Enigma of categorizing COVID-19-related lung parenchymal diseases and management experience with follow-up outcomes in Qatar: a case series.

Coronavirus disease 2019 (COVID-19) has become one of the worst global pandemics in recent history. Post-COVID-19 interstitial lung disease is a significant concern in COVID-19 survivors. It is a disabling clinical condition for patients and a burden on the healthcare system. With time and subsequent waves of COVID-19 globally, the post-COVID-19 sequelae of lung diseases can be debilitating. We report cases of three patients with persistent hypoxia post-COVID-19, raising concerns for interstitial lung disease in Qatar. In this report, we shared our experience of the patient's clinical course, complications, and outcomes with post-COVID-19 sequelae of lung parenchymal disease. Patients were followed up during and after treatment until recovery or discharge from the hospital.

Impact of multi-approach strategy on acid suppressive medication use in a teaching hospital in Qatar.

OBJECTIVE: To evaluate the impact of a multi-approach strategy to improve the appropriate usage of acid suppressive medication (ASM) in medical inpatients and compare it with the baseline data from 2007. SETTING: Five general medicine wards in a 600-bed teaching hospital in Doha, Qatar. METHOD: A prospective evaluation of the usage of ASM 1 year after a multi-approach strategy. This consisted of four main interventions: audit and feedback method (including awareness lectures to all medical and pharmacy staff), implementation of a usage guideline for medical inpatients, circulating a logarithmic chart on the proper usage of ASM for medical inpatients from admission through to discharge and participation of clinical pharmacists in the multidisciplinary rounds. All medical patients admitted from May through June 2009 were evaluated. Data about the usage of ASM were collected upon and during admission, at discharge and at the next follow-up visit. Justified indications for its usage were based on the approved product information and on evidence-based literature recommendations. Data were compared with the findings of the baseline clinical audit done 2 years earlier. MAIN OUTCOME MEASURE: The usage of ASM in justified and non-justified indications upon and during admission, at discharge and at the next follow up visit. RESULTS: A total of 414 patients were admitted during the study period, 208 patients (50%) received ASM compared to 53% in 2007 (206 patients out of 389). Seventy-four patients (36%) were using ASM upon admission compared to 48 patients (23%) in the 2007 clinical audit. Inappropriate ASM use decreased with 51% during admission (66 to 32%, P < 0.0001), 62% at discharge (34 to 13%, P < 0.0001) and 67% at the next follow up visit (15 to 5%, P = 0.0008). CONCLUSION: Despite the higher number of patients receiving ASM upon admission, the multi-approach strategy used in our institution resulted in a significant improvement in the appropriate usage of ASM in medical inpatients.

Prescribing pattern of acid suppressive medications for medical inpatients in a teaching hospital in Qatar.

OBJECTIVE: To assess the prescribing pattern of acid suppressive medications (ASMs) in medical inpatients in a teaching hospital in Qatar, and compare this with the American Food and Drug Administration approved indications, and published data. METHODS: This study is based on a review of the patient's medical records for the usage of ASMs, namely, histamine-2 receptor antagonists (H2RAs), and proton pump inhibitors (PPIs) in patients admitted consecutively to the medical wards of Hamad General Hospital, Doha, Qatar from May through June 2007. The review included the type of ASM used, timing of prescription (before, or during admission), risk factors for ulcer development, and indication for use. Records for patients using ASMs after discharge without justified indication were assessed 2 months later. RESULTS: A total of 389 patients were admitted, 206 (53%) received ASMs during their hospital stay, 48 (12%) of them were taking ASMs before admission. One hundred and eighty-four patients (89%) received PPI, and 22 (11%) received H2RA. During admission, the usage of ASMs was justified in 70 (34%) patients. One hundred and twenty-nine (63%) received ASMs after discharge, the usage of which was justified in only 59 (46%) patients. From the 70 patients receiving ASMs after discharge for unjustified indications, 30 (43%) patients were re-prescribed with ASMs, 2 months or more after discharge. CONCLUSION: Acid suppressive medications are prescribed in the majority of these patients without justified indication. Moreover, many of them continued their ASMs for at least 2 months after discharge.