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  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">JPSIM</journal-id>
      <journal-title-group>
        <journal-title>Journal of Pakistan Society of Internal Medicine</journal-title>
        <abbrev-title>J Pak Soc Intern Med</abbrev-title>
      </journal-title-group>
      <issn publication-format="print">2709-8729</issn>
      <issn publication-format="electronic">2710-0804</issn>
      <publisher>
        <publisher-name>Pakistan Society of Internal Medicine</publisher-name>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="doi">10.70302/jpsim.v3i2.2222</article-id>
      <article-id pub-id-type="publisher-id">jpsim.v3i2.2222</article-id>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Original Research</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Prevalence and Impact of COVID-19 in Immuno-compromised Individuals: An Experience from a Private Outpatient Setting of South Punjab, Pakistan</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author" corresp="yes">
          <name>
            <surname>Ali</surname>
            <given-names>Qazi Masroor</given-names>
          </name>
          <email>Masroorqazi@outlook.com</email>
          <xref ref-type="aff" rid="aff1"/>
          <xref ref-type="corresp" rid="cor1">*</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Imran</surname>
            <given-names>Ali</given-names>
          </name>
          <xref ref-type="aff" rid="aff1"/>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Shafique</surname>
            <given-names>Sadaf</given-names>
          </name>
          <xref ref-type="aff" rid="aff2"/>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Khan</surname>
            <given-names>Raheel</given-names>
          </name>
          <xref ref-type="aff" rid="aff2"/>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Ullah</surname>
            <given-names>Hafiz Muhammad Kaleem</given-names>
          </name>
          <xref ref-type="aff" rid="aff2"/>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Sohail</surname>
            <given-names>Sajjad</given-names>
          </name>
          <xref ref-type="aff" rid="aff2"/>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Tariq</surname>
            <given-names>Muhammad Sohail</given-names>
          </name>
          <xref ref-type="aff" rid="aff2"/>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Masroor</surname>
            <given-names>Maria</given-names>
          </name>
          <xref ref-type="aff" rid="aff3"/>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Chaudhary</surname>
            <given-names>Ghulam Muhy-u-din</given-names>
          </name>
          <xref ref-type="aff" rid="aff4"/>
        </contrib>
      </contrib-group>
      <aff id="aff1">
        <institution>Quaid-e-Azam Medical College</institution>
      </aff>
      <aff id="aff2">
        <institution>Bahawal Victoria Hospital Bahawalpur</institution>
      </aff>
      <aff id="aff3">
        <institution>Shaikh Zayed Hospital, Rahim Yar Khan</institution>
      </aff>
      <aff id="aff4">
        <institution>Nishtar Medical University, Multan</institution>
      </aff>
      <author-notes>
        <corresp id="cor1">*Correspondence: Qazi Masroor Ali (Masroorqazi@outlook.com)</corresp>
      </author-notes>
      <pub-date date-type="pub" publication-format="electronic" iso-8601-date="2022-06-15">
        <day>15</day>
        <month>06</month>
        <year>2022</year>
      </pub-date>
      <pub-date date-type="collection" publication-format="electronic">
        <year>2022</year>
      </pub-date>
      <volume>3</volume>
      <issue>2</issue>
      <fpage>117</fpage>
      <lpage>120</lpage>
      <history>
        <date date-type="received" iso-8601-date="2022-01-07">
          <day>07</day>
          <month>01</month>
          <year>2022</year>
        </date>
        <date date-type="accepted" iso-8601-date="2022-04-16">
          <day>16</day>
          <month>04</month>
          <year>2022</year>
        </date>
      </history>
      <permissions>
        <copyright-statement>Copyright © 2022 The Author(s)</copyright-statement>
        <copyright-year>2022</copyright-year>
        <copyright-holder>The Author(s)</copyright-holder>
        <ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/>
        <license license-type="open-access" xlink:href="https://creativecommons.org/licenses/by/4.0/">
          <ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by/4.0/</ali:license_ref>
          <license-p>This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
        </license>
      </permissions>
      <self-uri xlink:href="https://psimj.com/article/jpsim.v3i2.2222" content-type="text/html"/>
      <self-uri xlink:href="https://psimj.com/article/jpsim.v3i2.2222.pdf" content-type="application/pdf"/>
      <abstract>
        <sec>
          <title>Objective</title>
          <p>To find out the prevalence and impact of COVID-19 on immunocompromised patients visiting outpatient department of a private healthcare facility of South Punjab, Pakistan.</p>
        </sec>
        <sec>
          <title>Methodology</title>
          <p>This cross-sectional study was done at Outpatient Department of Aleena Hospital, Bahawalpur, Pakistan from 1st June 2020 to 30th December 2020. We included a total of 197 patients of both genders aged between 15 to 90 years visiting outpatient department of Aleena Hospital for various medical reasons. All patients underwent antibody testing for COVID-19 adopting immunochromatography for both IgG and IgM. A patient was labeled as immunocompromised if having diabetes mellitus or liver cirrhosis.</p>
        </sec>
        <sec>
          <title>Results</title>
          <p>In a total of 197 patients, 122 (61.9%) were male. Overall, mean age was 45.1±13.3 years ranging 15 to 90 years. A total of 50 (25.4%) cases were antibody positive for COVID-19. BMI ≥ 25 (p=0.045), and “been to close proximity with someone who travelled outside/inside the country” (p=0.014) were noted to have significant association with COVID-19 positive cases while all other variables had insignificant association (p&gt;0.05). Presence of diabetes mellitus was noted to have significant association with COVID-19 antibody positivity (p=0.002). Overall, no significant association of immunocompromised status and COVID-19 antibodies positivity was observed (p=0.090).</p>
        </sec>
        <sec>
          <title>Conclusion</title>
          <p>Prevalence of positive COVID-19 antibodies was very high among patients visiting outpatient department of a private healthcare setting of South Punjab, Pakistan. Immunocompromised individuals were not found to have any significant association with COVID-19 infections.</p>
        </sec>
      </abstract>
      <kwd-group xml:lang="en" kwd-group-type="author-keywords">
        <title>Keywords</title>
        <kwd>COVID-19</kwd>
        <kwd>diabetes mellitus</kwd>
        <kwd>immunocompromised</kwd>
        <kwd>polymerase chain reaction.</kwd>
      </kwd-group>
    </article-meta>
  </front>
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  <back>
    <ref-list>
      <title>References</title>
      <ref id="ref1">
        <label>1</label>
        <mixed-citation>Organization W.H. WHO Coronavirus disease (COVID-19) dashboard. [Updated 2020, cited 2022] Available from: [https://covid19.who.int/]</mixed-citation>
      </ref>
      <ref id="ref2">
        <label>2</label>
        <mixed-citation>Zhou Y, Yang Q, Chi J, Dong B, Lv W, Shen L, Wang Y. Comorbidities and the risk of severe or fatal outcomes associated with coronavirus disease 2019: A systematic review and meta-analysis. Int J Infect Dis. 2020;99(9):47-56.</mixed-citation>
      </ref>
      <ref id="ref3">
        <label>3</label>
        <mixed-citation>Zhang JJY, Lee KS, Ang LW, Leo YS, Young BE. Risk factors for severe disease and efficacy of treatment in patients infected with COVID-19: A systematic review, meta-analysis, and meta-regression analysis. Clin Infect Dis. 2020;71(16):2199-206.</mixed-citation>
      </ref>
      <ref id="ref4">
        <label>4</label>
        <mixed-citation>Vabret N, Britton GJ, Gruber C, Hegde S, Kim J, Kuksin M, et al. Immunology of COVID-19: Current state of the science. Immunity. 2020;52(6):910-41.</mixed-citation>
      </ref>
      <ref id="ref5">
        <label>5</label>
        <mixed-citation>Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, et al. Dysregulation of immune response in patients with Coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020;71(15):762-768.</mixed-citation>
      </ref>
      <ref id="ref6">
        <label>6</label>
        <mixed-citation>Anirvan P, Bharali P, Gogoi M, Thuluvath PJ, Singh SP, Satapathy SK. Liver injury in COVID-19: The hepatic aspect of the respiratory syndrome - what we know so far. World J Hepatol. 2020;12(12):1182-97.</mixed-citation>
      </ref>
      <ref id="ref7">
        <label>7</label>
        <mixed-citation>Wilk AJ, Rustagi A, Zhao NQ, Roque J, Martinez-Colon GJ, McKechnie JL, et al. A single-cell atlas of the peripheral immune response in patients with severe COVID-19. Nat Med. 2020;26(7):1070-6.</mixed-citation>
      </ref>
      <ref id="ref8">
        <label>8</label>
        <mixed-citation>Urra JM, Cabrera CM, Porras L, Ródenas I. Selective CD8 cell reduction by SARS-CoV-2 is associated with a worse prognosis and systemic inflammation in COVID-19 patients. Clin Immunol. 2020; <pub-id pub-id-type="doi">10.1016/j.clim.2020.108486</pub-id></mixed-citation>
      </ref>
      <ref id="ref9">
        <label>9</label>
        <mixed-citation>Goldman JD, Robinson PC, Uldrick TS, Ljungman P. COVID-19 in immunocompromised populations: implications for prognosis and repurposing of immunotherapies. J Immunother Cancer. 2021;9(6):e002630.</mixed-citation>
      </ref>
      <ref id="ref10">
        <label>10</label>
        <mixed-citation>Ahmed O, Asghar M, Khurshaidi M, Yasmin F, Kanwal N, Khokher AJ, et al. Provision of surgical services to COVID-19-infected patients at a tertiary care center in Pakistan: A one-year clinical review of the year 2020 in general surgery department. Cureus. 2021;13(1): e12705.</mixed-citation>
      </ref>
      <ref id="ref11">
        <label>11</label>
        <mixed-citation>Vaid N, Ardissino M, Reed TA, Goodall J, Utting P, Miscampbell M, et al. Clinical characteristics and outcomes of immunosuppressed patients hospitalized with COVID-19: experience from London. J Intern Med. 2021;289(3):385-94.</mixed-citation>
      </ref>
      <ref id="ref12">
        <label>12</label>
        <mixed-citation>Baek MS, Lee MT, Kim WY, Choi JC, Jung SY. COVID-19-related outcomes in immunocompromised patients: A nationwide study in Korea. PLoS One. 2021;16(10): e025764.</mixed-citation>
      </ref>
      <ref id="ref13">
        <label>13</label>
        <mixed-citation>Swann OV, Holden KA, Turtle L, Pollock L, Fairfield CJ, Drake TM, et al. Clinical characteristics of children and young people admitted to hospital with covid-19 in United Kingdom: prospective multicentre observational cohort study. BMJ. 2020; <pub-id pub-id-type="doi">10.1136/bmj.m3249</pub-id></mixed-citation>
      </ref>
      <ref id="ref14">
        <label>14</label>
        <mixed-citation>Ferrari A, Zecca M, Rizzari C, Porta F, Provenzi M, Marinoni M, et al. Children with cancer in the time of COVID-19: An 8-week report from the six pediatric onco-hematology centers in Lombardia, Italy. Pediatr Blood Cancer. 2020;67(8):e28410.</mixed-citation>
      </ref>
      <ref id="ref15">
        <label>15</label>
        <mixed-citation>Millen GC, Arnold R, Cazier JB, Curley H, Feltbower RG, Gamble A, et al. Severity of COVID-19 in children with cancer: Report from the United Kingdom Paediatric Coronavirus Cancer Monitoring Project. Br J Cancer. 2021;124(4):754-9.</mixed-citation>
      </ref>
      <ref id="ref16">
        <label>16</label>
        <mixed-citation>Chan KH, Lee PW, Chan CY, Lam KBH, Ho PL. Monitoring respiratory infections in covid-19 epidemics. BMJ. 2020; <pub-id pub-id-type="doi">10.1136/bmj.m1628</pub-id></mixed-citation>
      </ref>
      <ref id="ref17">
        <label>17</label>
        <mixed-citation>Abdi A, Jalilian M, Sarbarzeh PA, Vlaisavljevic Z. Diabetes and COVID-19: A systematic review on the current evidences. Diabetes Res ClinPract. 2020; <pub-id pub-id-type="doi">10.1016/j.diabres.2020.108347</pub-id></mixed-citation>
      </ref>
      <ref id="ref18">
        <label>18</label>
        <mixed-citation>Nassar M, Daoud A, Nso N, Medina L, Ghernautan V, Bhangoo H, et al. Diabetes mellitus and COVID-19: Review article. Diabetes MetabSyndr. 2021;15(6):102268.</mixed-citation>
      </ref>
      <ref id="ref19">
        <label>19</label>
        <mixed-citation>Shoaib N, Noureen N, Munir R, Shah FA, Ishtiaq N, Jamil N, et al. COVID-19 severity: Studying the clinical and demographic risk factors for adverse outcomes. PLoS One. 2021;16(8):e0255999.</mixed-citation>
      </ref>
    </ref-list>
  </back>
</article>
