Effect of Obesity on Clinical Outcomes in COVID-19 Patients.

Background Obesity is a well-known risk factor for developing severe coronavirus disease 2019 (COVID-19). In this study, we sought to determine the relationship between obesity and poor outcomes in patients with COVID-19 patients at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia. Methods We conducted a single-centered descriptive study of adult COVID-19 patients hospitalized between March 1 and December 31, 2020, at KAUH. Patients were classified according to body mass index (BMI) as overweight (BMI 25-29.9 kg/m2) or obese (BMI ≥30 kg/m2). The main outcomes were admission to the intensive care unit (ICU), intubation, and death. Results Data were analyzed from 300 COVID-19 patients. Most study participants were overweight (61.8%), and 38.2% were obese. The most significant comorbidities were diabetes (46.8%) and hypertension (41.9%). Both hospital mortality (10.4% for obese; 3.8% for overweight, p = 0.021) and intubation rates (34.6% for obese; 22.7% for overweight, p = 0.004) were significantly higher among obese patients than overweight patients. There was no significant difference in terms of ICU admission rate between both groups. However, intubation rates (34.6% for obese; 22.7% for overweight, p = 0.004) and hospital mortality (10.4% for obese; 3.8% for overweight, p = 0.021) were significantly higher among obese patients than overweight patients. Conclusions This study aimed to describe the effect of high BMI on the clinical outcome of COVID-19 patients in Saudi Arabia. Obesity is significantly correlated with poor clinical outcomes in COVID-19. It is also associated with higher mortality and the need for mechanical ventilation necessitating intensive care unit admission. Patients with higher BMI should be prioritized in the hospital setting, as they have a higher potential of developing severe COVID-19 complications and sequelae.

Impact of diabetes mellitus and co-morbidities on mortality in patients with COVID-19: A single-center retrospective study.

OBJECTIVES: To describe the effect of diabetes mellitus (DM) on clinical outcomes of patients admitted with COVID-19 infection. METHODS: We carried out a single center, observational, retrospective study. We included adult patients with laboratory-confirmed diagnosis of COVID-19 admitted to a tertiary hospital in Jeddah, Saudi Arabia, from April 2020 to December 2020. Electronic medical records were reviewed for demographics, clinical status, hospital course, and outcome; and they were compared between the patients with or without DM. RESULTS: Out of 198 patients included in the study, 86 (43.4%) were diabetic and 112 (56.5%) were non-diabetic. Majority of the patients were males 139 (70.2%) with a mean age of 54.14±14.89 years. In-hospital mortality rate was higher in diabetic patients than in non-diabetic patients (40 vs. 32; p=0.011). The most common comorbidity was hypertension (n=95, 48%) followed by ischemic heart disease (n=35, 17.7%), chronic kidney disease (n=17, 9.6%), and bronchial asthma (n=10, 5.1%). CONCLUSION: The risk of SARS-CoV-2 infection is higher among diabetic patients; particularly, those with preexisting co-morbidities or geriatric patients. Diabetic patients are prone to a severe clinical course of COVID-19 and a significantly higher mortality rate.

How Relevant is Obstetrician and Gynecologist Gender to Women in Saudi Arabia?

BACKGROUND: The patient-doctor relationship is one of the most important factors in determining the outcome of healthcare. The first step in establishing this relationship is choosing a physician. This study sought to identify patient preferences concerning the gender of their obstetrics and gynecology (OB-GYN) physician and the effect of religion and society on these choices. METHODS: A cross-sectional study was conducted at the OB-GYN outpatient clinics at King Abdulaziz University Hospital in Jeddah between February 2017 and June 2017. A total of 227 female patients were recruited. Eligible were women ages 18 years or older who had attended the clinic at least three times. A 30-item questionnaire was administered. RESULTS: Significantly, more female doctors were preferred for pelvic examination in lower income group (p=0.003), while male doctors were preferred for surgery (p=0.010) in higher income group. Significantly more male doctors were preferred for pelvic examination and gynecological surgery in >35-year age group (p=0.015 and p=0.017, respectively). With regard to predictors, embarrassment was the most significant factor reported for not choosing a male obstetrician/gynecologist (OB-GYN) in the younger age group. Nearly three-quarters (71.2%) of respondents with age ≤35 reported embarrassment as a factor for not choosing a male OB-GYN; 79.7% of this subgroup indicated that female doctors were more knowledgeable about women's health issues. CONCLUSION: Participants expressed a strong preference for female providers overall, although some women preferred male providers during certain circumstances (gynecologic surgery). Despite these gender preferences, more important to women in their choice of OB-GYN provider was the doctor's experience, qualifications, and reputation. Such trends are consistent with those culturally similar countries and in line with trends worldwide. These findings have the potential to significantly impact the personal health for women in Saudi Arabia and elsewhere in the Middle East where religious and cultural traditions are so important in decision-making.

The utility of proinflammatory markers in patients with obstructive sleep apnea.

PURPOSE: To evaluate the association of recently diagnosed obstructive sleep apnea (OSA) with TNF-α and IL-6 and to measure the effect of short-term continuous positive airway pressure (CPAP) therapy on these markers. METHODS: A prospective, open-label, controlled trial was conducted among patients referred for diagnostic polysomnography (PSG). After PSG, patients were divided into 3 groups: OSA intervention group (N = 21), OSA control untreated group (N = 19), and non-OSA control group (N = 24). IL-6 and TNF-α levels were measured at baseline and 1 month after intervention. Repeated measures (RM) ANOVA and ANCOVA were used to compare the three groups regarding changes in TNF-α and IL-6 levels by analyzing between-subject and within-subject effects as a function of time and adjusting for significant covariates. RESULTS: At baseline, IL-6 (p = 0.05) and TNF-α (p = 0.04) were significantly higher in the OSA patients than in the non-OSA controls. There was no effect of time either on the TNF-α (p = 0.069) or IL-6 (p = 0.717) after 1 month of CPAP. No interaction effect between group and time was found for either TNF-α (p = 0.240) or IL-6 (p = 0.552) after 1 month of CPAP. There was neither a group effect nor an interaction effect between group and time for either IL-6 or TNF α after adjusting for age, BMI, neck circumference, and AHI. CONCLUSION: This study showed increases in proinflammatory state as illustrated by plasma TNF-α and IL-6 levels among recently diagnosed OSA patients, but there were no changes in these inflammatory markers following 1-month CPAP therapy.