Leprosy is an ancient albeit neglected chronic infectious disease mainly affecting the skin and peripheral nerves, often affecting the world's most impoverished communities. This retrospective observational study was undertaken of clinically diagnosed patients with Leprosy presenting to the outpatient clinic in two timeframes: January 2019- December 2019 (pre COVID period in our country)and January 2020- December 2020 ( COVID period).Slit Skin Smears and bacteriological (BI)/morphological indices (MI) were calculated of these Reactional states and relapse, if present, were classified, features described, and compared. Among 32 clinically diagnosed cases of Leprosy, 17 (53%)presented in preCOVID period and 15 (46%) presented in the COVID era. Among the 17 patients of Leprosy (preCOVID),1most patients (70.5%) were paucibacillary. Three patients (17.6%) had Lepra reaction. The male to female ratio 1.4:1, and most patients were rom rural areas ,aged between third and fourth decade. The majority of the cases (58.8%)had BI of 1+.In 11 (64.7%) cases MI was less than 25. In comparison, patients who reported following the COVID outbreak were mainly multibacillary type (66.6%).Seven patients (46.6%) had Lepra reactions. There was a slight female preponderance in the patients (Male: female = 1:1.14).They mainly (66.6%) belonged to urban areas and were aged between fourth to fifth decade. The majority of the patients had a BI 4+ (66.6%). Most patients had MI greater than 50 (80%), 3 patients had relapse( 20%). The restrictions imposed by the pandemic have resulted in a delayed cccess to dermatological care, thus increasing the bacillary load and severity of Leprosy. The wide-reaching repercussions of COVID on the health care system have negatively impacted elimination efforts and increased the risk of Leprosy transmission. Large-scale studies are needed to assess the impact of COVID restrictions and ways to ensure the availability of drugs and supportive care.

ESDR070 - Bacillary Load and Reactional States in Leprosy -A Surge in Severity the COVID Era ?

50th Annual Meeting of the European Society for Dermatological Research. VIRTUAL MEETING