditions, including those with cardiovascular disease. We report the case of a 60-year-old man with vague gastrointestinal symptoms who waited more than 1 week to seek treatment for fear of COVID-19 infection. On presentation at another hospital, he was found to have had an anterior myocardial infarction, and he underwent percutaneous coronary intervention to stent an occluded proximal left anterior descending coronary artery. Subsequently, the patient experienced refractory cardiogenic shock and, during his transfer to our hospital, refractory ventricular …

Higher Entropy Observed In Sars-Cov-2 Genomes From The First Covid-19 Wave In Pakistan, Najia Karim Ghanchi, Asghar Nasir, Kiran I. Masood, Syed Hani Abidi, Syed Faisal Mahmood, Akber Kanji, Safina Abdul Razzak, Waqasuddin Khan, Saba Shahid, Maliha Yameen, Ali Raza, Javaria Ashraf, Zeeshan Ansar Ahmed, Mohammad Buksh Dharejo, Nazneen Islam, Zahra Hasan, Rumina Hasan

Department of Pathology and Laboratory Medicine

Background: We investigated the genome diversity of SARS-CoV-2 associated with the early COVID-19 period to investigate evolution of the virus in Pakistan.
Materials and methods: We studied ninety SARS-CoV-2 strains isolated between March and October 2020. Whole genome sequences from our laboratory and available genomes were used to investigate phylogeny, genetic variantion and mutation rates of SARS-CoV-2 strains in Pakistan. Site specific entropy analysis compared mutation rates between strains isolated before and after June 2020.
Results: In March, strains belonging to L, S, V and GH clades were observed but by October, only L and GH strains were present. The …

Balancing Science And Public Policy In Pakistan's Covid-19 Response, Zulfiqar Ahmed Bhutta, Faisal Sultan, Aamer Ikram, Adil H. Haider, Assad Hafeez, Muhammad Islam

Department of Paediatrics and Child Health

Background: Coronavirus disease 2019 (COVID-19) has affected the world in an unprecedented manner and South Asian countries were among the first to experience imported cases. Pakistan's response to COVID-19 has been under scrutiny for its granularity, reach and impact.
Aims: to evaluate objectively the chronology and depth of the response to COVID-19 in Pakistan.
Methods: We evaluated available national and subnational epidemiological and burden information on COVID-19 cases and deaths in Pakistan, including projection models available to the Government at an early stage of the pandemic.
Results: Pakistan, with a population of 215 million and considerable geographic diversity, experienced case …

Discrepancy Between Pcr Based Sars-Cov-2 Tests Suggests The Need To Re-Evaluate Diagnostic Assays, Zain Mushtaq, Sadia Shakoor, Akber Kanji, Najma Shaheen, Asghar Nasir, Zeeshan Ansar Ahmed, Imran Ahmed, Syed Faisal Mahmood, Rumina Hasan, Zahra Hasan

Section of Internal Medicine

Objective: We investigated the discrepancy between clinical and PCR-based diagnosis of COVID-19. We compared results of ten patients with mild to severe COVID-19. Respiratory samples from all cases were tested on the Roche SARS-CoV-2 (Cobas) assay, Filmarray RP2.1 (bioMereiux) and TaqPath™ COVID19 (Thermofisher) PCR assays.
Results: Laboratory records of ten patients with mild to severe COVID-19 were examined. Initially, respiratory samples from the patients were tested as negative on the SARS-CoV-2 Roche® assay. Further investigation using the BIOFIRE® Filmarray RP2.1 assay identified SARS-CoV-2 as the pathogen in all ten cases. To investigate possible discrepancies between PCR assays, additional testing was …

Perceptions And Experiences Of Healthcare Providers During Covid-19 Pandemic In Karachi, Pakistan: An Exploratory Qualitative Study, Anam Shahil Feroz, Nousheen Pradhan, Zarak Hussain Ahmed, Mashal Murad Shah, Nargis Asad, Sarah Saleem, Sameen Siddiqi

Community Health Sciences

Objective: To explore healthcare provider's perspectives and experiences of the barriers and facilitators to treat and manage COVID-19 cases.
Design and setting: We conducted an exploratory qualitative study using a purposive sampling approach, at a private tertiary care teaching hospital in Karachi, Pakistan. Study data were analysed manually using the conventional content analysis technique.
Participants: Key-informant interviews (KIIs) were conducted with senior management and hospital leadership and in-depth interviews (IDIs) were conducted with front-line healthcare providers.
Results: A total of 31 interviews (KIIs=19; IDIs=12) were conducted, between April and May 2020. Three overarching themes emerged. The first was 'challenges faced …

Impact Of Coronavirus Disease 2019 On Prevention And Elimination Strategies For Hepatitis B And Hepatitis C, Syed Tabish Rehman, Hareem Rehman, Shahab Abid

Section of Pulmonary & Critical Care

The coronavirus disease 2019 (COVID-19) pandemic has resulted in significant morbidity and mortality since its first case was discovered in December 2019. Since then, multiple countries have witnessed a healthcare system collapse due to the overwhelming demand for COVID-19 care. Drastic measures have been taken globally in order to curb the spread of the virus. However, those measures have led to the disruption of other aspects of healthcare, increasing the burden due to other medical conditions. We have also stepped back in achieving the ambitious goal set in place by World Health Organization to eliminate viral hepatitis as a public …

A Review Of The Cardiac And Cardiovascular Effects Of Covid-19 In Adults And Children, Bibhuti B Das, S Kristen Sexon Tejtel, Shriprasad Deshpande, Lara S Shekerdemian

The Texas Heart Institute Journal

Symptomatic coronavirus disease 2019 (COVID-19) typically affects the respiratory system but can involve the cardiovascular system. Cardiac complications of COVID-19 can result directly from myocarditis or indirectly from numerous other mechanisms. Differentiating between primary and secondary cardiovascular involvement-our focus in this review-may help to identify the long-term effects of COVID-19 on the heart in adults and children.

Delayed Treatment Of Acute Myocardial Infarction With Ventricular Septal Rupture Due To Patient Fear During The Covid-19 Pandemic, Minar Chhetry, Reema Bhatt, Nathan H Tehrani, Dimitrios V Avgerinos, Charles A Mack, Samuel J Lang, Xuming Dai

The Texas Heart Institute Journal

During the coronavirus disease 2019 (COVID-19) pandmic, more patients are presenting with complications late after acute myocardial infarction. We report the case of a 71-year-old man who delayed seeking medical care for 2 weeks, despite progressive shortness of breath, cough, and tactile fever, for fear of contracting COVID-19 in the hospital. Clinical and echocardiographic evaluation revealed a ventricular septal rupture secondary to acute myocardial infarction. The patient underwent urgent cardiac catheterization, followed by successful saphenous vein grafting to the left anterior descending coronary artery and open surgical repair of the ventricular septal rupture with a bovine pericardial patch. This case …

Covid-19 In Hemodialysis Patients, Sonia Yaqub, Amna Hamid, Zarghoona Naeem

Section of Nephrology

No abstract provided.

Characteristics Of Patients Presenting With Covid-19 From Balochistan Province And Lessons Learnt, Abida Munir Badini, Aurangzeb Badini, Naeem M. Mengal, Kashmira Nanji

Department of Family Medicine

Objective: With the spread of COVID-19 in Pakistan, Balochistan province with its unique problems of lowest literacy rates in the country, limited resources and a flail health care system is reporting an increasing number of cases of COVID-19. This study discusses the epidemiological and clinical characteristics of COVID-19 patients from the Balochistan province.
Study design: Situation report Place and Duration of Study: The study was conducted in Balochistan province of Pakistan. The completion date for the study was April 30, 2020.
Methodology: The data was retrieved from the daily situation report from the Health Department, Government of Balochistan. Descriptive statistics …

Comparison Of Clinical Characteristics And Outcomes Between Covid-19 Pneumonia And H1n1 Influenza, Nosheen Nasir, Iffat Khanum, Kiren Habib, Rimsha Ahmed, Mujahid Hussain, Zahra Hasan, Muhammad Irfan

Department of Medicine

Introduction: The COVID-19 pandemic has been likened to the 2009 H1N1 influenza pandemic. We aim to study the similarities and differences between patients hospitalized with COVID-19 and H1N1 influenza in order to provide better care to patients, particularly during the co-circulation of Influenza A Subtype H1N1 and SARS-CoV-2.
Material and methods: A retrospective cohort study was conducted in order to compare clinical characteristics, complications, and outcomes of hospitalized patients with PCR-confirmed H1N1 influenza pneumonia and COVID-19 at a tertiary care center in Karachi, Pakistan.
Results: A total of 115 patients hospitalized with COVID-19 were compared with 55 patients with H1N1 …

Concurrent Covid-19 Infection In Children With Acute Appendicitis: A Report Of Three Cases, Maximo J. Acevedo, Dylan Steffey, Johanne E. Dillon, James T. Lee, David J. Worhunsky

Radiology Faculty Publications

Literature describing patients with concomitant COVID-19 infection with acute appendicitis in pediatric patients is growing, and understanding the clinical picture of such patients is relevant in their treatment. We report 3 male children who were surgically treated for acute appendicitis and had concomitant SARS-CoV-2 infection. Our first patient was a 12-year-old male who presented with symptoms indicative of appendicitis but no respiratory symptoms associated with COVID-19 (eg cough, shortness of breath). Laboratory evaluation revealed leukopenia and an elevated C-reactive protein; imaging was consistent with acute appendicitis and an acute pulmonary viral infection. Though he lacked diffuse peritonitis on physical examination …