There is a lack of data describing the impact of the novel coronavirus 19 pandemic on the patients of chronic kidney disease stage V-dialysis (CKD V-D) from resourcelimited countries. A growing body of literature describes an increased susceptibility of CKD V-D to COVID-19 with adverse outcomes in those with severe disease. In the current retrospective report, we elucidate the outcome in consecutive 37 CKD V-D patients with COVID-19 from two dialysis centres in Mumbai, India. Of the 37 patients included in the study, 56.7% of patients were asymptomatic or had mild disease and 27% presented with severe symptoms. The recovery rate was 63%, all those who presented with a severe disease succumbed to the infection. Thirty per cent of patients presented with an extended dialysis break due to various logistic and social issues. Though the overall clinical presentation and outcomes of this cohort from a limited resource setting mimic the global scenario, unique social and logistic issues are an additional burden to the patient, caregivers and the health-care facilities, which may worsen the outcomes in the future as the pandemic continues to spread.

This checklist can be used by administrators and staff members in a range of congregate living settings (e.g., shelters, group homes, supportive housing). Although not specific for correctional facilities, some of the items on the checklist may be applicable to these settings. This checklist is not intended for use in long-term care facilities (a specific checklist exists for long-term care facilities).

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BACKGROUND The management of acute pancreatitis (AP) in children was historically derived from adult practice recommendations. Pediatric-specific recommendations for treatment of AP were recently developed by North American Society for Pediatric Gastroenterology, Hepatology and Nutrition, but their impact on clinical outcomes has yet to be evaluated. We developed an AP order set on the basis of these recommendations to assess impact on clinical outcomes. METHODS Patients admitted to a single center with 3 children’s hospitals in 2017 and 2018 for isolated AP were included in a retrospective review. Patient demographic data, order set use, treatment variables (eg, fluid type, rate, type and timing of diet initiation, and narcotic use), and outcome variables (eg, length of stay [LOS], PICU admission, and 30-day readmission) were collected. Mixed-effects modeling was used to estimate the impact of order set use on clinical outcomes. RESULTS There were 159 pancreatitis encounters and 137 unique patients who met inclusion criteria. In 2018, when using the log transform of LOS in a linear mixed-effects model for clustering by hospital, there was a 10% decrease in mean LOS, but this failed to reach statistical significance (P = .30). Among the 107 encounters who received at least 1 dose of narcotic, there were significantly fewer doses prescribed after implementation of the order set: mean (SD) of5.22 (2.86) vs 3.59 (2.47) (P < .001). Thirty-day readmission (P = .25) and PICU admission rates (P = .31) were not different between years. CONCLUSIONS The implementation of a pancreatitis order set is associated with a significant decrease in narcotic use in pediatric patients with AP without increasing readmission rates or PICU admissions.

In December 2019, an outbreak of viral pneumonia of unknown etiology arose in Wuhan, Hubei Province, China. Eventually isolated and named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), this virus has caused a global pandemic of the pneumonia-like Coronavirus Disease (COVID-19). With global infection rates and deaths mounting, the medical community has been forced to recognize, test, and treat these patients within a rapidly evolving situation and a shortage of resources. In this article, we summarize the most recent data pertaining to the clinical presentation, diagnostic tests, imaging, and management strategies for COVID-19. This article concludes with a discussion of ongoing efforts to develop critically needed therapeutics and vaccines, which may subsequently shape our responses to future pandemics.