Students' perception of asynchronous versus synchronous distance learning during COVID-19 pandemic in a medical college, southwestern region of Saudi Arabia.

BACKGROUND: COVID-19 preventive measures required a drastic shift to online teaching-learning in most of countries. Institutions used different combinations of live online lectures (synchronous) requiring students to attend the class in real-time, as well as recorded lectures uploaded by the instructors to be accessed by students as per their own convenience (asynchronous). We undertook this study to assess and compare the perceptions of students regarding their learning experiences in the synchronous versus asynchronous mode of instruction using  their teaching-learning during the compulsory online mode of instruction at the peak of the COVID-19 pandemic. METHODOLOGY: This cross-sectional questionnaire-based study received responses from 122 final-year medical students studying at the College of Medicine, King Khalid University, Abha, Saudi Arabia. An online 5-point Likert scale-based questionnaire was used to collect data regarding experience and perception towards synchronous and asynchronous learning. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0. A P-value less than 0.05 was considered significant. RESULT: All the students found both synchronous and asynchronous learning to be equally satisfying, enjoyable and comfortable. No statistically significant difference was found when both the methods were analyzed for enhancement of knowledge. The students opined that asynchronous learning helped them manage their time better whereas synchronous learning encouraged more interaction during the live lectures. CONCLUSION: Overall, the students' perceptions regarding both synchronous and asynchronous online learning were positive. As both methods have their advantages/limitations, a mix of both synchronous and asynchronous methods may be adopted depending upon the content of the topic and the desired learning outcomes.

Antimicrobial, Antidiabetic, Antioxidant, and Anticoagulant Activities of Cupressus sempervirens In Vitro and In Silico.

In the last decade, the urgent need to explore medicinal plants or drug development has increased enormously around the world to overcome numerous health problems. In the present investigation, HPLC indicated the existence of 18 phenolic and flavonoid compounds in the Cupressus sempervirens extract. Hesperetin represents the greatest concentration (25,579.57 µg/mL), while other compounds, such as pyro catechol, rutin, gallic acid, chlorogenic acid, naringenin, and quercetin, were recognized in concentrations of 2922.53 µg/mL, 1313.26 µg/mL, 1107.26 µg/mL, 389.09 µg/mL, 156.53 µg/mL, and 97.56 µg/mL, respectively. The well diffusion method documented the antibacterial/antifungal activity of C. sempervirens extract against E. faecalis, E. coli, C. albicans, S. typhi, S.aureus, and M. circinelloid with 35, 33, 32, 25, 23, and 21 mm inhibition zones, respectively, more than the standard antibiotic/antifungal agent. Low values ranging from 7.80 to 15.62 µg/mL of MIC and MBC were recorded for E. faecalis, E. coli, and C. albicans. From the 1- diphenyl-2-picryl hydrazyl (DPPH) assay, promising antioxidant activity was recorded for C. sempervirens extract with IC50 of an 8.97 µg/mL. Moreover, ferric reducing antioxidant power (FRAP) and total antioxidant capacity assays (TAC) confirmed the antioxidant activity of the extract, which was expressed as the ascorbic acid equivalent (AAE) of 366.9 ± 0.2 µg/mg and 102 ± 0.2 µg/mg of extracts, respectively. α-amylase and α-glucosidase inhibition % were determined to express the antidiabetic activity of the extract in vitro, with promising IC50 value (27.01 µg/mL) for α-amylase compared to that of acarbose (50.93 µg/mL), while IC50 value of the extract for α-glucosidase was 19.21µg/mL compared to that of acarbose 4.13 µg/mL. Prothrombin time (PT) and activated partial thromboplastin time (APTT) revealed the role of C. sempervirens extract as an anticoagulant agent if compared with the activity of heparin. Binding interactions of hesperetin and gallic acid were examined via the Molecular Operating Environment (MOE) Dock software against E. faecalis (PDB ID: 3CLQ), C. albicans (PDB ID: 7RJC), α-amylase (PDB ID: 4W93), and α-glucosidase (PDB ID: 3TOP). The obtained results shed light on how molecular modeling methods might inhibit the tested compounds, which have the potential to be useful in the treatment of target proteins.

Postintubation Tracheal Perforation While on Long-Term Steroid Therapy: A Case Report.

BACKGROUND: Endotracheal intubation is an essential basic skill for emergency physicians. The procedure can cause complications that should be recognized. Awareness and early identification of complications are needed to allow early intervention to optimize outcomes. The risk factors for tracheal perforation during intubation are typically related to the physician skill and experience and to the patient's comorbidities, including body habitus and chronic use of certain medications. CASE REPORT: We report a case of a 45-year-old man with renal transplant on tacrolimus and prednisolone for 16 years. He presented with decreased level of consciousness due to an acute intracranial hemorrhage and was intubated for airway protection. Post intubation, a significant subcutaneous emphysema was noted on the patient's neck and chest, which was subsequently determined to be caused by a tracheal perforation. The management of tracheal injury depends on the size and location of the tear, as well as the patient's clinical status and comorbidities. In this case, the tracheal perforation was treated conservatively and was successful. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case has been reported to increase awareness about this rare and potentially life-threatening event. The prevention of this rare injury can be difficult but use of a slightly smaller endotracheal tube in a high-risk patient can be of benefit. In addition, early consideration of this complication when there is an acute change in physiologic status will allow for rapid facilitated management.

A Case of Self-Induced Hydrostatic Colonic Perforation.

INTRODUCTION: Constipation is a common complaint. The elderly are five times more prone to constipation than young people because of the effects of medication, immobility, and a blunted urge to defecate. Many of these patients are demented, have cognitive deficits, or suffer from a psychiatric disorder. Colonic perforation caused by hydrostatic pressure is rare, and this typically occurs during fluoroscopic studies resulting when there is excessive intraluminal colonic pressure. Self-induced colonic perforation is even rarer. CASE REPORT: We report the case of a 95-year-old man who presented to the emergency department with an acute surgical abdomen and symptoms of sepsis. He had a history of longstanding constipation. He gave a history of frequent insertion of a rubber hose into his anal canal to relieve his constipation while rinsing his anus after defecation. After resuscitation, an emergency operation was performed, and sigmoid colon perforation was found in addition to pre-existing diverticular disease. Hartmann's procedure was performed after abdominal washout. Unfortunately, the patient died of multi-organ failure two days after surgery. CONCLUSION: Self-induced hydrostatic colonic perforation is rare. The consequence is fatal, especially in the elderly or in cases of delayed presentation.

Imaging Approach to the Diagnosis of Acute Appendicitis in a Group of Teaching Hospitals With 24/7 In-house Availability of Ultrasound Technologist: Effect of Timing of Request on Imaging Modality.

PURPOSE: The study sought determine effect of requisition timing on the initial-choice imaging modality in appendicitis evaluation. METHODS: This was an institutional review board-approved retrospective study, encompassing 3 University of Toronto teaching hospitals, offering 24/7 radiology coverage. All surgically proven appendicitis cases, from 2012-2014, were included and presurgical ultrasound (US) or computed tomography (CT) reports were analysed. Examinations were all requested by the emergency department, performed by the same technologists and reviewed or finalized by the same radiology group (residents fellows or attending). Two coverage categories, namely regular hours (8 am-5 pm, Monday-Friday) or after hours (5 pm-8 am, Monday-Friday and weekends) were compared. The percentage of the starting modality (US or CT), the rate of CT following an indeterminate US, and the sensitivity of each modality was compared between the 2 categories, utilising Mann-Whitney U and chi-square tests. RESULTS: Presurgical US or CT studies of 494 patients, from February 2012-August 2014, were evaluated. Regular-hours and after-hours coverage demonstrated 174 (89:85 women:men) and 320 (141:179 women:men; P < .04) patients. The average age, 37.9 ± 17.1 women versus 35.2 ± 13.7 men was not statistically different (P = .8). Regular hours included 89 of 174 (51.1%) of US-only examinations, 50 of 174 (29%) of CT-only examinations, and 35 of 174 (20%) of US examinations followed by CT examinations. After hours included 147 of 320 (46%) of US-only examinations, 147 of 320 (46%) of CT-only examinations, and 26 of 320 (8%) of US examinations followed by CT examinations (P < .001). The total diagnostic sensitivities for US and CT were 86% (81% regular hours, 90% after hours; P = .041) and 99.2% (100% regular hours, 99% after hours; P > .05), respectively. CONCLUSIONS: US was less utilised in acute appendicitis detection after hours, although its diagnostic sensitivity was better than regular-hours coverage.

Malignancy in a Solitary Thyroid Nodule: A Retrospective Histopathological Evaluation.

Objective: This study aimed to assess the presence and type of malignancy in patients who underwent thyroid surgery for solitary thyroid nodules. Methods: A retrospective review was performed of the case notes of all adult patients with solitary thyroid nodules who underwent thyroid surgery from 1 January 2019 to 31 October 2022. All patients had solitary thyroid nodules identified by ultrasonography. The electronic records of our pathology department were used to determine the pathological diagnosis. Results: Forty-two patients with solitary thyroid nodules underwent thyroid surgery. The mean age at presentation was 39.1 ± 12.6 years, and 76.2% of patients were female. The malignancy rate was 31%. Further histopathological analysis found that malignant solitary thyroid nodules were mostly papillary carcinoma. Conclusion: This study indicates that solitary thyroid nodules should be evaluated thoroughly and treated with a high index of suspicion because they have a high chance (31%) of being malignant.

Weakened continental lithosphere beneath the northern Red Sea inferred from elastic thickness.

The northern Red Sea (NRS) is considered an extended continental region that has resulted in a rift system. Gravity and bathymetry data were used to estimate the Moho depth and the elastic thickness Te of the lithosphere beneath the NRS region to characterize its flexural rigidity and understand its mechanical behavior. Focusing on the Mabahiss Deep in NRS, we analyzed the lithosphere's flexural rigidity. The observed long-wavelength positive Bouguer anomaly is attributed to crustal thinning and lithospheric mantle uplift. The crustal thickness varies from 28 km in coastal areas to 24 km beneath the axial rift, supporting a regional compensation model over the Airy model. Forward modeling suggests that the optimal model explaining the regional Bouguer anomaly is a flexural model with Te equal to 7 km, indicating a weak and irregular continental crust. The primary factor contributing to this weakness is heating activity. Given the weakened state of the crust and the ongoing extension in the region, the NRS rift could evolve into a rupture, potentially leading to the formation of oceanic crust.

Endovascular Repair in Blunt Thoracic Aortic Injury: A 10-Year Single Center Experience.

BACKGROUND: Life-threatening blunt thoracic aortic injury (BTAI) typically occurs alongside multiple other traumatic injuries. Symptoms of BTAI can range from being asymptomatic in the case of intimal tears to becoming catastrophic in the case of uncontained aortic ruptures. The aim of this research was to examine the clinical outcomes for those who underwent thoracic endovascular aortic repair (TEVAR) in hospital settings.  Methods: A cross-sectional retrospective study was conducted using patient data that were extracted from Al-Noor Specialist Hospital, Makkah, Saudi Arabia, for the duration between January 2011 and December 2021. This study included data from all patients aged 18 and up who had been diagnosed with BTAI and had undergone TEVAR. The BTAI diagnoses were confirmed using CT scans. Logistic regression was utilized to identify predictors of patients' health status improvement and length of stay. RESULTS: A total of 80 patients were involved. Around 50.0% (n=40) of the patients had grade 3 thoracic aortic injuries. The median duration of stay was 14.00 days (Interquartile range 21.00). Only one patient developed post-procedure complications (1.3%). Almost one-third (31.3%; n=25) of the patients required subclavian coverage. One patient developed intraoperative endoleak (1.3%). One patient developed an access site complication (1.3%). The mortality rate within 30 days of the operation was 1.3%. The vast majority of the patients (92.5%; n=74) showed improvement upon discharge from the hospital. The baseline patient characteristics and length of hospitalization had no effect on the improvement of patient status upon discharge or their length of stay (p>0.05). CONCLUSION: Patients with BTAI have shown an excellent success rate with TEVAR and a low complication rate. Predictors of procedure success and length of stay need to be identified; however, this can't be done without larger-scale investigations. This can aid in the development of preventative measures that improve clinical outcomes for the patients.

Controllable synthesis of a hybrid mesoporous sheets-like Fe0.5NiS2@ P, N-doped carbon electrocatalyst for alkaline oxygen evolution reaction.

Owing to the high cost of precious metal catalysts for the oxygen evolution reaction (OER), the production of highly efficient and affordable electrocatalysts is important for generating pollution-free and renewable energy via electrochemical processes. A facile hydrothermal approach was employed to synthesize hybrid mesoporous iron-nickel bimetallic sulfides @ P, N-doped carbon for the OER. The prepared Fe0.5NiS2@C exhibited an overpotential (η) of 250 mV at 10 mA/cm2. This exceeded the overpotentials recently reported for surface-modified P, N-doped carbon-based catalysts for the OER in a 1 M KOH medium. Moreover, the Fe0.5NiS2@C catalyst showed a notable Tafel slope of 90.5 mV/dec with long-dated stability even after 24 h at 10 mA/cm2. The superior OER performance of the Fe0.5NiS2@C catalysts may be due to their large surface area, sheet-like morphology with abundant active sites, fast transfer of mass and electrons, control of the electronic structure by co-treatment with heteroatoms (e.g., P and N), and the synergistic effect of bimetallic sulfides, making them favorable catalysts for the oxygen evolution reaction. Density functional theory (DFT) calculations showed that the Fe0.5NiS2@C catalyst exhibited strong H2O-adsorption energy. The enhanced OER activity of Fe0.5NiS2@C was attributed to its higher surface area, favorable H2O adsorption energy, improved electron transfer efficiency, and lower Gibbs free energy compared to those of the other proposed catalysts.

Patterns of Prescribing Postoperative Analgesic Medication After Thyroid Surgery: A Retrospective Cohort Study.

Background: Mild-to-moderate postoperative pain is common after surgical procedures of the thyroid. Opioid analgesics have been commonly prescribed in such cases, but their use has been debated owing to concerns regarding the addictive nature of opioids. Recently, experts from the Endocrine Surgery Section of the American Head and Neck Society released a consensus document to limit the use of opioids as the first-line pain control medication after head and neck or endocrine procedures. However, differences in pain management prescriptions have been noted in many settings. This study aims to assess the post-thyroid surgery pain control medication prescription practices of head and neck and endocrine surgeons. Methods: This study retrospectively reviewed the charts of 105 adult patients who underwent thyroid surgery (total thyroidectomy, thyroid lobectomy, or subtotal thyroidectomy) by head and neck or endocrine surgeons. The type of prescribed pain medication at hospital discharge postoperatively was then retrieved from each patient's discharge medication list. Descriptive statistics mean, standard deviations, frequencies, and percentages were computed, while the Chi-square test was applied to measure the significant differences among variables at a 5.00% significant level. Results: An outpatient oral opioid, in the form combining paracetamol and codeine, was prescribed for 62 (59%) patients, whereas 43 (41%) were discharged on paracetamol only. Conclusion: The use of opioids is the practice pattern for pain management among some head and neck or endocrine surgeons despite emerging evidence that supports the use of non-opioid and other alternative analgesic strategies in outpatient thyroid and parathyroid surgery. Further research and quality improvement interventions should be geared towards leading all health professionals to appropriate prescription practices to improve patient safety and reduce unnecessary opioid prescriptions.

Assessment of human health risks of toxic elements in coastal area between Al-Khafji and Al-Jubail, Saudi Arabia.

The present work aims to document the distribution of toxic elements (TEs) and assess the human health risk posed by the TEs in the marine sediment of the Arabian Gulf, Saudi Arabia. The descending order of TE averages (µg/g) was as follows: Ni > Cr > V > Zn > Pb > Cu > As > Co. Based on the enrichment factor values, only minor enrichment for Pb, As, Cr, and Ni was noted. The hazard index (HI) values for the non-carcinogenic risk of the TEs were less than 1.0, and the lifetime cancer risk values for carcinogenic Pb, Cr, and As ranged between 2.96 × 10-8 and 5.44 × 10-5, indicating no significant health hazards for the inhabitants of the study area.

Cancer Therapy-Related Cardiotoxicity: A Comprehensive Retrospective Analysis at Najran Cancer Center, Saudi Arabia.

Background Cardiotoxicity, produced as an adverse effect of anticancer therapy, is a common issue during cancer treatment. Acute coronary syndrome, myocarditis, arrhythmias, or heart failure can all be symptoms of this issue. Little is known about its occurrence among Saudi Arabian cancer patients. This study aims to investigate factors linked to anticancer therapy-related cardiotoxicity. Methods A retrospective study was conducted from April 2020 to May 2022 at the King Khalid Hospital, Najran, Saudi Arabia. The study included adult cancer patients receiving anticancer therapy, regardless of their cardiovascular disease history. Univariate analysis was used to investigate factors associated with the occurrence of cardiotoxicity related to anticancer therapy. Results Of 78 patients receiving anticancer therapy, cardiotoxicity occurred in 12 (15.4%) patients. The mean age was 56.5 ± 13.4 years, with 33.3% aged over 65 years. Comorbidities included hypertension (44; 56.4%), diabetes (41; 52.6%), dyslipidemia (13; 16.7%), smoking (16; 20.5%), heart disease (6; 7.7%), trastuzumab use (9; 11.5%), and chronic kidney disease (2; 2.6%). The most common cancers were breast cancer and gastrointestinal cancer (27.6% each). Monoclonal anticancer agents 35 (46.1%) and alkylating agents 29 (38.2%) were commonly used chemotherapies. Cardiac protective agents were used in 16 (21.1%) of patients, with angiotensin-converting enzyme (ACE) inhibitors 15 (19.7%) and statins (13; 17.1%) being the most prescribed. Baseline ejection fraction (EF) was normal in 69 (90.8%) of cases. The follow-up duration was 1.93 ± 1.90 years. A drop in EF occurred in five (6.6%) of cases. Dyslipidemia (OR: 0.12; 95% CI: 0.03-0.47, p=0.002), previous heart disease (OR: 0.14; 95% CI: 0.02-0.81, p=0.029), and impaired baseline EF (p=0.029) were associated with increased risk of cardiotoxicity. Statin (OR: 0.22; 95% CI: 0.05 to 0.84, p=0.028) and antiplatelet agents (OR: 0.19; 95% CI: 0.03 to 1.01, p=0.051) were protective agents against cardiac toxicity. Conclusion Effective anti-cancer therapy may be accompanied by an increased risk of cardiotoxicity. In this study, a history of prior heart disease, dyslipidemia, low baseline ejection fraction, and the administration of multiple anticancer therapy agents was associated with cardiotoxicity. Proactive management strategies aimed at mitigating the potential cardiotoxic effects of anti-cancer therapies are crucial.

Endoscopic Assessment Prior to Bariatric Surgery in Saudi Arabia.

BACKGROUND: There are marked local inconsistencies in the Arabian Peninsula about the role of preoperative esophagogastroduodenoscopy (EGD) in bariatric surgery. Thus, this study was conducted to determine the frequency of endoscopic and histological findings in the Saudi population presenting for pre-bariatric surgery evaluation. MATERIAL AND METHODS: This was a retrospective study that included all the patients who were evaluated by EGD at Dammam Medical Complex, Dammam, Saudi Arabia, between 2018 and 2021 as a part of their pre-bariatric-surgery evaluation. RESULTS: A total of 684 patients were included. They consisted of 250 male and 434 female patients (36.5% and 63.5%, respectively). The mean ± standard deviation for the patients' age and body mass index (BMI) were 36.4±10.6 years and 44.6±5.1 kg/m2, respectively. Significant endoscopic or histopathological findings as defined by the presence of large (≥ 2 cm) hiatus hernia, esophagitis, gastroesophageal reflux disease (GERD), Barrett esophagus, gastric ulcer, duodenal ulcer, or intestinal metaplasia were found in 143 patients (20.9%); 364 patients (53.2%) were diagnosed to have Helicobacter pylori infection. CONCLUSION: The high number of significant endoscopic and histopathological findings in our study supports the routine use of preoperative EGD in all bariatric surgery patients. However, omitting EGD before Roux-en-Y gastric bypass (RYGB) in asymptomatic patients is still reasonable as the most frequently found significant findings, esophagitis, and hiatus hernia, are less likely to impact the operative plans in RYGB. Similarly, active surveillance and treatment of H. pylori infections in obese patients are important but it is not clear whether H. pylori eradication should be done before bariatric surgery.

Factors Affecting Weight Reduction after Intragastric Balloon Insertion: A Retrospective Study.

BACKGROUND AND OBJECTIVES: Intragastric balloon (IGB) is a safe option for obesity management. However, studies determining the factors influencing the procedure's outcomes are scarce. Therefore, our goal was to determine the factors affecting weight reduction after IGB insertion. MATERIALS AND METHODS: This retrospective study included 126 obese patients who underwent IGB treatment using the ORBERA® Intragastric Balloon System. Patients' records were retrieved; and demographic data, initial body mass index (BMI), complications, compliance with both diet and exercise programs, and percentage of excess weight reduction were recorded. RESULTS: The study included 108 female (85.7%) and 18 male (14.3%) patients. The mean age was 31.7 ± 8.1 years. The percentage of excess weight loss (EWL) was 55.8 ± 35.7%. The mean weight loss was 13.01 ± 7.51 kg. A significant association was found between EWL and age, initial weight, initial body mass index, and the number of pregnancies. No major complications were observed. However, the balloon had to be removed early in two patients (1.59%) due to its rupture and in two other patients (1.59%) due to severe gastritis. CONCLUSIONS: IGB therapy is a safe and effective option for obesity management, associated with low rates of complications. The EWL after IGB insertion is significantly higher among older patients, those with a relatively low initial body mass index, those with a longer duration of IGB insertion, and female patients with less parity. Larger prospective studies are needed to support our results.

Obesity Concerns and the Future of a Nation's Health: A Cross-Sectional Study of Physical Activity and Related Awareness of Doctors-in-The-Making, Staff, and Faculty in a Saudi Arabian Medical College.

Background: Saudi Arabian population has amongst the highest prevalence of obesity globally. Apart from nutritional measures, physical activity is considered a major modifiable risk factor for the prevention of obesity and its consequences. An insight into the physical activity and awareness parameters of healthcare professionals and those in the making can provide an insight into how prepared we are to deal with the epidemic of non-communicable diseases. The aim of this study is to find out about the degree of physical activity undertaken by the medical students, faculty and staff at the College of Medicine, King Khalid University, as well as their awareness regarding physical activity guidelines. Methods: This study surveyed 300 adult participants - medical students, faculty and staff - in the College of Medicine, King Khalid University. An international validated questionnaire was used to assess the physical activity profile of participants as well as BMI parameters. Moreover, awareness and knowledge of the recommended physical activity guidelines for adults were also assessed. Results: The study participants comprised around 83% students, 9% faculty members, and 7% staff members. Around 55% of the participants were male, while the rest were female. More than 65% of participants across all categories reported low levels of physical activity, with only about 4.5% of participants across various age groups reporting high levels of physical activity. There was no significant difference by gender across the group (P value = 0.227). Only 17% of the study participants were knowledgeable of the recommended physical activity guidelines for adults. Conclusion: We found a low level of physical activity as well as inadequate awareness about the physical activity guidelines amongst our study participants. This study reiterates the urgent need for well-researched and well-funded health promoting interventions to promote physical activity, especially in the context of health professions' education.

The Effectiveness of COVID-19 Vaccines in Improving the Outcomes of Hospitalized COVID-19 Patients.

Background With the rapid spread of coronavirus disease 2019 (COVID-19), most countries took extreme measures to control the disease. Equitable access to safe and effective vaccines is critical to ending the COVID-19 pandemic. The Ministry of Health program in Saudi Arabia aimed to cover 17.4 million adults (70% of the adult population of Saudi Arabia) by the third quarter of 2021. We investigated the impact of the COVID-19 vaccine on the clinical course and outcomes of the admitted confirmed COVID-19 patients, in comparison to non-vaccinated patients. Methodology A retrospective cross-sectional record review was conducted for all hospitalized confirmed COVID-19 patients at Dammam Medical Complex (Eastern Province, Saudi Arabia) from June to July 2021. Two groups were studied according to the vaccination status (i.e., vaccinated and non-vaccinated). Information regarding comorbidities, length of stay, high oxygen requirements, ICU admission, and mortality data were collected and analyzed using the Python programming language (version 3.7.6) with the use of SciPy library (1.4.1) and Statsmodels module (v0.11.1). Results The sample included a total of 260 admitted confirmed COVID-19 cases. The mortality was significantly lower in the vaccinated group versus the non-vaccinated group with an odds ratio (OR) of 0.378 (CI 0.154-0.928). In addition, the OR of ICU admission was 0.476 (CI 0.218-1.042) and OR of endotracheal intubation was 0.561 (CI 0.249-1.265), but these did not reach statistical significance. We also detected a statistically significant relationship between mortality - regardless of vaccination status - and age ≥ 65 years (P=0.000, OR=7.51; 95%CI 3.13 to 18.04), chronic kidney disease (P=0.010, OR=5.62; CI 1.52 to 20.79), and renal transplant (P=0.037, OR=10.17; CI 1.15 to 89.76). Of note, most of our vaccinated patients received only a single dose (85%). Conclusion There is a significant reduction in mortality cases as well as less complicated hospital courses among the vaccinated group, in spite of the fact that most of our admitted patients had only a single vaccine shot. Suboptimal response to the vaccines was observed in the elder, chronic kidney disease, and renal transplant patients, hence the poorer outcomes in comparison to other patients.