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Background and aims COVID-19 disease appear to have been associated with significant mortality amongst doctors and health care workers globally. We explore the various risk factors associated with this occupational risk, especially focusing on India. This may elucidate lessons to protect these frontline workers during the COVID-19 pandemic. Methods We carried out a comprehensive review of the literature using suitable keywords such as ‘COVID-19’, ‘pandemics’, ‘physicians’ ‘mortality’ and ‘health personnel’ on the search engines of PubMed, SCOPUS, Google Scholar and ResearchGate in the month of July 2020 during the current COVID-19 pandemic and assessed mortality data. Results Mortality in health care professionals has been on the rise. The countries which faced the pandemic in the early months of 2020 have had a huge surge in mortality amongst doctors due to COVID-19. India continues to show a rising trend in COVID-19 cases, however although compared to the western world India has seen a comparatively favourable statistic. Male gender, elderly doctors and those belonging to Black, Asian, and Minority Ethnic (BAME) community seem to be predisposing factors in the western world. Conclusion COVID-19 has been associated with an increased mortality in doctors and health care workers. Until an effective cure/vaccine is developed, risk assessments at work, mitigating confounding factors, adequate supply of personal protective equipment (PPE) and enhanced protection against infection are necessary to protect health care professionals on the coronavirus frontline. Otherwise this occupational risk can lead to further untimely mortality and become another unintended consequence of the COVID-19 pandemic.

Due to the nature of their profession, health care personnel (HCP) have always been easy targets for transmission of communicable diseases like COVID-19. Shielding HCPs is of consequential significance in ensuring continued health care for the whole population in addition to reducing further spread. Close contact, repeated contact and prolonged contact are unavoidable in the intensive care (IC) environment. It is not uncommon for IC-HCPs to get carried away during an emergent situation, such as that posed by a suddenly deteriorating patient, and forgo the protective barriers that protect them from contracting a communicable infection. Some notable precautionary measures are mentioned below. This is by no means an exhaustive list.

The Global initiative against asthma (GINA) 2020 strategy has been released with some changes and updates. GINA recommends the continuation of medications, avoidance of nebulization and spirometry, and ensuring a written asthma action plan in COVID-19 times. GINA 2020 specifies which step of management is to be followed according to the patient's symptoms in an easy flowchart. Clinicians need to be aware of the changes and the evidence behind them.

COVID-19 is a pandemic with over 5 million cases worldwide. The disease has imposed a huge burden on health resources. Evaluation of clinical and epidemiological profiles of such patients can help in understanding and managing the outbreak more efficiently. This study was a prospective observational analysis of 200 diagnosed COVID-19 patients admitted to a tertiary care center from 20th march to 8th May 2020. All these patients were positive for COVID-19 by an oro-nasopharyngeal swab-rtPCR based testing. Analyses of demographic factors, clinical characteristics, comorbidities, laboratory parameters, and the outcomes were performed. The mean age of the population was 40 years with a slight male predominance (116 patients out of 200, 58%). A majority of the patients (147, 73.5 %) were symptomatic, with fever being the most common symptom (109, 54.5%), followed by cough (91, 45.5%). An older age, presence of symptoms and their duration, leukocytosis, a high quick SOFA score, a high modified SOFA score, need for ventilator support, an AST level more than 3 times the upper limit of normal (ULN), and a serum creatinine level of 2 mg/dl or greater were at a significantly higher risk of ICU admission and mortality. Presence of diabetes mellitus, AST > three times ULN, serum creatinine 2 mg/dl or higher, and a qSOFA score of 1 or higher were all associated with significantly greater odds of critical care requirement. Triage and severity assessment helps in deciding the requirement for a hospital stay and ICU admission for COVID-19 which can easily be done using clinical and laboratory parameters. A mild, moderate and severe category approach with defined criteria and treatment guidelines will help in judicious utilization of health-care resources, especially for developing countries like India.   *Other members of the Safdarjung Hospital COVID-19 working group: Balvinder Singh (Microbiology), MK Sen (Pulmonary Medicine), Shibdas Chakrabarti (Pulmonary Medicine), NK Gupta (Pulmonary medicine), AJ Mahendran (Pulmonary Medicine), Ramesh Meena (Medicine), G Usha (Anaesthesiology), Santvana Kohli (Anaesthesiology), Sahil Diwan (Anaesthesiology), Rushika Saksena (Microbiology), Vikramjeet Dutta (Microbiology), Anupam Kr Anveshi (Microbiology)

GOLD 2021 guidelines for COPD: what's new and why To The EditorThe Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2021 report dawns with an update to the diagnostic, preventive and therapeutic strategies for Chronic obstructive pulmonary disease (COPD). Unlike the previous update [1], there are no major changes in diagnostic and treatment directives. There are however, numerous small updates which stem from over two hundred new references that have been added [2].

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