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Background: Our study aimed to describe the group of severe COVID-19 patients at an institutional level, and determine factors associated with different outcomes. Methods: A retrospective chart review of patients admitted with severe acute hypoxic respiratory failure due to COVID-19 infection. Based on outcomes, we categorized 3 groups of severe COVID-19: (1) Favorable outcome: progressive care unit admission and discharge (2) Intermediate outcome: ICU care (3) Poor outcome: in-hospital mortality. Results: Eighty-nine patients met our inclusion criteria; 42.7% were female. The average age was 59.7 (standard deviation (SD):13.7). Most of the population were Caucasian (95.5%) and non-Hispanic (91.0%). Age, sex, race, and ethnicity were similar between outcome groups. Medicare and Medicaid patients accounted for 62.9%. The average BMI was 33.5 (SD:8.2). Moderate comorbidity was observed, with an average Charlson Comorbidity index (CCI) of 3.8 (SD:2.6). There were no differences in the average CCI between groups(p = 0.291). Many patients (67.4%) had hypertension, diabetes (42.7%) and chronic lung disease (32.6%). A statistical difference was found when chronic lung disease was evaluated; p = 0.002. The prevalence of chronic lung disease was 19.6%, 27.8%, and 40% in the favorable, intermediate, and poor outcome groups, respectively. Smoking history was associated with poor outcomes (p = 0.04). Only 7.9% were fully vaccinated. Almost half (46.1%) were intubated and mechanically ventilated. Patients spent an average of 12.1 days ventilated (SD:8.5), with an average of 6.0 days from admission to ventilation (SD:5.1). The intermediate group had a shorter average interval from admission to ventilator (77.2 hours, SD:67.6), than the poor group (212.8 hours, SD:126.8); (p = 0.001). The presence of bacterial pneumonia was greatest in the intermediate group (72.2%), compared to the favorable group (17.4%), and the poor group (56%); this was significant (p<0.0001). In-hospital mortality was seen in 28.1%. Conclusion: Most patients were male, obese, had moderate-level comorbidity, a history of tobacco abuse, and government-funded insurance. Nearly 50% required mechanical ventilation, and about 28% died during hospitalization. Bacterial pneumonia was most prevalent in intubated groups. Patients who were intubated with a good outcome were intubated earlier during their hospital course, with an average difference of 135.6 hours. A history of cigarette smoking and chronic lung disease were associated with poor outcomes. [ABSTRACT FROM AUTHOR]

Objective: To examine the disease course in COVID-19 affected pregnant women. Methods: A series of pregnant women with positive COVID-19 test result treated in a dedicated ward at a Teaching Hospital in Lahore, Pakistan, was collated between April and June 2020. A predesigned proforma was used for data collection concerning clinical characteristics, obstetric outcomes and vertical transmission to the newborn. Continuous variables were expressed as mean ± standard deviation (SD) and median with inter-quartile range. Categorical variables were expressed as frequency and percentages. The data was analyzed by using SPSS version 24. Results: There were 26 COVID-19 positive pregnant women with mean gestational age of 31± 8.8 weeks and mean age of 27±4 years. Of these, 10 (38.4%) were asymptomatic. Among symptomatic women 14/16 (87.5%) suffered fever and 11/16 (68.75%) had cough. One case of severe pneumonia experienced mortality. Of the 14 women delivered, 11 (78.5%) had caesarean section. There were no cases of miscarriage, spontaneous preterm labor, intrauterine demise, neonatal death or vertical transmission of COVID-19. Conclusion: The majority of pregnant women with COVID-19 suffered mild disease. Pregnancy did not appear to aggravate or change the course of COVID-19, nor did COVID-19 appear to increase the risk of obstetric complications. [ABSTRACT FROM AUTHOR]