Hospitalized COVID-19 Patients Research Articles

Pharmacodynamic, prognostic, and predictive biomarkers in severe and critical COVID-19 patients treated with sirukumab

We examined candidate biomarkers for efficacy outcomes in hospitalized COVID-19 patients who were treated with sirukumab, an IL-6 neutralizing antibody, in a randomized, double-blind, placebo-controlled, phase 2 trial. Between May 2020 and March 2021, 209 patients were randomized (sirukumab, n = 139; placebo, n = 70); 112 had critical COVID-19. Serum biomarkers were evaluated for the pharmacodynamic effect of sirukumab and for their potential prognostic and predictive effect on time to sustained clinical improvement up to Day 28, clinical improvement at Day 28, and mortality at Day 28. The absence of detectable IL-4 increase and smaller increases in CCL13 post-baseline were most significantly associated with better response to sirukumab (versus placebo) treatment for all clinical efficacy outcomes tested, especially in patients with critical COVID-19. These data suggest that patients with critical COVID-19 without detectable sirukumab-induced IL-4 levels are more likely to benefit from sirukumab treatment. ClinicalTrials.gov Identifier: NCT04380961.

Elevated levels of pro-thrombotic eNOS-negative platelets in COVID-19 patients

BackgroundPlatelet-rich microvascular thrombi are common in severe COVID-19. Endogenous nitric oxide (NO)-signaling limits thrombus formation and previously we identified platelet subpopulations with a differential ability to produce NO based on the presence or absence of endothelial nitric oxide synthase (eNOS). eNOS expression is counter-regulated by cytokines, and COVID-19-associated immune/inflammatory responses may affect the transcriptome profile of megakaryocytes and their platelet progeny. ObjectivesWe investigated whether the percentage of eNOS-negative to eNOS-positive platelets increases in COVID-19 patients and whether this change may be due to the actions of pro-inflammatory cytokines on megakaryocytes. MethodsPlatelets were isolated from hospitalized COVID-19 patients and COVID-19-negative controls. Platelet eNOS was measured by flow cytometry and plasma inflammatory cytokines by ELISA. Megakaryocytes from eNOS-GFP transgenic mice and the Meg-01 cell line were characterized to identify an appropriate model to study eNOS-based platelet subpopulation formation in response to inflammatory cytokines. ResultsCOVID-19 patients demonstrated a significant increase in eNOS-negative and a concomitant decrease in eNOS-positive platelets compared to controls, and this change was associated with disease severity as assessed by ICU admission. A higher eNOS-negative to –positive platelet percentage was associated with enhanced platelet activation as measured by surface CD62P. Accordingly, COVID-19 patients demonstrated higher TNF-α, IL-6, and IL-1β plasma concentrations than controls. Inflammatory cytokines associated with COVID-19 promoted eNOS-negative Meg-01 formation and enhanced subsequent eNOS-negative platelet-like particle formation. ConclusionsCOVID-19 patients have a higher percentage of eNOS-negative to –positive platelets, likely as a result of inflammatory response reducing megakaryocyte eNOS expression, which predisposes to thrombosis.

Lifestyle or low grade inflammation related determinants predict one-year all cause mortality in hospitalized covid-19 patients with overweight or obesity

Lifestyle or low grade inflammation related determinants predict one-year all cause mortality in hospitalized covid-19 patients with overweight or obesity

Association Between SARS-CoV-2 Infection and Acute Ischemic Colitis.

Ischemic colitis appears to be a rare but serious complication of COVID-19. About 33.3% hospitalized COVID-19 patients who underwent endoscopy showed features resembling ischemic colitis. The aim of this prospective study was to describe the symptoms, treatment, and outcomes of these patients, particularly their colonoscopy and histologic findings. We conducted a prospective study on ischemic bowel disease associated with COVID-19 across four centers from December 2022 to January 2023. All cases were identified through a comprehensive search of electronic medical records for procedure-related data. The initial diagnosis of ischemic bowel disease was confirmed using colonoscopy and biopsy findings. After the patients were discharged, a 12-month follow-up was conducted through regular phone interviews to assess their clinical outcomes. Overall, the study included 3 male patients and 9 female patients (age range, 33-76 years). Abdominal pain and hematochezia always occurred within 2weeks after COVID-19 infection (average 5.5 days). Gastrointestinal manifestations did not parallel the severity of COVID-19 infection. The descending colon was the most susceptible segment, which was involved in 10 patients (83.33%). Colonoscopy revealed diffuse redness, edema, bleeding, erosion, and ulceration of the intestinal mucosa, similar to the findings of ischemic colitis, and biopsy revealed crypt atrophy, reduction, and interstitial bleeding. All patients were self-limited without converting to chronic changes in the next 12 months. SARS-CoV-2 infection may induce transient acute colon ischemia within 2weeks, accompanied by severe clinical symptoms such as acute abdominal pain and hematochezia, which are self-limiting and do not lead to chronic symptoms.

Perspectives and lived experiences of survivors and caregivers of COVID-19 patients in a teaching hospital in a tribal district of Chhattisgarh, India

ABSTRACT Background: The rural–urban healthcare disparity in India was exacerbated during the COVID-19 pandemic, with the second wave hitting rural areas particularly hard due to weak infrastructure. A study in Chhattisgarh aims to explore the experiences of severely ill COVID-19 survivors and caregivers to inform patient-centric care delivery in primary settings. Methods: In this qualitative study, we conducted in-depth interviews with seven patients and seven caregivers during home visits or telephonically to understand lived experiences of receiving care for COVID-19 in an ICU in the public health system. Socioecological model was used to guide the qualitative inquiry. Results: COVID-19 patients faced stigma due to their diagnosis. The survivors felt lonely due to isolation, uncertainty about their illness, and fear of death. Poor mental health during ICU stay affected their physical health. Patients with caregivers felt supported despite visitor restrictions. Transparent communication with health providers reduced distress. Conclusion: The study in Chhattisgarh, India, highlights ICU survivors’ and caregivers’ experiences, revealing fear and loneliness among patients. Effective communication and caregiver presence improve outcomes, emphasizing holistic support. There’s an urgent need for palliative care integration, caregiver inclusion, and comprehensive post-discharge follow-up by primary-level practitioners in rural settings. Lack of state-level palliative care policy emphasizes the need for comprehensive initiatives to enhance healthcare outcomes.

The prognostic role of Neurologic Pupil Index in COVID-19 patients: a retrospective study.

Neurological complications have been observed in approximately 30% of hospitalized COVID-19 patients. The aim of this study was to evaluate whether early assessment of the Neurological Pupil Index (NPiTM) derived from an automated pupillometry could predict mortality in critically ill COVID-19 patients. Retrospective cohort study of adult critically ill COVID-19 patients admitted to the intensive care unit of a University Hospital; patients without NPi measurement were excluded. The worst NPi (i.e. lowest value from one eye) was collected daily and then computed over the first five days of assessment. Mortality was assessed at hospital discharge. The secondary endpoint involved assessing differences in neurological assessments between patients who developed neurological complications and those who did not. A total of 217 patients were included over the study period (median age 61 [50-68] years), 70% were males. A total of 97 patients (45%) died during the hospital stay. Among all patients, 35 (16%) experienced neurological complications. Non-survivors showed significantly a lower overall NPi (3.0 [2.0-4.1] vs. 3.4 [2.7-4.2]; P=0.04) than survivors. At multivariate logistic regression NPi was not significantly associated with in-hospital mortality. Moreover, no differences in different NPi measurements were observed between patients with and without neurological complications. In this study, NPi values were not independent predictor of mortality and neurological complications in critically ill COVID-19 patients.

Systemic cytokines related to memory function 6–9 months and 12–15 months after SARS-CoV-2 infection

Cognitive symptoms persisting beyond the acute phase of COVID-19 infection are commonly described for up to 2 years after infection. The relationship between cognitive performance, in particular episodic memory processes observed chronically after infection, and cytokine levels in the acute phase of COVID-19 has not yet been identified in humans. To determine whether the levels of cytokines IL1β, IL-6 and TNFα secreted in the acute phase of SARS-CoV-2 infection are associated and predict verbal and visuospatial episodic memory performance in humans 6 to 9 months and 12 to 15 months post-infection. The associations and predictive value of the concentration of cytokines measured in acute phase (IL-1β, IL-6, TNFα) from plasma samples of N = 33 hospitalized COVID-19 patients (mean age 61 years, 39–78, 65% in intensive care) in relation to their verbal and visuospatial episodic memory performance measured at 6–9 months and 12–15 months post-infection were analyzed. To do this, we used Spearman correlations and generalised linear mixed models. IL-1β levels were associated with verbal episodic memory total recall scores 6–9 months post-infection. At 12–15 months post-infection IL-6 predicted verbal episodic memory score. This study demonstrated that the severity of inflammatory reaction at acute phase of SARS-CoV-2 infection predicts verbal episodic memory performance in the long-term post-infection.

Survival of hospitalised COVID-19 patients in Hawassa, Ethiopia: a cohort study

The COVID-19 pandemic, caused by SARS-CoV-2, led to 622,119,701 reported cases and 6,546,118 deaths. Most studies on COVID-19 patients in hospitals are from high-income countries, lacking data for developing countries such as Ethiopia.This study assesses clinical features, demographics, and risk factors for in-hospital mortality in Hawassa, Ethiopia. The research cohort comprises 804 cases exhibiting clinical diagnoses and/or radiological findings and indicative of symptoms consistent with COVID-19 at Hawassa University Comprehensive Specialized Hospital from September 24, 2020, to November 26, 2021. In-hospital mortality rate was predicted using Cox regression. The median age was 45 years, with males making up 64.1% of the population. 173 (21.5%) fatalities occurred, with 125 (72.3%) among males. Male patients had higher mortality rates than females. Severe and critical cases were 24% and 21%. 49.1% had at least one comorbidity, with 12.6% having multiple. Common comorbidities were diabetes (15.9%) and hypertension (15.2%). The Cox regression in Ethiopian COVID-19 patients found that factors like gender, advanced age group, disease severity, symptoms upon admission, shortness of breath, sore throat, body weakness, hypertension, diabetes, multiple comorbidities, and prior health facility visits increased the risk of COVID-19 death, similar to high-income nations. However, in Ethiopia, COVID-19 patients were young and economically active. Patients with at least one symptom had reduced death risk. As a conclusion, COVID-19 in Ethiopia mainly affected the younger demographic, particularly economically active individuals. Early detection can reduce the risk of mortality. Prompt medical attention is essential, especially for individuals with comorbidities. Further research needed on diabetes and hypertension management to reduce mortality risk. Risk factors identified at admission play a crucial role in guiding clinical decisions for intensive monitoring and treatment. Broader risk indicators help prioritize patients for allocation of hospital resources, especially in regions with limited medical facilities. Government’s focus on timely testing and strict adherence to regulations crucial for reducing economic impact.

Association between Liver Damage and Disease Progression Markers with Mortality Risk and Mechanical Ventilation in Hospitalized COVID-19 Patients: A Nationwide Retrospective SARSTer Study.

(1) Background: Liver damage is an important component of acute COVID-19, and the advancement of preexisting liver disease is associated with a worse prognosis; (2) Methods: A nationwide retrospective study including 7444 patients aimed to evaluate levels of selected markers of liver damage and disease advancement and their association with mortality and mechanical ventilation (MV); (3) Results: Elevation of the following markers in multivariate models were associated with increased odds of mortality: Alanine transaminase (ALT), aspartate transaminase (AST), gamma-glutamyltransferase (GGT), lactate dehydrogenase (LDH), fibrosis-4 score (FIB-4), AST-to-platelet ratio index (APRI), and decreased levels of platelet count (PLT). Elevated levels of AST, LDH, APRI, FIB-4, and the AST/ALT ratio and decreased levels of PLT were associated with increased odds of MV in multivariate models. The best predictive accuracy against mortality was achieved with FIB-4 with AUC = 0.733 (95% CI, 0.718-0.749) at the optimal cut-off point of 2.764, while against MV was achieved with LDH with AUC = 0.753 (95% CI, 0.727-0.778) at the optimal cut-off point of 449.5 IU/L. (4) Conclusions: Our study confirms that the advancement of liver damage contributes to a worse prognosis in COVID-19 patients. Markers for liver damage and the advancement of liver disease can provide predictive value in clinical practice among COVID-19 patients.

Clinical prediction model for bacterial co-infection in hospitalized COVID-19 patients during four waves of the pandemic.

Estimates of bacterial coinfection in COVID-19 patients are highly variable and depend on many factors. Patients with severe or critical COVID-19 requiring intensive care unit admission have the highest risk of infection-related complications and death. Thus, the study of the incidence and risk factors for bacterial coinfection in this population is of special interest and may help guide empiric antibiotic therapy and avoid unnecessary antimicrobial treatment. The prediction model based on clinical criteria and simple laboratory tests may be a useful tool to predict bacterial co-infection in patients hospitalized with severe COVID-19.

Comparison of the Efficacy and Safety of Low Molecular Weight Heparins and Fondaparinux in Patients With COVID-19: A Systematic Review and Meta-Analysis.

Individuals diagnosed with COVID-19 are at a higher risk of arterial and venous thrombosis, mostly pulmonary microvascular thrombosis, which may significantly impair treatment and result in morbidity. This is a systematic review and meta-analysis of research papers that aimto evaluate the risk of bleeding and thrombosis among patientstreated with low molecular weight heparin or fondaparinux (LMWH/F). Additionally, we measured the overall death events. This study was conducted in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. A search was conducted in the Clinicaltrials.gov, PubMed, Scopus, and Web of Science databases to identify observational cohort studies and randomized-controlled clinical trials (RCTs) that compared LMWH/F in proven COVID-19 patients. A total of 220 people from two studies were included. Patients who were treated with fondaparinux had a lower risk of developing venous thromboembolism (VTE) (odds ratio (OR) 0.39; 95% confidence interval (CI) (0.14, 1.096); p = 0.168); pulmonary embolism (OR 0.169, 95% CI (0.021, 1.356), p = 0.094); and deep vein thrombosis compared to patients who received LMWH therapy. The data show a lower mortality rate in the LMWH groups (OR 1.135, 95% CI (0.463, 2.785), p = 0.781) and a lower frequency of bleeding (OR 1.657, 95% CI (0.456, 5.908), p = 0.436). Both drugs have shown anti-thrombotic properties in COVID-19 patients. Fondaparinux was somewhat more effective in reducing thrombosis episodes. This research demonstrates the safe use of LMWH for VTE prophylaxis in hospitalized COVID-19 patients based on bleeding and mortality outcomes.

Tracing In-Hospital COVID-19 Outcomes: A Multistate Model Exploration (TRACE).

This study aims to develop and apply multistate models to estimate, forecast, and manage hospital length of stay during the COVID-19 epidemic without using any external packages. Data from Bellvitge University Hospital in Barcelona, Spain, were analyzed, involving 2285 hospitalized COVID-19 patients with moderate to severe conditions. The implemented multistate model includes transition probabilities and risk rates calculated from transitions between defined states, such as admission, ICU transfer, discharge, and death. In addition to examining key factors like age and gender, diabetes, lymphocyte count, comorbidity burden, symptom duration, and different COVID-19 waves were analyzed. Based on the model, patients hospitalized stay an average of 11.90 days before discharge, 2.84 days before moving to the ICU, or 34.21 days before death. ICU patients remain for about 24.08 days, with subsequent stays of 124.30 days before discharge and 35.44 days before death. These results highlight hospital stays' varying durations and trajectories, providing critical insights into patient flow and healthcare resource utilization. Additionally, it can predict ICU peak loads for specific subgroups, aiding in preparedness. Future work will integrate the developed code into the hospital's Health Information System (HIS) following ISO 13606 EHR standards and implement recursive methods to enhance the model's efficiency and accuracy.

Severity, mortality, and incidence of venous thromboembolism in COVID-19 patients

BackgroundCOVID-19 is a global pandemic that negatively affected the world economy and the health care resources. It is associated with great health impact, mortality, and long-term sequelae.MethodsHistory taking computed tomography of the chest and laboratory investigations including complete blood count, liver and kidney function tests, serum ferritin, C-reactive protein, and D-dimer were done.ResultsA total of 246 hospitalized COVID-19 patients were enrolled. Male predominance (67.1% of the total study population) was observed. The mean age was 57.26 ± 14.08 years. Moderate cases comprised 63.8% of the total study population, 22.4% were severe cases, and 13.8% were critical cases. The mortality rate was 8.13% and 6.1% developed venous thromboembolism.ConclusionAge, smoking, and the presence of previous pulmonary disease were among the most important factors affecting COVID-19 severity. The severity of the disease greatly influences the incidence of venous thromboembolism and the outcome of the disease.

Effects of Short-Term Physiotherapy in Hospitalized COVID-19 Patients Infected with Mutant and Non-Mutant Virus: A Prospective Study

Aim: The aim of study, to assess the short term effects of physiotherapy on patients infected with mutant and non-mutant SARS-CoV-2 virus. Material and Methods: The patients included in the study were analyzed in two different groups. Patients infected with non-mutant SARS-CoV-2 were in Group 1 (n=16; age=53.81±9.48). Patients infected with mutant SARS-CoV-2 were included in Group 2 (n=16; age=55.25±10.12). Physiotherapy which included mobilization, normal range of motion, and a breathing exercise program, was performed on both groups (Group 1: Median=7.00; Min-Max=5-20 days; Group 2: Median: 7.00; Min-Max=4-15 days). All patients underwent a once-daily physiotherapy program. The patients' muscle strength, mobility, activities of daily living, exercise capacity, and perception of fatigue were evaluated. The mixed repeated measures ANOVA model was used to compare groups. Results: It was found that physiotherapy improved muscle strength, mobility, ability to perform activities of daily living, exercise capacity, and perception of fatigue in both groups (p0.05). Conclusion: The current study showed that a short term physiotherapy program was as successful in patients infected with mutant SARS-CoV-2 as it was in patients infected with non-mutant SARS-CoV-2. Physiotherapy is beneficial for COVID-19 disease, as it decreases functional limitation and symptoms of COVID-19 disease by contributing positively to muscle strength, mobility, activities of daily living, exercise capacity, and the perception of fatigue.

Potential Plasma Proteins (LGALS9, LAMP3, PRSS8 and AGRN) as Predictors of Hospitalisation Risk in COVID-19 Patients.

Background: The COVID-19 pandemic, caused by the novel coronavirus SARS-CoV-2, has posed unprecedented challenges to healthcare systems worldwide. Here, we have identified proteomic and genetic signatures for improved prognosis which is vital for COVID-19 research. Methods: We investigated the proteomic and genomic profile of COVID-19-positive patients (n = 400 for proteomics, n = 483 for genomics), focusing on differential regulation between hospitalised and non-hospitalised COVID-19 patients. Signatures had their predictive capabilities tested using independent machine learning models such as Support Vector Machine (SVM), Random Forest (RF) and Logistic Regression (LR). Results: This study has identified 224 differentially expressed proteins involved in various inflammatory and immunological pathways in hospitalised COVID-19 patients compared to non-hospitalised COVID-19 patients. LGALS9 (p-value < 0.001), LAMP3 (p-value < 0.001), PRSS8 (p-value < 0.001) and AGRN (p-value < 0.001) were identified as the most statistically significant proteins. Several hundred rsIDs were queried across the top 10 significant signatures, identifying three significant SNPs on the FSTL3 gene showing a correlation with hospitalisation status. Conclusions: Our study has not only identified key signatures of COVID-19 patients with worsened health but has also demonstrated their predictive capabilities as potential biomarkers, which suggests a staple role in the worsened health effects caused by COVID-19.

Outcomes of STEMI Patients in COVID-19 Pandemic: A Systematic Review and Meta-Analysis.

The global SARS-CoV-2 pandemic has disrupted health systems and put a huge strain on hospitals and healthcare workers. Prioritizing COVID-19 patients in hospitals caused irreversible harm to cardiac patients. Although multiple studies have shown that ST-segment elevation myocardial infarction (STEMI) patients have worse admission circumstances than before the pandemic, the hospital outcomes of these patients have remained limited. This systematic review and meta-analysis examined STEMI patient outcomes during the COVID-19 epidemic. We conducted systematic searches of MEDLINE (through PubMed), Web of Science, Scopus, and Embase through Jan 10, 2021. All studies with reporting in-hospital mortality, length of stay, and door-to-balloon time with over twenty participants were included. Articles without clear definitions or results were excluded. The study followed PRISMA guidelines. The outcomes of interest were door-to-balloon time, death, and hospital stay during COVID-19 pandemic compared prior. Our meta-analysis included 12 studies and 21170 people (115-6609). The pooled analysis showed significantly more pandemic mortality (OR=1.24; 95% CI: 1.07-1.43). Ten studies (13,091) recorded door-to-balloon times. Door-to-balloon time (in minutes) significantly increased during the pandemic (Standardized Mean Difference [SMD]= 0.46; 95% CI: 0.03-0.89). The length of hospital stay was reported by five studies (n=9448). Length of hospital stay (in days) was not significantly longer during the pandemic than before the outbreak (SMD= 0.04; 95% CI: -0.19-0.26). The COVID-19 pandemic is associated with increased mortality and door-to-balloon delay that might be attributable to the strict infection control measures in outbreak. Studies with a longer follow-up time are needed to investigate the outcomes of STEMI patients.

Higher incidence of new atrial fibrillation in hospitalised COVID-19 patients compared to lower respiratory tract infection, however, less patients anticoagulated at discharge

Higher incidence of new atrial fibrillation in hospitalised COVID-19 patients compared to lower respiratory tract infection, however, less patients anticoagulated at discharge

Oculomic stratification of COVID-19 patients' intensive therapy unit admission status and mortality by retinal morphological findings.

To investigate if retinal thickness has predictive utility in COVID-19 outcomes by evaluating the statistical association between retinal thickness using OCT and of COVID-19-related mortality. Secondary outcomes included associations between retinal thickness and length of stay (LoS) in hospital. In this retrospective cohort study, OCT scans from 230 COVID-19 patients admitted to the Intensive Care Unit (ITU) were compared with age and gender-matched patients with pneumonia from before March 2020. Total retinal, GCL + IPL, and RNFL thicknesses were recorded, and analysed with systemic measures collected at the time of admission and mortality outcomes, using linear regression models, Pearson's R correlation, and Principal Component Analysis. Retinal thickness was significantly associated with all-time mortality on follow up in the COVID-19 group (p = 0.015), but not 28-day mortality (p = 0.151). Retinal and GCL + IPL layer thicknesses were both significantly associated with LoS in hospital for COVID-19 patients (p = 0.006 for both), but not for patients with pneumonia (p = 0.706 and 0.989 respectively). RNFL thickness was not associated with LoS in either group (COVID-19 p = 0.097, pneumonia p = 0.692). Retinal thickness associated with LoS in hospital and long-term mortality in COVID-19 patients, suggesting that retinal structure could be a surrogate marker for frailty and predictor of disease severity in this group of patients, but not in patients with pneumonia from other causes.

Neuropsychiatric manifestations of hospitalized patients with coronavirus disease 2019 during the second wave in Egypt

BackgroundStudies suggested that COVID-19 virus causes neurological and psychiatric manifestations with different mechanisms. However, prevalence of neurological and psychiatric manifestations among COVID-19 patients varies across studies from 18.1%: 82.3%. The objective of this study was to determine neuropsychiatric manifestations in a sample of Egyptian COVID-19 hospitalized patients during the second wave of the pandemic and to detect factors affecting neurological and psychiatric prevalence. This cross-sectional study was conducted at Ain Shams university isolation hospitals and included 110 hospitalized COVID-19 patients, over a 2-month period from June 2021 to August 2021. Patients underwent a careful history taking, full neurological examination including Mini-Mental State Examination, the Structured Clinical Interview for DSM-IV (SCID I), COVID-19 severity criteria. Any available imaging and laboratory tests were recorded.Results83 (75.5%) patients had neurological manifestations. The most common neurological manifestations were headache (50.9%), hypogeusia (24.5%), hyposmia, paresthesia (23.6% each) and coma (15.5%). After exclusion of 17 patients who could not be examined by Mini-Mental State Examination, psychiatric manifestations were seen in 56 patients (61.5%) out of the remaining 91 patients. The most prevalent psychiatric disorders were delirium (30.8%), depression (19%), and adjustment disorder (17.5%). Moreover, hypertension, COVID-19 severity, place of admission, and high levels of LDH and ALT affected neurological manifestations prevalence.ConclusionsCOVID-19 infection and its immune reaction along with its social and psychological effects have a great impact on mental and physical health. Hence, neuropsychiatric evaluation cannot be ignored in any case with COVID-19 infection.

The Resilience of Healthcare Workers in Hospital During Covid-19 Crisis

The outbreak of the COVID-19 pandemic in all corners of the world has made all activities from various sectors difficult and even experience complete paralysis. As a result of the COVID-19 pandemic, a crisis emerged in various organizations engaged in the medical and non-medical fields. With the crisis due to the COVID-19 pandemic, a transformational leadership role is needed as a form to overcome feelings of worry, fear, and anxiety that arise in healthcare workers. The purpose of this review is to examine the resilience of healthcare workers amid the outbreak of the COVID-19 pandemic. Through well-established adopted questionnaires, data were collected from healthcare workers (N=134) treating COVID-19 patients in the Islamic Hospital in Surabaya, Indonesia. This type of research uses a quantitative approach, a sampling method with census technicalities, and the Partial Least Square (PLS) analysis method. The results showed that transformational Leadership had a positive effect on health workers. Then, there was no significant influence of transformational Leadership on negative effects on health workers. At the same time, from positive effects, it was found to have a significant influence on the resilience of health workers of Islamic Hospital during the COVID-19 crisis.