Predictors of disease severity in patients hospitalized with coronavirus disease 2019.

BACKGROUND: Coronavirus disease 2019 (COVID-19), caused by a novel coronavirus, manifests as a respiratory illness primarily and symptoms range from asymptomatic to severe respiratory syndrome and even death. During the pandemic, due to overcrowding of medical facilities, clinical assessment to triage patients for home care or in-hospital treatment was an essential element of management. OBJECTIVES: Study the demographic features, comorbidities and bio-markers that predict severe illness and mortality from COVID-19 infection. DESIGN: Retrospective observational SETTING: Single tertiary care center PATIENTS AND METHODS: The study included all patients admitted with a positive PCR test for COVID-19 during the period from March 2020 to September 2020 (7 months). Data on demographics, clinical data and laboratory parameters was collected from medical records every 3 days during hospital stay or up until transfer to ICU. MAIN OUTCOME MEASURES: Demographic, comorbidities and biochemical features that might predict severe COVID-19 disease. SAMPLE SIZE: 372 RESULTS: Of the 372 patients, 72 (19.4%) had severe disease requiring admission to intensive care unit (ICU); 6 (1.6%) died. Individuals over 62 years were more likely to be admitted to the ICU (P=.0001, while a BMI of 40 and higher increased the odds of severe disease (P=.032). Male gender (P=.042), hypertension (P=.006) and diabetes (P=.001) conferred a statistically significant increased risk of admission to ICU, while coexisting COPD, and ischemic heart disease did not. Laboratory features related to severe COVID-19 infection were: leukocytosis (P=.015), thrombocytopenia (P=.001), high levels of C-reactive protein (P=.0001), lactic dehydrogenase (P=.0001), D-dimer (P=.0001) and ferritin (P=.001). With the multivariate analysis, diabetes, high lac-tate dehydrogenase, C-reactive protein and thrombocytopenia were associated with severity of illness. CONCLUSIONS: Particular demographic and clinical parameters may predict severe illness and need for ICU care. LIMITATIONS: Single referral center, several cases of severe COVID-19 could not be included due to lack of consent and or data. CONFLICT OF INTEREST: None.

Senior health sciences students' perception of occupational risk of viral hepatitis and attitudes toward patients diagnosed with viral hepatitis B and C.

OBJECTIVES: Hepatitis B virus (HBV) and hepatitis C virus (HCV) are the most common causes of liver cirrhosis and hepatocellular carcinoma. Medical, applied medical science, and dental students constitute a high-risk group for HBV and HCV infections during their training or at the beginning of their careers. This study aimed to explore senior health science students' knowledge of and attitudes toward these infections. METHODS: Between December 2014 and December 2015, a cross-sectional survey was conducted among senior health science at the College of Medicine, the College of Dentistry, and the Laboratory Section of Applied Medical Sciences in Qassim University, Al-Qassim, Saudi Arabia. A validated questionnaire was randomly distributed to male and female senior students to test students' knowledge of the general information on hepatitis B and C as well as their attitudes toward hepatitis B and hepatitis C patients and the disease in general. RESULTS: A total of 205 respondents were invited, but only 180 participated in this survey. Higher knowledge was positively correlated with a higher belief in providing equitable care to hepatitis B/C patients and general anxiety about handling such patients (P < 0.004). Higher beliefs in equity and anxiety predicted higher knowledge when everything else was held constant. CONCLUSION: We found a positive relationship between knowledge levels and attitudes toward HBV and HCV patients. We therefore encourage health science colleges to offer more lectures on HBV and HCV to improve students' knowledge and thereby improve their attitudes.