Healthcare policies, precautionary measures and outcomes of mass gathering events in the era of COVID-19 pandemic: Expedited review.

With the onset of the COVID-19 pandemic in early 2020, several countries suspended or restricted mass gathering (MG) events to mitigate the risk of superspreading events. Prohibiting MGs aimed to lessen the likelihood of highly infectious persons coming into close contact with many others. Now that the world has opened its doors wide and removed most of precautionary measures, many questions arise. In this review, we aimed to summarize the current evidence regarding the policies and regulations that were implemented for the safe return of MG events. Besides, we highlighted the impact of the return of MG events during 2021 on the trajectory of COVID-19 spread. Canceling MG events can carry religious, societal, economic, and public negative consequences necessitating the safe return of these events. The experience with the COVID-19 pandemic was the foundation for the recommendations for the safe conduction of MG events during the pandemic by international public health bodies. When policymakers adequately applied precautionary measures and strategic approaches, we witnessed the safe holding of huge MG events without aggravating the COVID-19 situation or increasing the number of new cases beyond the capacity and readiness of the national healthcare system.

Application of Automated External Defibrillators Among the Public: A Cross-Sectional Study of Knowledge, Attitude, Practice, and Barriers of Use in Saudi Arabia.

Background: The likelihood of survival of an out-of-hospital cardiac arrest quadruples with the rapid application of basic life support (BLS). The public's ability to perform cardiopulmonary resuscitation (CPR) and use automated external defibrillators (AEDs) is extremely important. This study aimed to assess the public knowledge, attitudes, and practices (KAP) of utilizing AEDs and to understand barriers to AED application. Methods: We conducted a cross-sectional study from March 1-30, 2022. An electronic questionnaire was constructed and validated to measure the KAP for public AED utilization and its barriers. Results: Of the 406 participants, 244 (60.10%) were males. Male respondents had 17% less knowledge and poorer attitude towards using an AED as compared to female respondents. Knowledge and attitudes on using AEDs were low (70.7%) among Saudi nationals compared to those of foreign nationals. Those who were BLS/CPR trained had a 2.5 times greater understanding and willingness to use AEDs in public than those who were not. Barriers to AEDs in CPR/BLS-trained participants were: (1) accidentally hurting the victim (14.3%), (2) duty as a bystander to just call the ambulance and wait for help (12.1%), (3) never taught what to do (n = 41, 18.4%), (4) did not want to be scolded if performed wrong (3.1%), and (5) never witnessed such a situation (51.6%). Conclusion: There is a strong association between knowledge of and willingness to use AEDs in emergency situations among the public. Misconceptions about AEDs hinder their use. This calls for urgent training programs through accessible technology to reach the public.

Hajj 2021: Role of mitigation measures for health security.

PURPOSE: After the impressive results of the 2020 Hajj management, Saudi authorities decided to expand the quota to 60,000 pilgrims in 2021, which resulted in a convenient and successful experience. PATIENTS AND METHODS: This was a retrospective pre and post-study study conducted on all pilgrims attending the 2021 Hajj using the polymerase chain reaction (PCR) test surveillance with paired-swab samples (pre-Hajj and post-Hajj) to evaluate the risk potential of COVID-19 among Hajj pilgrims, the effectiveness of preventive measures and the potential effect of the Hajj ritual as a huge mass gathering on the epidemiological situation of the Saudi Arabian population. RESULT: Forty-one cases had positive COVID-19 infections out of a total of 58,428 pilgrims who attended the 2021 Hajj season, as detected by nonmandatory pre- and post-Hajj PCR. Notably, the 2021 Hajj season achieved a decreasing leg of the COVID-19 pandemic curve. The adjusted incidence rate in KSA from July 11th to August 7th ranged from 19 to 24 cases per 100,000 population. In contrast, the incidence rate for the same duration in Hajj ranged from 3 to 7 cases per 100,000 pilgrims. CONCLUSION: The Saudi mitigation plan ensured the safety of pilgrims and healthcare workers for Hajj, successfully limited the risk of COVID-19 transmission inside and contributed to global health security. The success story of Hajj in 2020 and 2021 during the pandemic represents a successful model for planning, achieving and managing future mass gatherings by integrating technology with global and national health policies and public health measures.

Independent Association of 25[OH]D Level on Reduced Glutathione and TNF-α in Patients with Diabetes and/or Hypertension.

Purpose: Oxidative and inflammatory pathways play a significant role in the pathophysiology of a wide variety of non-communicable diseases such as type 2 diabetes mellitus (T2DM) and hypertension. However, the effect of serum 25-hydroxyvitamin D (25[OH]D) on these pathways is still controversial. To evaluate the association of 25[OH]D on antioxidant and pro-inflammatory biomarkers, reduced glutathione (GSH) and tumor necrosis factor (TNF)-α, in T2DM and hypertensive patients. Patients and Methods: This is a cross-sectional study of a consecutive sample of patients attending the the Family Medicine clinic at King Abdullah bin Abdulaziz University Hospital (KAAUH). Participants were screened for eligibility according to the following criteria: aged above 18 years and diagnosed with T2DM and/or hypertension for at least one year. Patients receiving any kind of vitamin D or calcium supplements within the last three months were excluded, as were those with a history of renal failure, cancer, liver, thyroid, or any other chronic inflammatory diseases. Results: In total 424 T2DM and/or hypertensive patients (mean age 55±12 years) were recruited. In addition to routine physical and laboratory examinations, levels of serum 25[OH]D, GSH and TNF-α were measured. The prevalence of 25[OH]D deficiency (<50 nmol/L) was 35.1%, which was independent from GSH and TNF-α levels. In T2DM, hypertensive and patients having both diseases, GSH levels were 349.3±19, 355.4±19 and 428.8±20 µmol/L, respectively. Uncontrolled T2DM and hypertension patients showed significantly higher GSH compared with the controlled group. Males showed slightly higher level of TNF-α compared with females and uncontrolled hypertensive patients had relatively higher TNF-α level when evaluated against controlled hypertensive patients. . Conclusion: 25[OH]D level is independent of oxidative stress and inflammation, assessed by levels of GSH and TNF-α, respectively, in T2DM and hypertensive Saudi patients. .

SARS-CoV-2 Positivity in Early Infancy: A National Cohort From Saudi Arabia.

Background: Data on SARS-CoV-2 in infants ≤ 90 days are limited with conflicting reports regarding its presentation and outcomes. Methods: We conducted an ambispective cohort study using prospectively collected Health Electronic Surveillance Network Database by the Ministry of Health, Saudi Arabia. Infants of ≤ 90 days of age who had a positive RT-PCR test for SARS-CoV-2 virus were included. Patients were divided in Early neonatal (0-6 days), late neonatal (7-27 days), and post- neonatal (28-90 days) groups and were compared for clinical characteristics and outcomes by contacting parents and collecting information retrospectively. Results: Of 1,793 infants, 898 infants were included for analysis. Most infants in the early neonatal group had no features of infection (tested based on maternal positivity), whereas most infants in the late and post- neonatal groups were tested because of clinical features of infection. Fever and respiratory signs were the most common presenting feature in the late and post-neonatal groups. Hospitalization was higher in the early neonatal group (80%), compared to the two other groups. The overall mortality in the cohort was 1.6%. Conclusion: SARS-CoV-2 infection in infants ≤ 90 days might not be as rare as previously reported. The clinical presentation varies based on age at positive RT-PCR result.

The Role of Digital Technology in Responding to COVID-19 Pandemic: Saudi Arabia's Experience.

INTRODUCTION: The novel coronavirus (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a single-chain ribonucleic acid (RNA) virus. As of March 25, 2021, the total number of positive cases and fatalities in the Kingdom of Saudi Arabia (KSA) had reached 386,300 and 6624, respectively, with a case fatality rate of 1.71%. The KSA was among the leading nations to heed the advice of WHO officials and put strict precautionary and preventive measures in place to curb the early spread of COVID-19 before it was declared a global pandemic. METHODOLOGY: This was an uncontrolled before-after study following a mixed-method approach for data collection. National and regional data were extracted from the Health Electronic Surveillance Network (HESN), a centralized public health collection system for quantitative and statistical data. Quantitative and qualitative methods have been utilized in studying data derived from tech media. RESULTS: The Saudi authorities utilized different technological tools to aid in managing and combating the COVID-19 pandemic. In the case of Al Madinah Al Mounawarah, after the implementation of several technologies, the most important being Tawakkalna, the number of active daily cases decreased by 61%. CONCLUSION: The use of the Tawakkalna application was proven to be a successful method in fighting the COVID-19 pandemic in the KSA. This vital and essential experience warrants the use of different digital technology that offers a personalized profile displaying the person's status (affected, vaccinated, or no history of infection). This application played and will continue to play a crucial and effective role in pandemic containment in Saudi Arabia.