Novel coronavirus disease (COVID-19) pandemic: A recent mini review.

The COVID-19, caused by a novel coronavirus, was declared as a global pandemic by WHO more than five months ago, and we are still experiencing a state of global emergency. More than 74.30 million confirmed cases of the COVID-19 have been reported globally so far, with an average fatality rate of almost 3.0%. Seven different types of coronaviruses had been detected from humans; three of them have resulted in severe outbreaks, i.e., MERS-CoV, SARS-CoV, and SARS-CoV-2. Phylogenetic analysis of the genomes suggests that the possible occurrence of recombination between SARS-like-CoVs from pangolin and bat might have led to the origin of SARS-CoV-2 and the COVID-19 outbreak. Coronaviruses are positive-sense, single-stranded RNA viruses and harbour a genome (30 kb) consisting of two terminal untranslated regions and twelve putative functional open reading frames (ORFs), encoding for non-structural and structural proteins. There are sixteen putative non-structural proteins, including proteases, RNA-dependent RNA polymerase, helicase, other proteins involved in the transcription and replication of SARS-CoV-2, and four structural proteins, including spike protein (S), envelope (E), membrane (M), and nucleocapsid (N). SARS-CoV-2 infection, with a heavy viral load in the body, destroys the human lungs through cytokine storm, especially in elderly persons and people with immunosuppressed disorders. A number of drugs have been repurposed and employed, but still, no specific antiviral medicine has been approved by the FDA to treat this disease. This review provides a current status of the COVID-19, epidemiology, an overview of phylogeny, mode of action, diagnosis, and possible treatment methods and vaccines.

Evaluation of Blood parameters, Covid-19 Vaccine Adverse effects, Hesitancy, and Acceptance rate in Pregnant Women: A Cross-sectional study

The study aimed to analyzepre and post-Covid-19 vaccination adverse reactions experienced by pregnant women. The sum of 145 samples of blood collected from the pregnant women enrolled in Tertiary care hospitals, in Peshawar. Those pregnant women who participated from Peshawar were 54, Dir 23, Charsda 16, Mardan 15, Swat 12, Banu 7, Kohat 4, Malakand 3, Dera Ismail Khan 4, Dara Khyber 2, Mohmand 2, Parachinar 1, Laki marwat 1 and Bajwar was 1.Our study examined the slight change in signs and symptoms in pregnant women against Covid-19 vaccines but did not find any change in the blood parameters. Our findings isolated good results of Covid-19 vaccine acceptance in pregnant women but need more studies and clinical trials to develop a safe, effective and potent vaccine for pregnant women.Recognizing mentalities among study groups will be valuable for coming up with vaccine strategies that increment the ongoing pandemic.

Artificial intelligence assisted acute patient journey.

Artificial intelligence is taking the world by storm and soon will be aiding patients in their journey at the hospital. The trials and tribulations of the healthcare system during the COVID-19 pandemic have set the stage for shifting healthcare from a physical to a cyber-physical space. A physician can now remotely monitor a patient, admitting them only if they meet certain thresholds, thereby reducing the total number of admissions at the hospital. Coordination, communication, and resource management have been core issues for any industry. However, it is most accurate in healthcare. Both systems and providers are exhausted under the burden of increasing data and complexity of care delivery, increasing costs, and financial burden. Simultaneously, there is a digital transformation of healthcare in the making. This transformation provides an opportunity to create systems of care that are artificial intelligence-enabled. Healthcare resources can be utilized more justly. The wastage of financial and intellectual resources in an overcrowded healthcare system can be avoided by implementing IoT, telehealth, and AI/ML-based algorithms. It is imperative to consider the design principles of the patient's journey while simultaneously prioritizing a better user experience to alleviate physician concerns. This paper discusses the entire blueprint of the AI/ML-assisted patient journey and its impact on healthcare provision.

Development of myocarditis and pericarditis after COVID-19 vaccination in children and adolescents: A systematic review.

Myocarditis and pericarditis have been reported after COVID-19 vaccine administration in children and adolescents, raising the concern about their possible association with these vaccines. The objective was to explore the incidence, clinical presentation, and association of myocarditis and pericarditis with COVID-19 vaccines in children and adolescents. We conducted a systematic literature search on three databases, that is, Cochrane, MEDLINE/PubMed, and EMBASE from inception till March 2022. A total of three case reports, four case series, and six observational studies were included in the review. For case reports and case series, the mean age of the patients was 17.4 years, with 96.9% being male. Chest pain (n = 31, 93.9%), fever (n = 18, 54.5%), myalgias (n = 15, 45.4%) and headache (n = 9, 27.2%) were the most common presentations. Out of 33 patients, 32 (96.9%) of patients received Pfizer-BioNTech whereas only one (3.03%) received Moderna (mRNA 1273). Clinical investigations revealed ST elevation (n = 32, 97%), and elevated CRP (n = 9, 27.2%) and cardiac troponin (n = 29, 87.8%). The pooled incidence of myocarditis and pericarditis from observational studies was (0.00063%) and (0.000074%) %, respectively. Myocarditis and pericarditis in children and adolescents after the COVID-19 vaccines were more prevalent among males and more commonly observed after the second dose of Pfizer. Though the overall incidence was low, however, the clinicians should consider myocarditis and pericarditis as probable diagnosis when encountering young patients, with a history of vaccine administration, presenting with suggestive findings.

Synthesis, characterization, molecular docking and biological evaluation of Schiff Base derivatives of cefpodoxime.

Synthesis of new Cefpodoxime derivatives via Schiff Bases mechanism and the efficiency of their antimicrobial and antiviral activities were addressed. They were analyzed for structural validation by using spectroscopic techniques using FTIR, 1HNMR, and 13CNMR. Molecular docking against IBV Virus papain-like protease (PLPro) was done with Auto dock tools against compounds having excellent IC50 values against IBV (Corona Class) virus. All derivatives showed strong zone of inhibition ranges from (55 ± 2.0 to 70 ± 0.8 mm) against E. coli. Compounds 1,2,4 and 6 derivatives showed remarkable activity against Stenotrophomonas maltophilia and Serratia marcescens. But For most the newly synthesized derivatives C 1 (64 ± 1.60), C 3 (32 ± 0.80), and C 8 (64 ± 1.60) showed potential IC50 values against two variants of Corona class viruses i.e. Avian Influenza (H9) and Avian corona (IBV) viruses. The current study revealed that newly synthesized Schiff Bases possessed strong anti-viral potential. Further studies may make a breakthrough in medical sciences to tackle latest challenges such as Corona Virus Diseases.

Corporate Dividend Policies during the COVID-19 Pandemic

In this paper, we examine the changes in corporate dividend policies during the COVID-19 shock. For empirical analysis, we employ annual data of 360 companies from the Pakistan Stock Exchange over the period 2015–2020. Using descriptive analysis and Logit regression models, we find that firms were more likely to either omit or reduce dividend payments during the pandemic year of 2020 as compared to the trends in pre-COVID-19 years of 2015–2019. Further, firms with higher profitability, asset turnover and size were less likely to opt for dividend omissions. On the contrary, dividend omissions were more likely among firms with higher debt ratios. The findings of this study helps to understand firm dividend policies during crisis periods.

Artificial intelligence assisted acute patient journey

Artificial intelligence is taking the world by storm and soon will be aiding patients in their journey at the hospital. The trials and tribulations of the healthcare system during the COVID-19 pandemic have set the stage for shifting healthcare from a physical to a cyber-physical space. A physician can now remotely monitor a patient, admitting them only if they meet certain thresholds, thereby reducing the total number of admissions at the hospital. Coordination, communication, and resource management have been core issues for any industry. However, it is most accurate in healthcare. Both systems and providers are exhausted under the burden of increasing data and complexity of care delivery, increasing costs, and financial burden. Simultaneously, there is a digital transformation of healthcare in the making. This transformation provides an opportunity to create systems of care that are artificial intelligence-enabled. Healthcare resources can be utilized more justly. The wastage of financial and intellectual resources in an overcrowded healthcare system can be avoided by implementing IoT, telehealth, and AI/ML-based algorithms. It is imperative to consider the design principles of the patient's journey while simultaneously prioritizing a better user experience to alleviate physician concerns. This paper discusses the entire blueprint of the AI/ML-assisted patient journey and its impact on healthcare provision.

A study to evaluate the impact of COVID-19 on Lifestyle of Medical students

Background: Stressful situations are often linked with poor health and lifestyle behaviors (e.g., unhealthy diet, limited physical activity, poor sleep quality etc.). Subsequent to the nationwide lockdown in Pakistan due to COVID-19 pandemic, medical students experienced substantial lifestyle changes along with academic stresses. The goal of this study was to measure the impact that the COVID-19 lockdown had on lifestyle like sleep, physical activity and nutrition, substance abuse, dealing with finances, spirituality and family life, with respect to a sample of Pakistani medical students. Methods: This crosssectional online study involving 1100 medical students (68.7% females) from five medical colleges in Pakistan, used self-administered questionnaire to evaluate the impact of pandemic related restrictions on lifestyle of medical students in Pakistan from AugustSeptember 2020. Parameters such as physical activity, sleep, nutrition, smoking and substance abuse, family life, finances, internet use and spirituality were studied. Results: Fifty-nine percent of medical students reported a significant effect of lockdown on their physical activity. Only 5.8% people clearly followed or adhered to a routine during the pandemic. About 54.6% students have found that physical activity and exercise significantly reduced their anxiety. More than half of respondents reported increase in screen time, weight gain and poor sleep with 3.1% of students stating an increased use of sleeping pills to fall asleep Another 18.3% students had an increased worry regarding COVID19 based on the information they received on internet. No significant increase in substance uses and alcohol use or family conflicts among students post pandemic was noted. Conclusion: Our findings underscore that COVID-19 pandemic has led to undesired changes in health and lifestyle habits of medical students, which may, to some extent, be responsible for higher negative impact. Hence it is important for medical colleges to start awareness campaigns to tackle challenges for medical students physical and emotional well-being.

Comprehensive Phytochemical Profiling, Biological Activities, and Molecular Docking Studies of Pleurospermum candollei: An Insight into Potential for Natural Products Development.

The purpose of this study was to find the biological propensities of the vegetable plant Pleurospermum candollei by investigating its phytochemical profile and biological activities. Phytochemical analysis was done by spectroscopic methods to investigate the amount of total polyphenols, and biological evaluation was done by the different antioxidant, enzyme inhibitory (tyrosinase, α-amylase, and α-glucosidase), thrombolytic, and antibacterial activities. The highest amount of total phenolic and flavonoid contents was observed in methanolic extract (240.69 ± 2.94 mg GAE/g and 167.59 ± 3.47 mg QE/g); the fractions showed comparatively less quantity (57.02 ± 1.31 to 144.02 ± 2.11 mg GAE/g, and 48.21 ± 0.75 to 96.58 ± 2.30 mg QE/g). The effect of these bioactive contents was also related to biological activities. GCMS analysis led to the identification of bioactive compounds with different biological effects from methanolic extract (antioxidant; 55.07%, antimicrobial; 56.41%), while the identified compounds from the n-hexane fraction with antioxidant properties constituted 67.86%, and those with antimicrobial effects constituted 82.95%; however, the synergetic effect of polyphenols may also have contributed to the highest value of biological activities of methanolic extract. Molecular docking was also performed to understand the relationship of identified secondary metabolites with enzyme-inhibitory activities. The thrombolytic activity was also significant (40.18 ± 1.80 to 57.15 ± 1.10 % clot lysis) in comparison with streptokinase (78.5 ± 1.53 to 82.34 ± 1.25% clot lysis). Methanolic extract also showed good activity against Gram-positive strains of bacteria, and the highest activity was observed against Bacillus subtilis. The findings of this study will improve our knowledge of phytochemistry, and biological activities of P. candollei, which seems to be a ray of hope to design formulations of natural products for the improvement of health and prevention of chronic diseases; however, further research may address the development of novel drugs for use in pharmaceuticals.

Chest X-ray Classification for the Detection of COVID-19 Using Deep Learning Techniques.

Recent technological developments pave the path for deep learning-based techniques to be used in almost every domain of life. The precision of deep learning techniques make it possible for these to be used in the medical field for the classification and detection of various diseases. Recently, the coronavirus (COVID-19) pandemic has put a lot of pressure on the health system all around the world. The diagnosis of COVID-19 is possible by PCR testing and medical imagining. Since COVID-19 is highly contagious, diagnosis using chest X-ray is considered safe in various situations. In this study, a deep learning-based technique is proposed to classify COVID-19 infection from other non-COVID-19 infections. To classify COVID-19, three different pre-trained models named EfficientNetB1, NasNetMobile and MobileNetV2 are used. The augmented dataset is used for training deep learning models while two different training strategies have been used for classification. In this study, not only are the deep learning model fine-tuned but also the hyperparameters are fine-tuned, which significantly improves the performance of the fine-tuned deep learning models. Moreover, the classification head is regularized to improve the performance. For the evaluation of the proposed techniques, several performance parameters are used to gauge the performance. EfficientNetB1 with regularized classification head outperforms the other models. The proposed technique successfully classifies four classes that include COVID-19, viral pneumonia, lung opacity, and normal, with an accuracy of 96.13%. The proposed technique shows superiority in terms of accuracy when compared with recent techniques present in the literature.

A quadruple blinded placebo controlled randomised trial to evaluate the effectiveness of an Iodine complex for patients with mild to moderate COVID-19 in Pakistan (I-COVID-PK): A structured summary of a study protocol for a randomised controlled trial.

OBJECTIVES: The objective of the study is to measure the efficacy of ionic-iodine polymer complex [1] for clinical and radiological improvement in coronavirus disease 2019 (COVID-19) patients. TRIAL DESIGN: The trial will be closed label, randomized and placebo-controlled with a 1:1:1:1 allocation ratio and superiority framework. PARTICIPANTS: All PCR confirmed COVID-19 adult patients including non-pregnant females, with mild to moderate disease, will be enrolled from Shaikh Zayed Post-Graduate Medical Complex, Ali Clinic and Doctors Lounge in Lahore (Pakistan). Patients with any pre-existing chronic illness will be excluded from the study. INTERVENTION AND COMPARATOR: In this multi-armed study ionic-iodine polymer complex with 200 mg of elemental iodine will be given using three formulations to evaluate efficacy. Patients will be receiving either encapsulated iodine complex of 200 mg (arm A), iodine complex syrup form 40 ml (arm B), iodine complex throat spray of 2 puffs (arm C) or empty capsule (arm D) as placebo; all three times a day. All the 4 arms will be receiving standard care as per version 3.0 of the clinical management guidelines for COVID-19 established by the Ministry of National Health Services of Pakistan. MAIN OUTCOMES: Primary outcomes will be viral clearance with radiological and clinical improvement. SARS-CoV-2 RT-PCR and HRCT chest scans will be done on the admission day and then after every fourth day for 12 days or till the symptoms are resolved. RT-PCR will only be shown as positive or negative while HRCT chest scoring will be done depending on the area and severity of lung involvement [2]. Time taken for the alleviation of symptoms will be calculated by the number of days the patient remained symptomatic. 30-day mortality will be considered as a secondary outcome. RANDOMISATION: Stratification for initial COVID-19 status (or days from initial symptoms as a proxy), age groups, gender, baseline severity of symptoms and co-morbidities will be used to ensure that the study arms remain balanced in size for the 1:1:1:1 allocation ratio. Randomization will be done using the lottery method. As patients are being admitted at different times, they will be recruited after obtaining their voluntary written informed consent following all standard protocols of the infection, control and disinfection. BLINDING (MASKING): This is a quadruple (participants, care providers, investigators and outcomes assessors) blinded study where only the study's Primary Investigator will have information about the arms and their interventions. NUMBERS TO BE RANDOMISED (SAMPLE SIZE): 200 patients will be randomized into four groups with three experimental and one placebo arm. TRIAL STATUS: Protocol Version Number is 2.3 and it is approved from IRB Shaikh Zayed Hospital with ID SZMC/IRB/Internal0056/2020 on July 14th, 2020. The recruitment is in progress. It was started on July 30, 2020, and the estimated end date for the trial is August 15, 2021. TRIAL REGISTRATION: Clinical Trial has been retrospectively registered on www.clinicaltrials.gov with registration ID NCT04473261 dated July 16, 2020. FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). With the intention of expediting dissemination of this trial, the conventional formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol. The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines.

How common are taste and smell abnormalities in COVID-19? A systematic review and meta-analysis.

OBJECTIVE: Olfactory and gustatory dysfunction (OGD) are important early clinical symptoms of COVID-19. We aim to calculate the pooled prevalence of these symptoms and discuss the likely implications on clinical practice such as their use as screening tools and potential prognosis indicators. METHODS: Using a combination of keywords and medical subject headings, we searched for observational studies in the following five databases: Medline/PubMed, Scopus, Cochrane Library, Web of Science, and Google Scholar. Two authors independently screened and selected the final articles according to the inclusion criteria. Two investigators independently assessed the risk of bias in individual studies using the Newcastle-Ottawa Scale. Heterogeneity and publication bias were also assessed. The reported outcome of the pooled analysis was the prevalence of OGD calculated using a random-effect model. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed to report results. RESULTS: Seventeen studies with a total sample size of 4149 were included in this meta-analysis. Out of these, 2106 and 2676 patients reported some degree of olfactory and/or gustatory dysfunction with COVID-19, respectively. The reported outcomes were in terms of pooled prevalence, with gustatory dysfunction being 57.33% and olfactory dysfunction being 59.69%, a significantly high occurrence. CONCLUSION: There is a high occurrence of smell and taste impairment in COVID-19. Given the lack of objective testing for detecting OGD in most studies, the high prevalence found is likely to be an underestimation of the true prevalence. This implies that physicians must use them as reliable early indicators of COVID-19 and employ them before using expensive tests.

Hyponatremia and extrapontine myelinolysis in a patient with COVID-19: A case report.

Until we have strong evidence to the contrary, symptomatic hyponatremia should be treated with extra caution in COVID-19 co-infection patients as the latter could be another risk factor for the development of extrapontine myelinolysis.

The association of posterior reversible encephalopathy syndrome with COVID-19: A systematic review.

The rise in Coronavirus disease 2019 (COVID-19) cases is revealing its unique neurological manifestations. In light of the emerging evidence, a possible association with Posterior Reversible Encephalopathy Syndrome (PRES) is being consistently reported. We conducted a systematic literature search on four databases namely Pubmed/MEDLINE, Cochrane, Google Scholar, and Science Direct. After rigorous screening as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a total of 34 articles describing 56 cases were selected as a part of this review. The mean age of the patients was 56.6 ± 15.3 years. The most common clinical presentation of PRES was altered mental status (58.9%) followed by seizures (46.4%) and visual disturbances (23.2%) while hypertension and diabetes mellitus were the most commonly reported comorbidities. 91.1% of the cases reported Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) findings suggestive of PRES in the brain. Symptomatic management was employed in most of the cases to control seizures and blood pressure, and 44 patients (78.5%) fully or partially recovered. The most likely underlying mechanism involves COVID-19 mediated cytokine storm syndrome that leads to endothelial damage and increased permeability of the cerebral vessels, thus causing the characteristic edema of PRES. High neuronal and glial cell expression of Angiotensin Converting Enzyme-2 (ACE-2) receptors also suggests the possibility of direct viral damage. Since timely diagnosis and treatment reports a good prognosis, it is vital for physicians and neurologists to be well-versed with this association.

The pathogenesis of COVID-19-induced IgA nephropathy and IgA vasculitis: A systematic review.

OBJECTIVE: IgA nephropathy (IgAN) and IgA vasculitis (IgAV) are part of a similar clinical spectrum. Both clinical conditions occur with the coronavirus disease 2019 (COVID-19). This review aims to recognize the novel association of IgAN and IgAV with COVID-19 and describe its underlying pathogenesis. METHODS: We conducted a systematic literature search and data extraction from PubMed, Cochrane, ScienceDirect, and Google Scholar following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS: Our search identified 13 cases reporting IgAV and IgAN associated with COVID-19 infection and 4 cases of IgAN following COVID-19 vaccination. The mean, mode, and median ages of patients were 23.8, 4, and 8 years, respectively. Most cases associated with COVID-19 infection were reported in males (77%). Rash and purpura (85%) were the most common clinical features, followed by gastrointestinal symptoms (62%). In symptomatic cases, skin or renal biopsy and immunofluorescence confirmed the diagnosis of IgAN or IgAV. Most patients were treated with steroids and reported recovery or improvement; however, death was reported in two patients. CONCLUSION: There is a paucity of scientific evidence on the pathogenesis of the association of IgAN and IgAV with COVID-19, which thus needs further study. Current research suggests the role of IgA-mediated immune response, evidenced by early seroconversion to IgA in COVID-19 patients and the role of IgA in immune hyperactivation as the predominant mediator of the disease process. Clinicians, especially nephrologists and paediatricians, need to recognize this association, as this disease is usually self-limited and can lead to complete recovery if prompt diagnosis and treatment are provided.

Nano-biofortification of different crops to immune against COVID-19: A review.

Human health and its improvement are the main target of several studies related to medical, agricultural and industrial sciences. The human health is the primary conclusion of many studies. The improving of human health may include supplying the people with enough and safe nutrients against malnutrition to fight against multiple diseases like COVID-19. Biofortification is a process by which the edible plants can be enriched with essential nutrients for human health against malnutrition. After the great success of biofortification approach in the human struggle against malnutrition, a new biotechnological tool in enriching the crops with essential nutrients in the form of nanoparticles to supplement human diet with balanced diet is called nano-biofortification. Nano biofortification can be achieved by applying the nano particles of essential nutrients (e.g., Cu, Fe, Se and Zn) foliar or their nano-fertilizers in soils or waters. Not all essential nutrients for human nutrition can be biofortified in the nano-form using all edible plants but there are several obstacles prevent this approach. These stumbling blocks are increased due to COVID-19 and its problems including the global trade, global breakdown between countries, and global crisis of food production. The main target of this review was to evaluate the nano-biofortification process and its using against malnutrition as a new approach in the era of COVID-19. This review also opens many questions, which are needed to be answered like is nano-biofortification a promising solution against malnutrition? Is COVID-19 will increase the global crisis of malnutrition? What is the best method of applied nano-nutrients to achieve nano-biofortification? What are the challenges of nano-biofortification during and post of the COVID-19?

Reorganising for COVID-19 pandemic: a review of structural modifications by the department of internal medicine in low to middle-income countries

Scientists classified the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as a novel coronavirus on January 7, 2020. The World Health Organization (WHO) acknowledged the SARS-CoV-2 outburst a public health emergency of international concern on January 30, 2020. Since its origin, this virus has disrupted the best healthcare systems, economies, and strained financial resources;and for underdeveloped countries' healthcare systems, the virus has become a crisis. To tackle the potential hazards from this virus, our Department restructured the services that not only helped us to cope with the pandemic, but also provided an example to copy for other contemporary institutes. This article aims to describe the measures and structural changes undertaken by the Internal Medicine Department, Aga Khan University Hospital (AKUH), Karachi, Pakistan.

The Association of Subacute Thyroiditis with COVID-19: a Systematic Review.

The multisystem effects of SARS-CoV-2 encompass the thyroid gland as well. Emerging evidence suggests that SARS-CoV-2 can act as a trigger for subacute thyroiditis (SAT). We conducted a systematic literature search using PubMed/Medline and Google Scholar to identify cases of subacute thyroiditis associated with COVID-19 and evaluated patient-level demographics, major clinical features, laboratory findings and outcomes. In the 21 cases that we reviewed, the mean age of patients was 40.0 ± 11.3 years with a greater female preponderance (71.4%). Mean number days between the start of COVID-19 illness and the appearance of SAT symptoms were 25.2 ± 10.1. Five patients were confirmed to have ongoing COVID-19, whereas the infection had resolved in 16 patients before onset of SAT symptoms. Fever and neck pain were the most common presenting complaints (81%). Ninety-four percent of patients reported some type of hyperthyroid symptoms, while the labs in all 21 patients (100%) confirmed this with low TSH and high T3 or T4. Inflammatory markers were elevated in all cases that reported ESR and CRP. All 21 cases (100%) had ultrasound findings suggestive of SAT. Steroids and anti-inflammatory drugs were the mainstay of treatment, and all patients reported resolution of symptoms; however, 5 patients (23.8%) were reported to have a hypothyroid illness on follow-up. Large-scale studies are needed for a better understanding of the underlying pathogenic mechanisms, but current evidence suggests that clinicians need to recognize the possibility of SAT both in ongoing and resolved COVID-19 infection to optimize patient care.