King Fahad University Hospital, a leading public healthcare institution in the Eastern region of KSA, implemented a disruptive innovation of Telepharmacy in pursuit of compliance with the National COVID-19 Response Framework. It emerged and proved to be an essential and critical pillar in suppression and mitigation strategies. Telepharmacy innovation resulted in Pharmacy staffing protection and provided uninterrupted access and care continuum to the pharmaceutical services, both for COVID-19 and Collateral care. This reform-oriented initiative culminated in adopting engineering and administrative controls to design the workflows, practices, and interactions between healthcare providers, patients, and pharmaceutical frontline staff. Pharmaceutical services enhanced its surge capacity (14,618 OPD requests & 10,030 Inpatient orders) and improved capability (41,242 counseling sessions) to address the daunting challenge of complying with the inpatient needs and robust outpatient pharmaceutical consumer services. Pharmacy services established a harmonious momentum between spatial and temporal consumers amidst the peak of the pandemic, where footfalls, air gaps, physical proximity and use of crisis standard of care was an institutional priority and national obligation. This powerful tool of Telepharmacy significantly had an impact on the technical efficiency and healthcare system's effectiveness on resource utilization in this newly adopted institutional pandemic response model. Core determinants of safe, integrated medication management use were protected by using e-tools and vehicles such as WhatsApp, webpage portals, and applications along with express shipping couriers.

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Second wave of the new coronavirus (SARS-CoV-2) has been declared throughout the world. It has been always thought that children are the least affected group. A new childhood disease, referred to as MIS-C (Multisystem Inflammation Syndrome) or PIMS-TS (Pediatric Inflammatory Multiorgan Syndrome Temporally related to SARS-CoV-2) was first recognized in April 2020. Shock and multiorgan failure affected some of those children that required intensive care; others were clinically similar to Kawasaki disease or toxic shock. The clinical evidence suggests that this inflammatory multisystem syndrome is temporally associated with severe acute respiratory syndrome corona virus 2. Many clinical uncertainties regarding this new disease rapidly became apparent in prevalence, clinical phenotypes, variable severity, clinical course, and optimal management. We aim to increase awareness of this syndrome regarding the diagnosis and management of children with suspected PIMS-TS by presenting two clinical cases and illustrating the available medical literature in regards to establishing the diagnosis and the appropriate therapeutic interventions. SARS-Cov-2 related medical impacts on children seem not well clarified yet. When a PIMS-TS case is suspected then full investigations should be done, children who have persistent fever associated with abdominal pain, diarrhea ,vomiting ,cough, neurologic symptoms should have primary blood tests to identify PIMS-TS: full blood count, CRP: C-reactive protein,  BUN: Blood Urea Nitrogen, Cr: Creatinine, Electrolytes and liver function. Multidisciplinary team approach seems mandatory from the very beginning. Despite the use of IVIG in the treatment of all diagnosed cases, steroids in regular doses could be a good alternative and requires further investigative evaluations.