Effect of Pfizer/BioNTech and Oxford/AstraZeneca vaccines against COVID-19 morbidity and mortality in real-world settings at countrywide vaccination campaign in Saudi Arabia.

OBJECTIVE: Vaccinations are highly essential to control infectious diseases and epidemics. Presently, the entire world faces a challenging crisis of "Severe Acute Respiratory Diseases Coronavirus 2 (SARS-CoV-2), also known as the COVID-19 pandemic". The impact of vaccines at national levels to reduce the SARS-CoV-2 cases and deaths are unclear, and people have concerns about the effectiveness of vaccines in real-world settings. This study's objective was to examine the effect of the "Pfizer/BioNTech and Oxford/AstraZeneca" vaccines to prevent SARS-CoV-2 cases and deaths in Saudi Arabia. MATERIALS AND METHODS: In this retrospective cohort study, we collected data on SARS-CoV-2 cases and deaths from the date of the first case of SARS-CoV-2 in Saudi Arabia March 2, 2020, to the date of launching the vaccination campaign on December 14, 2020; and from December 15, 2020, to September 8, 2021. We recorded the World Health Organization data and Ministry of Health of Saudi Arabia to evaluate the impact of the "Pfizer/BioNTech, (BNT162b2 mRNA) and Oxford/AstraZeneca (AZD1222)" vaccine against SARS-CoV-2 cases and deaths before and after the vaccination campaign in Saudi Arabia. RESULTS: Saudi Arabia launched the "Pfizer/BioNTech and Oxford/AstraZeneca" vaccination campaign against SARS-CoV-2 on December 14, 2020. In Saudi Arabia, before the vaccination campaign from March 2, 2020, to December 14, 2020, the mean daily SARS-CoV-2 cases were 1235.60, daily deaths were 22.70, that significantly reduced (p=0.0001) compared to the period after the vaccination campaign from December 15, 2020, to September 8, 2021, in which the daily cases fell to 692.08, and daily deaths fell to 9.48 (p=0.0001). CONCLUSIONS: In Saudi Arabia, Pfizer/BioNTech and Oxford/AstraZeneca vaccinations significantly reduced the number of SARS-CoV-2 cases and deaths after the vaccination compared to the period before the vaccination campaign at country levels. The study findings demonstrate that vaccination and adherence to nonpharmaceutical intervention can better control the COVID-19 pandemic.

Effect of heat and humidity on the incidence and mortality due to COVID-19 pandemic in European countries.

OBJECTIVE: The weather allied conditions have an impact on air, water, soil, food, ecosystem, feelings, behaviors, and pattern of health and disease. The present study aims to investigate the impact of heat and humidity on the daily basis incidence and mortality due to COVID-19 pandemic in European countries. MATERIALS AND METHODS: We selected 10 European countries, Russia, United Kingdom, Spain, Italy, Germany, Turkey, France, Belgium, Netherlands and Belarus. This region has a relatively low temperature and high humidity, and has homogenous European ethnicity with almost similar socioeconomic culture and health care system. The data on COVID-19 pandemic including daily new cases and new deaths were recorded from World Health Organization (WHO). The information on daily temperature and humidity was obtained from world climate web "Time and Date". The daily cases, deaths, temperature and humidity were recorded from the date of appearance of first case of "Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)" in the European region, from Jan 27, 2020 to July 17, 2020. RESULTS: In 10 European countries, (Russia, United Kingdom, Spain, Italy, Germany, Turkey, France, Belgium, Netherlands and Belarus), the daily basis mean temperature from Jan 27, 2020 to July 17, 2020 was 17.07±0.18°C, and humidity was 54.78±0.47%. The overall results revealed a significant inverse correlation between humidity and the number of cases (r= -0.134, p<0.001) and deaths (r= -0.126, p<0.001). Moreover, an increase in temperature was linked with an increase in the number of cases (r=0.062, p=0.013) and deaths (r=0.118, p<0.001). The regression analysis results further revealed that with an increase of 1% humidity the number of cases (ß = -15.90, p<0.001) and deaths (ß=-1.56, p<0.001) reduced significantly. Whereas, with an increase of 1°C in temperature the number of cases (ß = 20.65, p<0.001) and deaths (ß = 3.71, p<0.001) increased significantly. CONCLUSIONS: Increase in relative humidity was associated with a decrease in the number of daily cases and deaths, however, a rise in temperature was allied with an upsurge in the number of daily cases and daily deaths due to COVID-19 pandemic in European countries. The study findings on weather events and COVID-19 pandemic have an impact at European regional levels to project the incidence and mortality trends with regional weather events to enhance public health readiness and assist in planning to fight against this pandemic situation.

Climate and COVID-19 pandemic: effect of heat and humidity on the incidence and mortality in world's top ten hottest and top ten coldest countries.

OBJECTIVE: The COVID-19 pandemic has caused a global public health crisis with social, psychological and long-lasting economical damages. Weather-related dynamics have an impact on the pattern of human health and disease. The present study aimed to investigate the impact of heat and humidity on daily basis incidence and mortality due to COVID-19 pandemic in ten of the world's hottest countries compared to ten of the coldest ones. MATERIALS AND METHODS: Worldwide, we selected 20 countries; 10 hottest countries with the highest temperatures and 10 coldest countries with the lowest temperature. The selection of the countries was based on the daily basis mean temperature from the date of appearance of the initial cases of COVID-19, Dec 29, 2019 to May 12, 2020. In the world's 10 hottest countries, the mean temperature was (26.31±1.51) and humidity (44.67±4.97). However, in the world's 10 coldest countries the mean temperature was (6.19±1.61) and humidity (57.26±2.35). The data on the global outbreak of COVID-19, daily new cases and deaths were recorded from World Health Organization, and daily information on temperature and humidity was obtained from metrological web "Time and Date". RESULTS: In countries with high temperatures and low humidity, the mean daily cases incidence were (407.12±24.33); cumulative cases (9094.34±708.29); and cumulative deaths (452.84±43.30) were significantly low compared to countries with low temperatures and high humidity: daily cases (1876.72±207.37); cumulative cases (44232.38±5875.11); and cumulative deaths (2008.29±310.13). Moreover, COVID-19 cases and deaths per million population were significantly low in countries with high temperatures (cases 711.23, and deaths 16.27) compared to countries with low temperatures (cases 1685.99; and deaths 86.40). Furthermore, in hottest countries, a 1% increase in humidity reduced number of cases and deaths by (ß = -5.40, p<0.001) and (ß = -0.187, p=0.004) respectively. A similar trend was seen with a 1°C increase in temperature, reducing the number of deaths by (ß = -1.35. p<0.001). CONCLUSIONS: The results revealed a significant decrease in incidence of daily cases and deaths in countries with high temperatures and low humidity (warmest countries), compared to those countries with low temperatures and high humidity (coldest countries). The findings could be of interest to the policymakers and the health officials on the epidemiological trends of COVID-19 pandemic and weather changes.

Effect of temperature and humidity on the dynamics of daily new cases and deaths due to COVID-19 outbreak in Gulf countries in Middle East Region.

OBJECTIVE: Weather-related dynamics have an impact on the pattern of health and disease. The present study aimed to investigate the effect of temperature and humidity on the daily new cases and daily new deaths due to COVID-19 in Gulf Cooperation Council (GCC) countries in the Middle East. MATERIALS AND METHODS: We selected all the six GCC countries, including Saudi Arabia, United Arab Emirates, Bahrain, Kuwait, Qatar and Oman. This region has a relatively high temperature and humidity, and has homogenous Arab ethnicity with a similar socioeconomic culture. The data on the global outbreak of COVID-19, including daily new cases and deaths were recorded from World Health Organization. The information on daily temperature and humidity was obtained from world climate web "Time and Date". The daily basis, mean temperature and humidity were recorded from the date of appearance of first case of COVID-19 in the region, Jan 29, 2020 to May 15, 2020. We also evaluated the growth factor, "a ratio by which a quantity multiplies itself over time; it equals daily cases divided by cases on the previous day". RESULTS: In GCC countries, the daily basis mean temperature from Jan 29, 2020 to May 15, 2020 was 29.20±0.30°C and humidity was 37.95±4.40%. The results revealed that there was a negative correlation and decrease in the number of daily cases and deaths from COVID-19 with increase in humidity in Oman, Kuwait, Qatar, Bahrain, United Arab Emirates and Saudi Arabia. The correlation coefficient between temperature with daily cases shows that an increase in temperature was associated with an increase in daily cases and deaths due to COVID-19, however, the temperature is still gradually rising in the region. The growth factor result for daily cases was 1.09±0.00 and daily deaths was 1.07±0.03 for COVID-19, and shows declining trends in GCC region. CONCLUSIONS: An increase in relative humidity was associated with a decrease in the number of daily cases and deaths due to COVID-19 in GCC countries. The daily growth factor for patients and deaths shows a declining trend. However, the climate is swiftly changing in the region; further studies may be conducted during the peak of summer season. The findings have outcomes for policymakers and health officials about the impact of temperature and humidity on epidemiological trends of daily new cases and deaths due to COVID-19.

Novel coronavirus 2019-nCoV: prevalence, biological and clinical characteristics comparison with SARS-CoV and MERS-CoV.

OBJECTIVE: Human infections with zoonotic coronavirus contain emerging and reemerging pathogenic characteristics which have raised great public health concern. This study aimed at investigating the global prevalence, biological and clinical characteristics of novel coronavirus, Wuhan China (2019-nCoV), Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV), and Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection outbreaks. MATERIALS AND METHODS: The data on the global outbreak of "2019-nCoV, SARS-CoV, and MERS-CoV" were obtained from World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), concerned ministries and research institutes. We also recorded the information from research documents published in global scientific journals indexed in ISI Web of Science and research centers on the prevalence, biological and clinical characteristics of 2019-nCoV, SARS-CoV, and MERS-CoV. RESULTS: Worldwide, SARS-CoV involved 32 countries, with 8422 confirmed cases and 916 (10.87%) casualties from November 2002 to August 2003. MERS-CoV spread over 27 states, causing 2496 cases and 868 (34.77%) fatalities during the period April 2012 to December 2019. However, the novel coronavirus 2019-nCoV spread swiftly the global borders of 27 countries. It infected 34799 people and resulted in 724 (2.08%) casualties during the period December 29, 2019 to February 7, 2020. The fatality rate of coronavirus MERS-CoV was (34.77%) higher than SARS-CoV (10.87%) and 2019-nCoV (2.08%); however, the 2019-nCoV transmitted rapidly in comparison to SARS-CoV and MERS-CoV. CONCLUSIONS: The novel coronavirus 2019-nCoV has diverse epidemiological and biological characteristics, making it more contagious than SARS-CoV and MERS-CoV. It has affected more people in a short time period compared to SARS-CoV and MERS-CoV, although the fatality rate of MERS-CoV was higher than SARS-CoV and 2019-nCoV. The major clinical manifestations in coronavirus infections 2019-nCoV, MERS-CoV, and SARS CoV are fever, chills, cough, shortness of breath, generalized myalgia, malaise, drowsy, diarrhea, confusion, dyspnea, and pneumonia. Global health authorities should take immediate measures to prevent the outbreaks of such emerging and reemerging pathogens across the globe to minimize the disease burden locally and globally.

Prevalence of type 2 diabetes in the Arab world: impact of GDP and energy consumption.

OBJECTIVE: Diabetes Mellitus (DM) is a rapidly growing and most challenging health issue of the 21st century. This study aimed to investigate the prevalence of type-2 DM and its association with Gross Domestic Product (GDP) and energy consumption in the Arab world countries. MATERIALS AND METHODS: We identified 88 articles through systematic searches including Institute of Scientific Information (ISI) Web of Science, PubMed and EMBASE databases published between 1980-2015. The related literature was searched by using the keywords including diabetes mellitus, prevalence, incidence, epidemiology of type-2 diabetes mellitus (T2DM), and names of the individual Arab world countries. The articles were selected and investigated for the prevalence of T2DM. No limitations were imposed in the design of the study or publication language. Finally, 50 peer-reviewed publications were included and the rest were excluded. RESULTS: Arab world countries with the highest prevalence of T2DM are: Kingdom of Saudi Arabia 31.6%, Oman 29%, Kuwait 25.4%, Bahrain 25.0% and United Arab Emirates 25.0%. The lowest prevalence was found in Mauritania (4.7%) and Somalia (3.9%). The highest prevalence was observed in Gulf Cooperation Council (GCC) countries (25.45%) whilst non-GCC countries had the lowest prevalence (12.69%). The combined mean prevalence of T2DM in both GCC and Non-GCC Arab countries was 16.17%. The prevalence of T2DM was found to be significantly associated with higher Gross Domestic Product (GDP) (p=0.020) and energy consumption (p=0.017). CONCLUSIONS: In the Arab world, the countries with the highest prevalence of type 2 diabetes mellitus are: Saudi Arabia, Oman, Kuwait, Bahrain and UAE, whilst the countries with the lowest prevalence are Mauritania and Somalia. This prevalence was significantly associated with high GDP per capita and energy consumption. Arab states must incorporate diabetes preventive policies on a war-footing basis to minimize the burden of the disease.

Diabetes during Ramadan - PRE-approach model: presentation, risk stratification, education.

OBJECTIVE: Fasting (Sawm) during Ramadan is one of the five pillars of Islam and mandatory for all Muslim healthy adults. Most of the Muslim diabetic patients insist on fasting in Ramadan despite their exemption. Due to paucity of literature, diabetes during Ramadan is underestimated and the statistics are not reflecting the actual reality. The aim of this study is to highlight the demographics in diabetic Muslim population and emphasize its ramifications on Ramadan fasting. METHODS: In this study, we developed a 3 step PRE-approach model based on Presentation, Risk stratification, Education in diabetics who fast during Ramadan. For the establishment of this model we identified 40 published studies in database searches including ISI-web of science and pub-med. We searched the related literature by using the key words including diabetes mellitus, Ramadan fasting. All studies in which diabetes and fasting in Ramadan was investigated were included. There was no limitation on publication status, design or language. Finally, we included 35 publications and remaining 5 were excluded from the study. RESULTS: The diabetic patients who fast are at risk of severe hypoglycemia, hyperglycemia, diabetic ketoacidosis, dehydration, thrombosis, strokes and retinal artery occlusion. Lack of education, poor healthcare and no structured guidance cause adeverse health consequences. CONCLUSIONS: It is vital to empower the healthcare workers and the patients in the frontlines with appropriate information. To preempt and minimize the problems faced by the diabetic patients who fast, available resources should be mobilized to efficiently and effectively reach out these patients. Diabetic patient educational guidelines about Ramadan fasting should be disseminated and translated into major regional languages to minimize the complications. Diabetic patients who are stable, free of deteriorating complications and able to manage can be allowed to fast.

Impact of R&D expenditures on research publications, patents and high-tech exports among European countries.

OBJECTIVES: This study aimed to compare the impact of Research&Development (R&D) expenditures on research publications, patents and high-tech exports among European countries. MATERIALS AND METHODS: In this study, 47 European countries were included. The information regarding European countries, their per capita Gross Domestic Product (GDP), R&D spending, number of universities, indexed scientific journals, high technology exports and number of patents were collected. We recorded the total number of research documents in various science and social sciences subjects during the period 1996-2011. The main source for information was World Bank, Web of Science, Thomson Reuters and SCImago/Scopus. RESULTS: The mean GDP per capita for all the European countries is 23372.64 ± 3588.42 US$, yearly per capita spending on R&D 1.14 ± 0.13 US$, number of universities 48.17 ± 10.26, mean number of Institute of Scientific Information (ISI) indexed journal per country 90.72 ± 38.47, high technology exports 12.86 ± 1.59 and number of patent applications 61504.23 ± 22961.85. The mean of research documents published in various science and social science subjects among all the European countries during the period 1996-2011 is 213405.70 ± 56493.04. Spending on R&D, number of universities, indexed journals, high technology exports and number of patents have a positive correlation with number of published documents in various science and social science subjects. We found a positive correlation between patent application and high-tech exports. However, there was no association between GDP per capita and research outcomes. CONCLUSIONS: It is concluded that, the most important contributing factors towards a knowledge based economy are spending on R&D, number of universities, scientific indexed journals and research publications, which in turn give a boast to patents, high technology exports and ultimately GDP.

Impact of GDP, spending on R&D, number of universities and scientific journals on research publications in pharmacological sciences in Middle East.

OBJECTIVES: Research in pharmacological science is vital to support the health needs of human beings. Measuring the research output provides information that forms the basis of strategic decisions. This study aimed to investigate the impact of Gross Domestic Product (GDP), spending on Research and Development (R&D), number of universities and scientific journals on research documents (papers), citable documents, citations per document and H-index in pharmacological science among Middle East countries. MATERIALS AND METHODS: All the 16 Middle East countries were included in the study. The information regarding GDP, spending on R&D, total number of universities and indexed scientific journals were collected. We recorded the total number of research documents, citable documents, citations per document and H-index in pharmacological science during the period 1996-2011. The main sources for information were World Bank, Web of Science, Journal Citation Reports (Thomson Reuters) and SCI-mago/Scopus. RESULTS: The mean per capita GDP of all the Middle East countries is 18125.49±5386.28 US$, spending on R&D 0.63±0.28% of GDP in US$, number of universities 36.56±11.33 and mean ISI indexed journal are 8.25±3.93. The number of research documents published in pharmacological science among the Middle East countries during the period 1996-2011 is 1344.44±499.34; citable documents 1286.37±476.34; citations per document 7.62± 0.84; and H-index is 30.68±6.32. There was a positive correlation between spending on R&D and citations per documents (r = 0.56, p = 0.02), H-Index (r = 0.56, p = 0.02); number of universities and research documents (r = 0.72, p = 0.002), citable documents (r = 0.72, p = 0.001); ISI indexed journals and research documents (r = 0.88, p = 0.0001), citable documents (r = 0.88, p = 0.0001), H-Index (r = 0.67, p = 0.004). However, there was no correlation between the GDP per capita and research outcome in pharmacological science. CONCLUSIONS: There is a positive association between spending on R&D, number of universities and indexed scientific journals on research outcome in pharmacological science in Middle East.

Research productivity of Pakistan in medical sciences during the period 1996-2012.

OBJECTIVES: This study aimed to investigate the degree of research outcome in medical science subjects in Pakistan during the period 1996-2012. MATERIALS AND METHODS: In this study, the research papers published in various global science journals during the period 1996-2012 were accessed. We recorded the total number of research documents having an affiliation with a Pakistan. The main source for information was Institute of Scientific Information (ISI) Web of Science, Thomson Reuters and SCI-mago/Scopus. RESULTS: In global science, Pakistan contributed 58133 research papers in all science and social sciences both in ISI and non ISI indexed journals. However, in medical sciences the total number of research papers from Pakistan are 25604, citable documents 23874, citations 128061, mean citations per documents 6.45 and mean Hirsch index is 35.33. In Pakistan, the upward trend of articles published in global medical science was from the period 1996-2008. However, from 2008 the trend is markedly declined. CONCLUSIONS: Pakistan significantly improved its international ranking positions in research during the period 2000-2008. However, the upward trend of research papers published in global medical science could not be retained and from the year 2008 the trend started declining. This trend of research papers further declined in year 2012 compared to year 2011. It is suggested that, Pakistan must take strategic steps to enhance the research culture and increase the research and development expenditure in the country.

Research progress and prospects of Saudi Arabia in global medical sciences.

OBJECTIVES: Since last decade, Saudi Arabia has been swiftly moving ahead to promote an education and research in the country. This study aimed to investigate the research outcome of Saudi Arabia in medical sciences during the period 1996-2012. MATERIAL AND METHODS: In this study, the research papers published in various global science journals during the period 1996-2012 were accessed. We recorded the total number of research documents having an affiliation with Saudi Arabia. The main source for information was Institute of Scientific Information (ISI) Web of Science, Thomson Reuters and SCI-mago/Scopus. RESULTS: In global science data base, Saudi Arabia contributed 103804 documents in all science and social sciences. In medicine the total number of research papers from Saudi Arabia are 16196, citable documents 14732, total citations 102827, citations per documents 6.36 and Hirsch index (h-index) is 92. However, in combined medical and allied health sciences the total number of research papers are 27246, citable documents 25416, total citations 181999, mean citations per documents 7.07 and mean h-index is 41.44. Furthermore, Saudi Arabia contributed 40797 research documents in ISI indexed journals only and also 151 research documents in highly reputable and towering science journals. CONCLUSIONS: Saudi Arabia's research performance in global medical sciences has markedly increased during the period 2006-2012. The research publications are continuously on mounting path; however, the number of citations has decreased. The country improved its regional as well as international research rankings and graded 45 in the world in year 2012.