Introduction Corona pandemic has resulted in a high mortality rate among health care professionals. The purpose of this study was to assess the knowledge and practices of health care providers during this pandemic in Punjab, Pakistan. Methods A web based cross sectional survey was conducted during 2 nd of April to 20 th April 2020 targeting health care professionals working in Punjab, Pakistan. A sample of 540 participants was collected using non probability, convenient sampling technique. Data was generated by using on line google forms after taking IRB approval from institution. Results Adequate knowledge was found among health care providers regarding diagnostic tests, modes of transmission, incubation period and preventive strategies. Significant association was seen in knowledge of post graduate and MBBS doctors (Bachelor of Medicine and Bachelor of Surgery) regarding viral etiology (p = 0.006), sign and symptoms (p = 0.000), risk factors (p = 0.000) and mortality rates (p = 0.001). Hand washing was considered as best preventive measure by 95% of the health care providers. Conclusion Post graduate doctors have better knowledge regarding corona virus disease transmission, risk factors, incubation period and preventive strategies as compared to undergraduate doctors.

Background and Objective: COVID-19 can cause severe acute respiratory distress syndrome. With deteriorating disease, most of the patients may require intensive care admission. This study was carried out to determine and evaluate the response of Tocilizumab with special reference to C-reactive protein (CRP) in critically ill patients presented to Farooq Hospital, West Wood Lahore.Methods: This retrospective study included the data of 55 critically ill COVID-19 patients (respiratory rate ≥30, SpO2<93%, oxygen requirement ≥5L/min, PaO2/FiO2 ≤300 mmHg) admitted in Corona unit of Farooq Hospital West Wood Lahore, who were being treated with Tocilizumab alongwith standard treatment protocol between April 27 and June 21, 2020. The data has been retrieved from hospital records after taking appropriate permission and consent. Demographic, clinical features and serum CRP were recorded for each of them, before and after administration of Tocilizumab. Data analysis was done by Statistical Package for the Social Sciences (SPSS) version 22.0 and expressed as frequency and percentages.Results: Out of 55 patients who were administered Tocilizumab, 72.7% survived whereas 27.3% died. There was higher median reduction of CRP levels in patients who survived (77.5 to 34.9 mg/L) as compared to those who died (65.5 to 45.3 mg/L). There was a statistically significant difference between CRP levels at the time of admission, 72 hours after Tocilizumab was administered (P<0.0001). Conclusion:Tocilizumab administration might be helpful in reducing the complications of cytokine storm in patients with severe COVID-19 pneumonia.

Objective: The main objective of the current study was to identify clinical and laboratory parameters associated with hypoxemia in patients with coronavirus disease 2019 (COVID-19). Materials and Methods: This retrospective study was carried out in Farooq Hospital, West Wood, Lahore. A total of 188 COVID-19 positive patients admitted to the corona unit of our hospital were enrolled in this study. The diagnosis of COVID-19 was confirmed either by Reverse transcriptase-polymerase chain reaction (RT-PCR) or clinical and imaging studies. Detailed demographic, clinical, laboratory and x-ray chest findings were recorded for each of these patients. Results: Age, number of days in the hospital, and hypertension were found to be significant. Lymphocytes, neutrophil counts, urea, and C- Reactive Protein (CRP) were significantly associated with oxygen saturation levels, less than 92% in COVID-19 patients. Conclusion: In this study, it was observed that hypoxemia was independently associated with clinical parameters and serum biomarkers. These may help/ guide in the clinical management of patients presenting with hypoxemia, particularly in a limited resource setting.

Background Globally, there is an increased risk of COVID-19 infection among front-line health workers (FHW). This study aimed to evaluate the knowledge, attitude, and practices of FHW of Pakistan after receiving the COVID-19 vaccine. Methods A population web-based survey on COVID-19 vaccine was conducted on 635 FHW in Pakistan between April 15, 2021, and July 15, 2021. The survey focused on four main sections consisting of socio-demographic data, knowledge, attitude, and practices after receiving the COVID-19 vaccine. The data was analyzed on SPSS. p < 0.05 was considered significant. Results Overall, 60% of FHW were nervous before getting vaccinated, with the leading reason to get vaccinated being their concern to protect themselves and their community (53.4%). A majority of FHW had fear about the unseen side effects of the COVID-19 vaccine (59.7%) used in Pakistan, with the most common side effect reported as soreness at the injection site (39%). It has been noted that almost all of the FHW observed preventive practices after getting vaccinated. The results showed that married respondents had favorable practices towards COVID-19 vaccines (B = 0.53, p < 0.01) (B, unstandardized regression coefficient). It was also found that more informational sources (B = 0.19, p < 0.01), higher knowledge of vaccination (B = 0.15, p < 0.001), and favorable attitude toward vaccine (B = 0.12, p < 0.001) significantly predicted favorable practices toward COVID-19 vaccination. Conclusion The findings reflect that FHW, though they were worried about its side effects, have good knowledge and a positive attitude after getting the COVID-19 vaccine. This study is significant as the FHWs are a symbol for guidance, a reliable source of information, and an encouraging means of receiving COVID-19 vaccine for the general public. This study also reported that post-vaccination side effects were mild which will aid in reducing the vaccine hesitancy among the general Pakistani population.

Aim: To assess the baseline renal profile of patients with COVID-19. Methods: It was a cross sectional study, conducted in hospitals of Rawalpindi Medical University from March to August 2020. Consecutive 169 confirmed cases of COVID-19 were enrolled. Patients with history of kidney disease were not included. Peripheral blood samples were analysed for renal functions on fully automated chemistry analyser. Estimated glomerular filtration rate (eGFR) for every patient was calculated using two equations for chronic kidney disease epidemiology collaboration (CKD-EPI) and modification of diet in renal disease (MDRD). Results: Out of total 169 COVID-19 patients, 97(57%) were males 72(43%) were females. The mean age was 54.1±16.30 (18 to 92) years. A total of 96(57%) patients were below 60 years of age. Mean Urea, serum creatinine (Scr) and blood urea nitrogen (BUN) were found to be elevated in this study cohort with no statistically significant difference with respect to age and gender (P value >0.05). Scr was raised in 46(27%) while 113(67%) and 103 (62%) patients had elevated serum Urea and BUN respectively. eGFR of <60mL/min/1.73m2 was observed in 50(30%) of patients. Conclusion: Elevated mean Urea, Scr and BUN were observed in COVID 19 patients without any significant difference according to age and gender. Moderate to severe derangement in eGFR was noted in one third of COVID 19 patients. Keywords: COVID-19, Renal function test, Estimated glomerular filtration rate