Interim Analysis of Impact of Adding Low Dose Pulmonary Radiotherapy to Moderate COVID-19 Pneumonia Patients: IMpaCt-RT Study.

Background: Treatment for coronavirus disease 2019 (COVID-19) pneumonia remains largely supportive till date and multiple clinical trials took place within the short span of time to evaluate the role of investigational therapies. The anti-inflammatory effect of low dose whole lung radiation in treating pneumonia has been documented earlier. This clinical trial analyzed the effect of low dose radiation therapy (LDRT) in a moderately affected COVID-19 pneumonia patient cohort and has evaluated its effect in stopping the conversion of moderate disease into severe disease. Methods: Patients with moderate COVID-19 pneumonia as characterized by the Ministry of Health and Family Welfare (MOHFW), Government of India, were randomized (1:1) to low dose whole lung radiation versus no radiation. All treatment of patients was concurrently being given as per institutional protocol. Patients were followed up with clinical and laboratory parameters monitored on Days 1, 3, 7, and 14. Computed tomography scan (CT scan) of thorax was performed on Days 1 and 7. Patients were evaluated for conversion of moderate into severe disease as per National Early Warning Score-2 (NEWS-2 score) as the primary end point. The secondary endpoints included changes in ratio between peripheral capillary oxygen saturation and fraction of inspired oxygen (SpO2/FiO2), biochemical markers, 25-point CT severity score, and radiation induced acute pulmonary toxicities. Findings: At the interim analysis, there were seven patients in the radiation arm and six in the control. A whole lung LDRT improved the outcome of SpO2/FiO2 at Day 3; however it did not convert into a statistically significant improvement for the NEWS-2 score. The serum levels of LDH, CRP, Ferritin and D-dimer were significantly reduced on 14 days in the LDRT arm in comparison to the baseline value but were not significant between the two groups. Interpretation: LDRT seems to have the potential to prevent moderate COVID-19 pneumonia from a deteriorating to severe category. However, further randomized clinical trial with an adequate number of such patients is warranted to establish the definitive role of LDRT in the management of COVID-19 pneumonia. Funding: An intramural research project bearing code: I-27/621, was sanctioned from the All India Institute of Medical Sciences, Patna, India. Clinical Trial Registration: Clinical Trials Registry-India (CTRI/2021/06/033912, 25th May 2021) ctri.nic.in/Clinicaltrials/login.php.

Go Digital! Determinants of Continuance Usage of Mobile Payment Apps: Focusing on the Mediating Role of Gamification

Background: COVID-19 spread over the last two years has been instrumental in shifting physical banking transactions to mobile-based banking transactions. Recently, M-payments have dominated online and point-of-sale (POS) transactions in the Asia-pacific region. Therefore, there was a need to study the factors influencing M-payments. This research has been conducted to determine the significant factors influencing the usage and continuance usage of M-payment apps in an emerging country and particularly how gamified features enhance the usage of M-payments apps.is study is based on the perspectives of the Unified theory of acceptance and use of technology (UTAUT2) and information system success (ISS) theory, and it adds three new determinants—trust, gamified features, and continued use of mobile payments to better explain and forecast users' behavioral intentions and continued use of mobile payment applications (M-payments apps). Method: The research has employed two studies on sample data from young users of M-payment apps (n=898), the dataset was analyzed through structural equation modelling for mediation and moderation analysis in study one. The second study was grounded through Vignette experiments to analyze the effects of the degree of gamified features on the continued usage of M-payments. Results: The results reported that behavioral intention to adopt, and usage of mobile payments are significantly mediated by gamified features and gamified features are partially mediating continuance usage of M-payments. Trust is the key to enabling continuance usage amongst the users of M-payments. These findings extend the understanding of users' continuance intention in the context of payments apps. Conclusion: This study would be helpful in presenting insights for the M-payments service providers and the associated banks to develop strategy for the continuance usage of mobile payment apps.

Needle-free injection system delivery of ZyCoV-D DNA vaccine demonstrated improved immunogenicity and protective efficacy in rhesus macaques against SARS-CoV-2.

The apprehension of needles related to injection site pain, risk of transmitting bloodborne pathogens, and effective mass immunization have led to the development of a needle-free injection system (NFIS). Here, we evaluated the efficacy of the NFIS and needle injection system (NIS) for the delivery and immunogenicity of DNA vaccine candidate ZyCoV-D in rhesus macaques against SARS-CoV-2 infection. Briefly, 20 rhesus macaques were divided into 5 groups (4 animals each), that is, I (1 mg dose by NIS), II (2 mg dose by NIS), III (1 mg dose by NFIS), IV (2 mg dose by NFIS) and V (phosphate-buffer saline [PBS]). The macaques were immunized with the vaccine candidates/PBS intradermally on Days 0, 28, and 56. Subsequently, the animals were challenged with live SARS-CoV-2 after 15 weeks of the first immunization. Blood, nasal swab, throat swab, and bronchoalveolar lavage fluid specimens were collected on 0, 1, 3, 5, and 7 days post infection from each animal to determine immune response and viral clearance. Among all the five groups, 2 mg dose by NFIS elicited significant titers of IgG and neutralizing antibody after immunization with enhancement in their titers postvirus challenge. Besides this, it also induced increased lymphocyte proliferation and cytokine response. The minimal viral load post-SARS-CoV-2 challenge and significant immune response in the immunized animals demonstrated the efficiency of NFIS in delivering 2 mg ZyCoV-D vaccine candidate.

Intra-Familial Transmission Patterns of COVID-19 Infection among the Rural Residents of Ahmedabad, Gujarat, during an Epidemic of SARS-CoV-2 in India.

We are yet to completely understand the transmission dynamics of coronavirus disease 2019 (COVID-19), a highly infectious disease, and research exploring the same is currently lacking. Hence, a community-based cross-sectional study was conducted to assess the intra-familial transmission pattern of COVID-19 among the rural residents of Ahmedabad, Gujarat, in relation to possible determinants, with a special focus on the viral load as an important factor. This cross-sectional study included visiting 195 families. We interviewed families with at least one case of COVID-19 infection. We recorded information about sociodemographic profiles and secondary transmission of cases. Out of the 195 families, 114 confirmed having at least one infected case within the family. Approximately 38.6% (44/114) of the index cases were asymptomatic, which was much higher than the low viral load index cases. Index cases with high, moderate, and low viral loads had transmitted the infection with an average of 3.3, 1.5, 0.4 secondary cases per index case, respectively. Approximately one-third of the COVID-19 cases were asymptomatic, and the affected individuals were capable of transmitting the disease within families. Moreover, index cases with a higher viral load had a higher transmission potential to generate more secondary cases, as compared to those with a low viral load.

Translation and reliability of the caregiver quality of life index-cancer (CQOLC) Scale in Hindi and it's association with the Kessler psychological distress scale (K10) for cancer caregivers at a tertiary radiotherapy centre in India.

BACKGROUND: With increasing incidence of cancer worldwide and increasing burden of treatment over the patients with cancer, the caregivers of those patients with cancer also suffer from psychological distress which ultimately affects their Quality of Life (QOL). This aspect is often overlooked which may ultimately lead to compromised patient care. PURPOSE: To translate the Caregiver Quality of Life Index-Cancer (CQOLC) Scale in Hindi and assess its association with Kesslers's psychological distress scale (K-10) for determining the quality of life (QoL) of caregivers of patients with cancer in India. METHODS: This is a single institute, hospital based cross sectional study performed from July 2020 to March 2021. Caregiver Quality of Life Index-Cancer (CQOLC) Scale, employing standard 'forward-backforward' translation procedure, the English-language version of the questionnaire was translated into Hindi-language by experts and administered to each caregiver. Cronbach's alpha was used for internal consistency. Kesslers's psychological distress scale (K-10) was analysed on interview basis. RESULTS: A total evaluated responders were 264. The hindi versions of the CQOLC was validated by cronbach's alpha method with internal consistency between 0.8 and 0.91. The majority of the caregivers were of the age group 31-40 yrs (42.05%). The male to female ratio was 6.54:1. CQOLC good score(0-45) was obtained in 27.27%, fair(46-90) in 55.30% and poor(91-140) in 17.42%. For K-10 distress scale very mild(10-19), mild(20-24), moderate(25-29) and severe(30-50) was observed in 47.73%, 11.74%, 11.74% and 28.79% respectively. A strong relation was found between the caregivers with poor CQOLC score and severe K-10 score(p<0.001). CONCLUSION: The Hindi version of CQOLC was accepted and its correlation with the point psychological distress predictor (K-10) scale was a valuable method to identify caregivers with poor QOL and severe distress levels.

Geospatial View of Air Pollution and Health Risk Over North Indian Region in COVID-19 Scenario

Air pollutant concentration, air quality index (AQI), and Excess risk (ER%) is assessed during January 2020 to June 2021 and in three scenarios including pre-lockdown, lockdown and post-lockdown based on 47 ground station data (during January 2020 to June 2020) distributed over northern part of India (including Delhi, Haryana, Punjab, part of Uttar Pradesh, and part of Rajasthan) using statistics and geographic information system (GIS) techniques. Daily and monthly variations of air pollutants (During January 2020 to June 2021) over the region showed a systematic pattern with high pollutant level during October and November while low during March, April (in dry period) and July–September (in wet period). In three scenarios viz. pre, during and post-lockdown the average concentration for PM2.5 was 71.1 ± 45 µg/m3, 39 ± 20 µg/m3 and 40 + 17 µg/m3, for PM10 was 139 ± 72 µg/m3, 96 ± 55 µg/m3 and 105 ± 57 µg/m3, for NO2 was 28 ± 21 µg/m3, 17 ± 13 µg/m3 and 18 ± 12 µg/m3, for NH3 was 33 ± 24 µg/m3, 25 ± 18 µg/m3 and 29 ± 22 µg/m3, for CO was 1 ± 0.65 mg/m3, 0.7 ± 0.5 mg/m3, and 0.7 ± 0.5 mg/m3, for O3 was 29 ± 20 µg/m3, 39 ± 23 µg/m3 and 39 ± 22 µg/m3 and for SO2 was 14 ± 11 µg/m3, 14 ± 12 µg/m3 and 12.5 ± 8.9 µg/m3. Significant decrease in mean pollutants concentration, AQI and ER % was observed in lockdown period amid COVID-19. PM2.5, PM10, NO2, NH3 and CO decreased by 46%, 31%, 39%, 24% and 34%, respectively, in lockdown scenario as compared to the pre-lockdown scenario while the O3 get increased. A decrease of 39% in AQI was observed as compared to pre-lockdown scenario;however, the difference was less when compared with post-lockdown scenario. The decrease in total ER% was 60.36% over the study area due to improvement in air quality over the region amid COVID-19 lockdown. The meteorological conditions in 2020 were found consistent with respect to 2019 and very less influence was observed on the concentration of air pollutants (less r2 among the pollutants and meteorological parameters).

Interim Analysis of Impact of Adding Low Dose Pulmonary Radiotherapy to Moderate COVID-19 Pneumonia Patients: IMpaCt-RT Study

Background Treatment for coronavirus disease 2019 (COVID-19) pneumonia remains largely supportive till date and multiple clinical trials took place within the short span of time to evaluate the role of investigational therapies. The anti-inflammatory effect of low dose whole lung radiation in treating pneumonia has been documented earlier. This clinical trial analyzed the effect of low dose radiation therapy (LDRT) in a moderately affected COVID-19 pneumonia patient cohort and has evaluated its effect in stopping the conversion of moderate disease into severe disease. Methods Patients with moderate COVID-19 pneumonia as characterized by the Ministry of Health and Family Welfare (MOHFW), Government of India, were randomized (1:1) to low dose whole lung radiation versus no radiation. All treatment of patients was concurrently being given as per institutional protocol. Patients were followed up with clinical and laboratory parameters monitored on Days 1, 3, 7, and 14. Computed tomography scan (CT scan) of thorax was performed on Days 1 and 7. Patients were evaluated for conversion of moderate into severe disease as per National Early Warning Score-2 (NEWS-2 score) as the primary end point. The secondary endpoints included changes in ratio between peripheral capillary oxygen saturation and fraction of inspired oxygen (SpO2/FiO2), biochemical markers, 25-point CT severity score, and radiation induced acute pulmonary toxicities. Findings At the interim analysis, there were seven patients in the radiation arm and six in the control. A whole lung LDRT improved the outcome of SpO2/FiO2 at Day 3;however it did not convert into a statistically significant improvement for the NEWS-2 score. The serum levels of LDH, CRP, Ferritin and D-dimer were significantly reduced on 14 days in the LDRT arm in comparison to the baseline value but were not significant between the two groups. Interpretation LDRT seems to have the potential to prevent moderate COVID-19 pneumonia from a deteriorating to severe category. However, further randomized clinical trial with an adequate number of such patients is warranted to establish the definitive role of LDRT in the management of COVID-19 pneumonia. Funding An intramural research project bearing code: I-27/621, was sanctioned from the All India Institute of Medical Sciences, Patna, India. Clinical Trial Registration Clinical Trials Registry-India (CTRI/2021/06/033912, 25th May 2021) ctri.nic.in/Clinicaltrials/login.php

An epidemiological study and trend analysis of laboratory confirmed COVID-19 cases among children in North India.

Background: The role of children in transmitting the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus is difficult to ascertain and the consequences remain unclear. This is necessary for public health or infection control purposes. The objective of this study was to describe the epidemiological, month-wise trends and clinical characteristics of coronavirus disease 2019 (COVID-19) infection among children in a tertiary care hospital. Materials and Methods: A cross-sectional study was performed on all pediatric samples of suspected cases of SARS-CoV-2 infection. The samples were received from the adjoining districts and our Institution in the Department of Microbiology from June to November 2020. Cases were then confirmed by real-time reverse transcriptase-polymerase chain reaction. Results: Of the total 62,030 pediatric samples tested, 847 (1.3%) were SARS-CoV-2 positive. The majority of positive cases were between the ages of 11-15 years. The median age of confirmed patients was 14 years. The male to female ratio was 1.5:1. Infants represented 1.6% of the positive cases. About 62.1% of all positive cases were asymptomatic. Childhood cases increased from June 2020 and peaked in September 2020 before declining. Conclusion: Children of all ages appeared susceptible to COVID-19 and accounted for a very small proportion of confirmed cases. Mostly, children were found to be asymptomatic. Young children can be important transmitters of SARS-CoV-2 infection in the general population. This population can be important for targeting immunization efforts throughout a rapidly evolving situation. Our findings provide further evidence of the distribution of infection in children and the transmission of SARS-CoV-2.

Traditional medicinal plants used for treating emerging and re-emerging viral diseases in northern Nigeria.

Introduction: For decades, viral diseases have been treated using medicinal plants and herbal practices in the northern part of Nigeria. Though scarcely investigated, these medicinal plants could serve as potential sources for novel antiviral drugs against emerging and remerging viral diseases. Therefore, this study is aimed at investigating the medicinal practices and plants used to treat emerging and re-emerging viral diseases including hepatitis, poliomyelitis, monkeypox, smallpox, yellow fever, Lassa fever, meningitis, and COVID-19 in some northern states; Katsina, Kebbi, Kwara and Sokoto states. Method: Administered questionnaires and oral interviews were used to collect information on medicinal plants, method of preparation of herbal formulations, diagnosis, and treatment of viral diseases. Medicinal plants were collected, botanically identified, and assigned voucher numbers. The plant names were verified using www.theplantlist.org, www.worldfloraonline.org and the international plant names index. Result: A total of 280 participating herbal medicine practitioners (HMPs) mentioned 131 plants belonging to 65 families. Plant parts such as roots, bark, leaf, seed, and fruit were prepared as a decoction, concoction, infusion, or ointment for oral and topical treatment of viral diseases. Moringa oleifera (75.3%), Elaeis guineensis Jacq. (80%), and Acacia nilotica (70%) were the most frequently mentioned plants in Kebbi, Kwara and Sokoto states, respectively. Conclusion: The study revealed scarcely investigated and uninvestigated medicinal plants used to treat hepatitis, poliomyelitis, monkeypox, smallpox, yellow fever, Lassa fever, meningitis, and COVID-19. Future studies should be conducted to determine the antiviral potency and isolate novel bioactive agents from these plants against viral diseases.

Insights into COVID-19 Vaccine Development Based on Immunogenic Structural Proteins of SARS-CoV-2, Host Immune Responses, and Herd Immunity.

The first quarter of the 21st century has remarkably been characterized by a multitude of challenges confronting human society as a whole in terms of several outbreaks of infectious viral diseases, such as the 2003 severe acute respiratory syndrome (SARS), China; the 2009 influenza H1N1, Mexico; the 2012 Middle East respiratory syndrome (MERS), Saudi Arabia; and the ongoing coronavirus disease 19 (COVID-19), China. COVID-19, caused by SARS-CoV-2, reportedly broke out in December 2019, Wuhan, the capital of China's Hubei province, and continues unabated, leading to considerable devastation and death worldwide. The most common target organ of SARS-CoV-2 is the lungs, especially the bronchial and alveolar epithelial cells, culminating in acute respiratory distress syndrome (ARDS) in severe patients. Nevertheless, other tissues and organs are also known to be critically affected following infection, thereby complicating the overall aetiology and prognosis. Excluding H1N1, the SARS-CoV (also referred as SARS-CoV-1), MERS, and SARS-CoV-2 are collectively referred to as coronaviruses, and taxonomically placed under the realm Riboviria, order Nidovirales, suborder Cornidovirineae, family Coronaviridae, subfamily Orthocoronavirinae, genus Betacoronavirus, and subgenus Sarbecovirus. As of 23 September 2021, the ongoing SARS-CoV-2 pandemic has globally resulted in around 229 million and 4.7 million reported infections and deaths, respectively, apart from causing huge psychosomatic debilitation, academic loss, and deep economic recession. Such an unprecedented pandemic has compelled researchers, especially epidemiologists and immunologists, to search for SARS-CoV-2-associated potential immunogenic molecules to develop a vaccine as an immediate prophylactic measure. Amongst multiple structural and non-structural proteins, the homotrimeric spike (S) glycoprotein has been empirically found as the most suitable candidate for vaccine development owing to its immense immunogenic potential, which makes it capable of eliciting both humoral and cell-mediated immune responses. As a consequence, it has become possible to design appropriate, safe, and effective vaccines, apart from related therapeutic agents, to reduce both morbidity and mortality. As of 23 September 2021, four vaccines, namely, Comirnaty, COVID-19 vaccine Janssen, Spikevax, and Vaxzevria, have received the European Medicines Agency's (EMA) approval, and around thirty are under the phase three clinical trial with emergency authorization by the vaccine-developing country-specific National Regulatory Authority (NRA). In addition, 100-150 vaccines are under various phases of pre-clinical and clinical trials. The mainstay of global vaccination is to introduce herd immunity, which would protect the majority of the population, including immunocompromised individuals, from infection and disease. Here, we primarily discuss category-wise vaccine development, their respective advantages and disadvantages, associated efficiency and potential safety aspects, antigenicity of SARS-CoV-2 structural proteins and immune responses to them along with the emergence of SARS-CoV-2 VOC, and the urgent need of achieving herd immunity to contain the pandemic.

Vaccination of cancer patients against COVID-19: towards the end of a dilemma.

With the emergence of second wave of COVID-19 infection globally, particularly in India in March-April 2021, protection by massive vaccination drive has become the need of the hour. Vaccines have been proved to reduce the risk of developing severe illness and are emerging as vital tools in the battle against COVID-19. As per the GLOBOCAN database, nearly 19.3 million new cancer cases have been reported in 2020 globally, which posed a significant challenge to health care providers to protect such large number of 'vulnerable' patients from COVID-19. Nevertheless, a considerable degree of doubt, hesitancy and misconceptions are noted regarding the administration of vaccines particularly during active immuno-suppressant treatment. This review article highlights the added vulnerability of cancer patients to the COVID-19 infection and has explored the immunological challenges associated with malignancy, anticancer treatment and COVID-19 vaccination.

Children, comorbidities and COVID-19 - What tilts the balance?

Background: Data on the outcome of children with SARS-COV-2 infection (COVID-19) is still evolving as the pandemic unfolds. Aims and Objective: The present study aims at describing the clinical severity, course and outcome of COVID-19 in children who had underlying illnesses or co-infections. Materials and Methods: Retrospective, single center, observational study, conducted in a pediatric tertiary care center at Noida (National Capital Region, India). Results: We analyzed the data of 15 children with co-morbidities associated with COVID-19. Cancer (n=4, 26.6%), co-infections (n=5, 33.3%), Thalassemia major (n=2, 13.3%) and one child each with celiac disease, cholelithiasis, Duchenne muscular dystrophy and multiple rib fractures were diagnosed with COVID-19. None were asymptomatic. 9 children (60%) had mild symptoms and 4 had moderate symptoms (26.6%) with respiratory distress. 2 children had severe respiratory distress requiring high flow oxygen. Convalescent plasma, IVIG, Oseltamivir, Azithromycin, Hydroxychloroquine were given as treatment in varying combinations. All children recovered from COVID-19. Conclusion: Active malignancy, hypogammaglobinemia, underlying lung disease were associated with moderate to severe symptoms in this series of patients. Convalescent plasma helped in both children with severe hypoxia. [ABSTRACT FROM AUTHOR] Copyright of Asian Journal of Medical Sciences is the property of Manipal Colleges of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Clinical correlation of severe acute respiratory syndrome-coronavirus-2 cases in selected districts of Uttar Pradesh: A cross-sectional hospital-based study.

BACKGROUND: The novel coronavirus (CoV) has resulted in a global pandemic despite drastic measures to avoid contagious spread. On April 3, 2020, there were around 1 million reported cases and 51,515 deaths due to CoV disease 2019. The disease presents with flu-like symptoms such as fever, dry cough, and fatigue. India being a resource-limited country, it is very important to differentiate the suspected cases clinically. AIM: The aim was to know the correlation of various clinical features of severe acute respiratory syndrome CoV 2 (SARS-CoV-2)-infected cases in selected districts of UP. SETTING AND DESIGN: This was a retrospective cross-sectional hospital-based study. MATERIALS AND METHODS: This was a retrospective cross-sectional study performed on 1243 suspected cases of SARS-CoV-2 infection from March 25, 2020 to April 17, 2020 in the department of microbiology of our institute to know the incidence of SARS-CoV-2 infection in selected districts of Uttar Pradesh. These cases were analyzed to see the association of various clinical symptoms with SARS-CoV-2 infection. For statistical analysis, Pearson's Chi-square test was performed using SPSS version 23. RESULTS: Out of total suspected cases, 4.5% were positive. Travel history was present in 80.4% of positive cases. About 83.9% had fever, 28.6% had shortness of breath, 35.7% had dry cough, 17.9% had either Type I or II diabetes mellitus, 12.5% had chronic kidney disease, and 7.1% had obstructive pulmonary diseases. CONCLUSION: Negative clinical history is very important in ruling out the suspected cases who came out to be free from the infection.

Why airborne transmission hasn't been conclusive in case of COVID-19? An atmospheric science perspective.

Airborne transmission is one of the routes for the spread of COVID-19 which is caused by inhalation of smaller droplets1 containing SARS-CoV-2 (i.e., either virus-laden particulate matter: PM and/or droplet nuclei) in an indoor environment. Notably, a significant fraction of the small droplets, along with respiratory droplets, is produced by both symptomatic and asymptomatic individuals during expiratory events such as breathing, sneezing, coughing and speaking. When these small droplets are exposed to the ambient environment, they may interact with PM and may remain suspended in the atmosphere even for several hours. Therefore, it is important to know the fate of these droplets and processes (e.g., physical and chemical) in the atmosphere to better understand airborne transmission. Therefore, we reviewed existing literature focussed on the transmission of SARS-CoV-2 in the spread of COVID-19 and present an environmental perspective on why airborne transmission hasn't been very conclusive so far. In addition, we discuss various environmental factors (e.g., temperature, humidity, etc.) and sampling difficulties, which affect the conclusions of the studies focussed on airborne transmission. One of the reasons for reduced emphasis on airborne transmission could be that the smaller droplets have less number of viruses as compared to larger droplets. Further, smaller droplets can evaporate faster, exposing SARS-CoV-2 within the small droplets to the environment, whose viability may further reduce. For example, these small droplets containing SARS-CoV-2 might also physically combine with or attach to pre-existing PM so that their behaviour and fate may be governed by PM composition. Thus, the measurement of their infectivity and viability is highly uncertain due to a lack of robust sampling system to separately collect virions in the atmosphere. We believe that the present review will help to minimize the gap in our understanding of the current pandemic and develop a robust epidemiological method for mortality assessment.

Use of convalescent plasma for managing severe COVID-19 infection in 2-month-old infant

Abstract A 58-day-old female infant reported with complaints of fever, difficult breathing, loose stool, vomiting and refusal to feed for 4 days. Laboratory work showed anaemia, leucocytosis with elevated neutrophils and thrombocytopenia along with high C-reactive protein and D-dimer with bilateral patchy infiltrate on X-ray and positivity for COVID-19. Her blood culture was also positive for Gram-negative bacilli (acinetobacter lwoffii). Along with antibiotics, she was given 50 ml convalescent plasma. She was off oxygen within 2 days and showed improvement in lung lesions, and RT-PCR was negative by day 7 and discharged by day 10 of transfusion.