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The post-Covid symptoms among patients hospitalised with covid has to be determined for elucidating the spectrum of illness which persists even after the apparent recovery. The understanding of the post-Covid symptoms will help us to better manage aftermath of the pandemic. Our aim is to determine the incidence of post-Covid symptoms in a cohort of inpatients who recovered from COVID-19 from a tertiary care centre in South India.120 survivors from patients admitted with COVID 19 were prospectively followed up for 6 weeks after their discharge from the hospital. The cohort included 50 patients requiring Intensive care unit (ICU) care and 70 ward patients. The follow-up was conducted on the second and sixth week after discharge with a structured questionnaire. The questionnaire was filled by the patient/ bystanders during their visit to the hospital for follow-up at 2 weeks and through telephone follow up at 6 weeks.Mean age of the cohort was 55 years and 55% were males. 58.3% had mild covid and 41.7% had moderate to severe covid infection. 60.8% (n=73) of patients had at least one persistent symptom at sixth week of discharge. 50 (41.7%) patients required intensive care during their inpatient stay. Presence of persistent symptoms at 6 weeks was not associated with severity of illness, age or requirement for intensive care. Fatigue was the most common reported persistent symptom with a prevalence of 55.8% followed by weight loss (22.5%) and dyspnoea (20%). Female sex (OR 2.4, 95% CI: 1.03-5.58, p = 0.041) and steroid administration during hospital stay (OR: 4.43; 95% CI: 1.9-10.28, p = 0.001), were found to be significant risk factors for the presence of post-Covid symptoms at 6 weeks as revealed by logistic regression analysis.60.8% of inpatients treated for covid had post-Covid symptoms at 6 weeks post- discharge from hospital. Female sex and steroid administration during hospital stay were identified as predictors of persistence of post-Covid symptoms at 6weeks.

Primary objective was to determine an association between Atherosclerotic Cardiovascular Disease (ASCVD) and Framingham (FRS) risk scores with Syntax score(SS). Secondary objective was to determine sensitivity, specificity and discriminative ability of FRS and ASCVD risk scores in detecting Coronary Artery Disease (CAD) and predicting its severity.This is a cross-sectional study carried out in the Comprehensive Health Clinic of Amrita Institute of Medical Sciences, Kochi, Kerala. Patients voluntarily visiting the clinic for a health check-up were referred to Cardiology based on a positive treadmill test result where they underwent a coronary angiogram. Secondary data on patients' demographics, prior history of cardiovascular diseases, investigations and interventional procedures was collected from the hospital registry. The risk scores were calculated using the data through online calculators. Analysis was carried out using SPSS.Chi-square analysis showed significant association between FRS and SS. Both FRS and ASCVD risk scores have good sensitivity for CAD while having good specificity for patients with high Syntax score (SS≥33). ROC curve showed that ASCVD risk score has a higher positive likelihood ratio than FRS for predicting CAD and high Syntax Score Patients.The study concludes that FRS and ASCVD risk scores are effective risk predicting models for CAD. FRS is a more sensitive risk score than ASCVD risk score in predicting CAD whereas ASCVD risk score has a higher ability to differentiate patients with CAD and high Syntax Score than FRS.

Background Colistin has re-emerged as last line antimicrobial to combat MDR GNB. There is need for robust pharmacokinetic (PK) and pharmacodynamics (PD) data to guide dosing. This study assessed the PK of CMS and colistin and its impact on clinical cure (CC) and acute kidney injury (AKI) in critically ill patients with normal baseline renal function. Methods Adult critically ill patients with colistin susceptible MDR/XDR infections and normal renal function who were treated with intravenous CMS (9MU CMS loading dose (LD) followed by maintenance (MD) 3MU every 8 hour starting 24 hours after LD) were recruited into this prospective observational study. For PK sampling, 3mL venous blood was drawn immediately before LD and at 0.5, 1, 2, 4, 8 and 12 hours after LD. During MD, samples were collected before and at 1, 2 and 8 hours after the eight and nineth infusion. Colistin plasma concentrations were determined by LC–MS. Results A total of 280 serum samples were analyzed from 20 patients. Sixty percent had pneumonia. Predominant pathogens were Klebsiella pneumonia (12) and Acinetobacter spp. (8). Mean creatinine clearance (CrCl) was 115 ± 24 mL/minute (72.3–208.8). All patients received combination therapy with colistin, 18(90%) received meropenem and 5(25%) received tigecycline. Clinical cure rate was 50% (10/20) and mortality rate was 25% (5/20). Mean LD colistin Cmax were 3 ± 1.1 mg/L (1.75–5.14) and 2.37 ± 1.2 mg/L (1.52–5.54) among CC and CF groups, respectively (P = 0.13). MD colistin Css avg was 2.25 ± 1.3 mg/L and 1.78 ± 1.1 mg/L in CC and CF groups, respectively. The mean AUC0–24/MIC ratio of MD colistin was 92.76 ± 65.5 and 76.59 ± 51.8 for CC and CF groups, respectively (P = 0.27). In pneumonia, AUC0–24/MIC for Acinetobacter spp. was higher in the CC (71.18 ± 10.20) than in the CF group (40.88 ± 16.28) (P = 0.05). Renal injury was 5% at 7 days and 40% at end of therapy. Ten to 20% of patients with CrCl ≥ 100 mL/minute had Css avg ≥ 2 mg/L. Majority of CF with AKI had Css avg between 1 and 1.5 mg/L Conclusion Clinical cure was low at 50%. Sub-inhibitory Css avg and increased volume of distribution following MD could have contributed to high failure. Colistin exposures were similar to those reported in other published cohorts with no consistent exposure-response relationship. Based on these results, there is an important role for therapeutic drug monitoring with Colistin. Disclosures All authors: No reported disclosures.

The objective of this study was to report a case of a person with psychiatric illness treated with clozapine presented with diabetic ketoacidosis (DKA). A clinical monitoring was done on a 38-year-old Indian man affected by schizoaffective disorder, bipolar type presented with DKA after 3 months of clozapine therapy (250 mg/day). After treatment of DKA and discontinuation of clozapine, the patient improved symptomatically, his blood sugar levels normalized and insulin requirements also decreased. This report thus highlights that clinicians should be vigilant about the potential risk of new-onset diabetes and DKA in patients taking clozapine and utilize appropriate clinical and laboratory monitoring early in the course of treatment to prevent serious adverse effects.