Short-term side effects of BNT162b2 vaccine in primary care settings in Qatar: a retrospective study.

Background: Despite the established effectiveness of the BNT162b2 Vaccine, the novel technology demands careful safety monitoring. While global studies have explored its safety, local data remains limited and exhibits some variability. This study investigated short-term side effects among BNT162b2 vaccinated individuals in Qatar. Methods: A retrospective analysis was conducted using data extracted from the electronic health records of individuals aged 18 or older across 8 primary health centers who received either the first or second dose of the BNT162b2 vaccine during the period from December 23, 2020, to April 24, 2021. The proportions of individuals experiencing short-term side effects after each dose were calculated. Logistic regression and log binomial regression analyses were used to explore associations with the side effects. Results: Among 7,764 participants, 5,489 received the first dose and 2,275 the second, with similar demographics between the groups. After the first dose, 5.5% reported at least one local side effect, compared to 3.9% after the second, with a 1.4 times higher incidence after the first dose (RR 1.4, 95% CI 1.14-1.75) compared to the second. Systemic side effects after the second dose were 2.6 times more common than after the first (RR 2.6, 95% CI 2.15-3.14). Gender, nationality, history of prior COVID-19 infection, and obesity were significantly associated with side effects after the first dose, while age, gender, and nationality, were significant factors after the second dose. Conclusion: The rates of side effects following the BNT162b2 vaccine in Qatar were relatively low, with age, gender, nationality, previous infection, and obesity identified as significant predictors. These results emphasize the need for tailored vaccination strategies and contributes valuable insights for evidence-based decision-making in ongoing and future vaccination campaigns.

Experience of X-linked hypophosphatemic rickets in the Gulf Cooperation Council countries: case series.

Summary: X-linked hypophosphatemic rickets (XLH), the most prevalent form of inherited hypophosphatemic rickets, is caused by loss-of-function mutations in the gene encoding phosphate-regulating endopeptidase homolog, X-linked (PHEX). This case series presents 14 cases of XLH from Gulf Cooperation Council (GCC) countries. The patients' medical history, biochemical and radiological investigative findings, as well as treatment responses and side effects from both conventional and burosumab therapy, are described. Cases were aged 2-40 years at diagnosis. There were two male cases and 12 female cases. All cases were treated with conventional therapy which resulted in a lack of improvement in or worsening of the clinical signs and symptoms of rickets or biochemical parameters. Side effects of conventional therapy included nausea, diarrhea, abdominal pain, nephrocalcinosis, and hyperparathyroidism, which affected the patients' quality of life and adherence to treatment. In the 10 patients treated with burosumab, there was a marked improvement in the biochemical markers of rickets, with a mean increase in serum phosphate of +0.56 mmol/L and tubular maximum phosphate reabsorption (TmP) to glomerular filtration rate (GFR) ratio (TmP/GFR) of +0.39 mmol/L at 12 months compared to baseline. Furthermore, a mean decrease in serum alkaline phosphatase (ALP) of -80.80 IU/L and parathyroid hormone (PTH) of -63.61 pmol/L at 12 months compared to baseline was observed in these patients. Additionally, patients treated with burosumab reported reduced pain, muscle weakness, and fatigue as well as the ability to lead more physically active lives with no significant side effects of treatment. Learning points: Conventional therapy resulted in a suboptimal response, with a lack of improvement of clinical signs and symptoms. Side effects of conventional therapy included nausea, diarrhea, abdominal pain, nephrocalcinosis, and hyperparathyroidism, which affected the patients' quality of life and adherence to treatment. Burosumab demonstrated marked improvements in the biochemical markers of rickets, in addition to reducing pain, muscle weakness, and fatigue. There were no significant side effects associated with burosumab therapy.

Sickness absenteeism among primary health care workers in Qatar before and during the COVID-19 pandemic.

OBJECTIVES: To explore the patterns, trends, nature, and extent of changes in sickness absence among health care workers (HCWs) at the Primary Health Care Corporation (PHCC) in Qatar-during the COVID-19 pandemic compared to previous years and uncover the main associated factors. METHODS: We conducted a retrospective analysis of all sick leaves' records of PHCC HCWs regardless of their profession from January 2019 till August 2021. RESULTS: A total of 41,132 sick leaves were taken during the studied period. The majority of HCWs who availed sick leaves were between 30-39 years (45.9%), females (65.1%), and expatriates (65.1%). Compared with pre-COVID-19 (Jan 2019-Feb 2020), Wave 1 of COVID-19 had significantly less incidence of sick leaves per day per 1000 HCWs. While wave 2 had significantly higher incidence of sick leaves compared to both pre-COVID-19 and wave 1. The number of sick leaves per person among female HCWs was significantly higher than that of male HCWs. Moreover, the number of sick leaves per person among locals were about two times the number among expatriate HCWs. Physicians and nurses had significantly lower number of sick leave per person compared to other professions. The rates of sick leaves due to suspected or confirmed COVID-19 infection, back/neck pain and gastroenteritis were significantly higher in the second wave compared to the first wave of COVID-19. CONCLUSION: Overall and cause specific sick leave rates among HCWs varied significantly across different periods of the COVID-19 pandemic. COVID-19 related sick leave rate was higher during the second wave compared to first one. By addressing the root causes of sick leaves, it is possible to reduce the burden on HCWs and ensure their continued ability to provide essential care to those in need.

Clinical and laboratory characteristics of patients hospitalised with COVID-19: clinical outcomes in Abu Dhabi, United Arab Emirates.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in December 2019. The severity of coronavirus disease 2019 (COVID-19) ranges from asymptomatic to severe and potentially fatal. We aimed to describe the clinical and laboratory features and outcomes of hospitalised patients with COVID-19 within the Abu Dhabi Healthcare Services Facilities (SEHA). METHODS: Our retrospective analysis of patient data collected from electronic health records (EHRs) available from the SEHA health information system included all patients admitted from 1 March to 31 May 2020 with a laboratory-confirmed PCR diagnosis of SARS-CoV-2 infection. Data of clinical features, co-morbidities, laboratory markers, length of hospital stay, treatment received and mortality were analysed according to severe versus non-severe disease. RESULTS: The study included 9390 patients. Patients were divided into severe and non-severe groups. Seven hundred twenty-one (7.68%) patients required intensive care, whereas the remaining patients (92.32%) had mild or moderate disease. The mean patient age of our cohort (41.8 years) was lower than the global average. Our population had male predominance, and it included various nationalities. The major co-morbidities were hypertension, diabetes mellitus and chronic kidney disease. Laboratory tests revealed significant differences in lactate dehydrogenase, ferritin, C-reactive protein, interleukin-6 and creatinine levels and the neutrophil count between the severe and non-severe groups. The most common anti-viral therapy was the combination of Hydroxychloroquine and Favipiravir. The overall in-hospital mortality rate was 1.63%, although the rate was 19.56% in the severe group. The mortality rate was higher in adults younger than 30 years than in those older than 60 years (2.3% vs. 0.95%). CONCLUSIONS: Our analysis suggested that Abu Dhabi had lower COVID-19 morbidity and mortalities rates were less than the reported rates then in China, Italy and the US. The affected population was relatively young, and it had an international representation. Globally, Abu Dhabi had one of the highest testing rates in relation to the population volume. We believe the early identification of patients and their younger age resulted in more favourable outcomes.

COVID-19 infection across workplace settings in Qatar: a comparison of COVID-19 positivity rates of screened workers from March 1st until July 31st, 2020.

INTRODUCTION: COVID-19 transmission was significant amongst Qatar's working population during the March-July 2020 outbreak. The study aimed to estimate the risk of exposure for COVID-19 across various workplace settings and demographics in the State of Qatar. METHODS: A cross-sectional study was conducted utilizing surveillance data of all workplaces with 10 or more laboratory-confirmed cases of COVID-19. These workplaces were categorized using a mapping table adapted from the North American Industry Classification System (NAICS) codes, 2017 version. The data was then analyzed to estimate and compare the positivity rate as an indicator of the risk of developing COVID-19 infection across various workplace settings in the State of Qatar. RESULTS: The highest positivity rate was reported amongst the Construction & Related (40.0%) and the Retail & Wholesale Trade sectors (40.0%), whereas, the lowest positivity rate was attributed to the healthcare workplace setting (11.0%). The highest incidence of COVID-19 infections occurred in South Asian nationalities and in the male gender. The private funded sector employees have seen higher positivity rate than employees of the governmental funded sector. CONCLUSION: The elevated risk of infection in Construction and Retail & Wholesale Trade is probably due to environmental and educational vulnerabilities. The predominant labor force of those workplace categories is South Asian craft and male manual workers. Alternatively, the better containment of the healthcare workplace setting can be attributed to the enforcement of infection control and occupational safety measures. These findings imply the importance of using preventive and surveillance strategies for high-risk workplace settings appropriately.

Epidemiology Characteristics of COVID-19 Infection Amongst Primary Health Care Workers in Qatar: March-October 2020.

Background: COVID-19 transmission was significant among Healthcare workers worldwide. In March 2020, Qatar started reporting numbers of COVID-19 positive cases among workers in Primary Health Care Corporation (PHCC). The study estimates the burden of the aforementioned infections and examines the demographic characteristics associated with the recorded positivity rates. Method: A cross-sectional descriptive study was conducted among Primary healthcare workers between March 1st and October 31st, 2020. The study examined the positivity rate of the different types of Primary healthcare workers and, analyzed the demographic characteristics of the infected persons. Results: 1,048 (87.4%) of the infected Health Care Workers (HCWs) belonged to the age group below 45 years, and 488 (40.7%) HCWs were females. 450 (37.5%) were HCWs clinical staff working in one of the 27 PHCC Health Centers (HCs) Despite the increased patient footfall and risk environment, the COVID dedicated HCs had an attack rate of 10.1%, which is not significantly different from the average attack rate of 8.9% among staff located in other HCs (p = 0.26). Storekeepers, engineering & maintenance staff, housekeeping staff, support staff, and security staff (outsourced non-clinical positions) had the highest positivity rates, 100, 67.2, 47.1, 32.4, and 29.5% respectively. Conclusion: The elevated risk of infection among outsourced non-clinical healthcare workers can be explained by environmental factors such as living conditions. Furthermore, better containment within clinical healthcare workers can be attributed to strict safety training and compliance with preventative measures which is recommended to be implemented across all settings.

Clinical, neuroimaging, and molecular spectrum of TECPR2-associated hereditary sensory and autonomic neuropathy with intellectual disability.

Bi-allelic TECPR2 variants have been associated with a complex syndrome with features of both a neurodevelopmental and neurodegenerative disorder. Here, we provide a comprehensive clinical description and variant interpretation framework for this genetic locus. Through international collaboration, we identified 17 individuals from 15 families with bi-allelic TECPR2-variants. We systemically reviewed clinical and molecular data from this cohort and 11 cases previously reported. Phenotypes were standardized using Human Phenotype Ontology terms. A cross-sectional analysis revealed global developmental delay/intellectual disability, muscular hypotonia, ataxia, hyporeflexia, respiratory infections, and central/nocturnal hypopnea as core manifestations. A review of brain magnetic resonance imaging scans demonstrated a thin corpus callosum in 52%. We evaluated 17 distinct variants. Missense variants in TECPR2 are predominantly located in the N- and C-terminal regions containing ß-propeller repeats. Despite constituting nearly half of disease-associated TECPR2 variants, classifying missense variants as (likely) pathogenic according to ACMG criteria remains challenging. We estimate a pathogenic variant carrier frequency of 1/1221 in the general and 1/155 in the Jewish Ashkenazi populations. Based on clinical, neuroimaging, and genetic data, we provide recommendations for variant reporting, clinical assessment, and surveillance/treatment of individuals with TECPR2-associated disorder. This sets the stage for future prospective natural history studies.

Distal Esophageal Duplication Cyst with Gastro-Esophageal Reflux Disease: A Rare Association and a Management Challenge.

Esophageal duplication cysts are rare congenital abnormalities of the foregut and may be associated with other conditions. Association of esophageal duplication with Gastro-Esophageal Reflux Disease (GERD) has not been reported in children. We are reporting a case of a 16 months baby who had antenatal diagnosis of diaphragmatic hernia. Postnatal CTchest, however, suggested a distal esophageal duplication cyst and a contrast esophagogram showed grade-IV GER. A thoracoscopy in another hospital excluded esophageal duplication at that time. Later, he presented with hematemesis in our department and was re-evaluated. Repeat CTconfirmed a persistent 2.5 x 1.3 cm cyst in distal esophagus. Upper GI endoscopy suggested grade-II esophagitis with a wide patent gastro-esophageal junction. The child was treated with left thoracotomy, excision of the duplication cyst and thoracic fundoplication. He had an uneventful post-operative recovery and is doing well at 6 months follow-up.