Knowledge and Attitude of Rheumatic Fever and Rheumatic Heart Disease Among the Makkah City Population, Saudi Arabia.

Background Rheumatic heart disease (RHD) is a prominent sequela of rheumatic fever (RF) and the most common cause of acquired valvular disease worldwide. Patients develop RHD as a result of autoimmune reactions caused by an untreated group A Streptococcus (GAS) throat infection, resulting in significant valvular destruction. Objectives The current study aimed to assess the knowledge and attitude of RF and RHD among the Makkah city population in Saudi Arabia. Methods An observational cross-sectional study was conducted on a convenience sample of 1364 adult participants from Makkah city in Saudi Arabia. Data were collected through an online survey that was disseminated on different electronic platforms. Then, the obtained data were analyzed using SPSS version 23 (IBM Corp., Armonk, New York, USA). Results A total of 1364 participants completed the questionnaire; female participants constituted 58.1% (n = 792) and those between 18 and 30 years old represented 57.6% of the sample (n = 785). Knowledge of rheumatic fever was classified as poor (31.9%, n = 435), fair (44.8%, n = 611), and good (23.3%, n = 318). Female participants were shown to have better knowledge than males (p = 0.034). The attitude toward rheumatic fever and rheumatic heart disease was classified as negative (27.9%, n = 380), neutral (49.1%, n = 670), and positive (23%, n = 314). Conclusions This study concludes that adults in Makkah city, Saudi Arabia, have poor knowledge about RF and RHD. There is a notable gap in their knowledge regarding the association between sore throat and RF, bacterial dermatitis and RF, the common age for RF, and the necessity of using antibiotics appropriately to prevent this disease. The study also revealed negative attitudes toward RF and RHD among Makkah citizens, but most of them recommended health education campaigns to increase public awareness about this important disease. The results of this study will assist in the development of awareness campaigns about RF and RHD. Finally, qualitative studies are recommended to fully understand what the population perceives about this morbidity.

Guillain-Barré Syndrome in an Elderly Patient as a Complication of COVID-19 Infection.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an infection that mainly affects the respiratory system. It may present with fever, fatigue, dry cough, and dyspnea. In addition, numerous studies and case reports discussed those viruses showing their effects on the nervous system. In this report, we present a case of a 66-year-old Saudi man who had been recovering from symptoms related to coronavirus 2019 (COVID-19) associated disease. He was presented with sudden progressive ascending weakness that started in the left leg, and it spread to involve both legs and then both arms, five days prior to hospitalization. Lumbar puncture and nerve conduction studies showed that the patient has an acute motor-sensory axonal neuropathy (AMSAN) variant of Guillain-Barré syndrome (GBS). The patient was treated with intravenous immunoglobulin (IVIG) and supportive care. The patient was discharged after 15 days of hospitalization with clinical improvement. In conclusion, to our knowledge, this study investigated the first reported case of GBS in an elderly patient as a complication of COVID-19 infection in Saudi Arabia, with the most severe variant AMSAN. As the COVID-19 pandemic continues, clinicians should consider GBS as a neurological complication of COVID-19, and therapy must be initiated. Further studies are needed to study the possible mechanism of GBS in patients with COVID-19 in the future.