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Background Many international studies have reported the outcomes and predictors of coronavirus disease 2019 (COVID-19); however, only a few national studies have reported predictors of poor outcomes among adult hospitalized patients with COVID-19. Therefore, this study aimed to describe the clinical characteristics and complications of COVID-19 and identify predictors of poor outcomes. Methods This was a retrospective cohort study. All adult patients confirmed with COVID-19 who were admitted at the King Abdulaziz Medical City (KAMC)-Jeddah between March 1, 2020, and December 31, 2020, were included; pediatric and pregnant patients were excluded. The clinical features and complications of COVID-19 were tested for association with poor outcomes (intensive care unit [ICU] admission or death) using chi-square and Fisher's exact tests. In addition, logistic regression analysis was performed to identify the predictors of poor outcomes. Results A total of 527 patients were included in this study. Forty-two patients (8%) (6-10, 95% confidence interval [CI]) died: 13 in the general wards and 29 in the ICU. Of the 84 patients admitted to the ICU, 65 underwent invasive mechanical ventilation. Poor outcome affected 97 patients (18%) (15-22, 95% CI). Shortness of breath, oxygen saturation <92%, and abnormal chest x-ray findings were associated with poor outcomes (P-value < 0.001). In addition, lymphocyte counts were significantly lower, while c-reactive protein levels were significantly higher among patients with poor outcomes (P-value < 0.001). The most common complications were acute cardiac (83 patients, 16%), acute kidney (78 patients, 15%), and liver injuries (76 patients, 14%). Predictors of poor outcome were the updated Charlson comorbidity index (CCI) (odds ratio [OR] 1.2 [95% CI 1.1-1.4]), liver injury (OR 2.6 [95% CI 1.3-4.9]), acute kidney injury (OR 4.3 [95% CI 2.3-7.8]), and acute cardiac injury (OR 5.1 [95% CI 2.8-9.4]). Conclusions COVID-19 disease is associated with significant morbidity and mortality. Predictors of poor outcomes among COVID-19 hospitalized patients were the updated CCI, liver injury, acute kidney, and acute myocardial injuries. Subsequently, the risk of poor COVID-19 outcomes is increased among patients with multiple comorbidities and/or multiple COVID-19 complications.
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BACKGROUND: Coronavirus disease 19 is a pandemic affecting millions worldwide. Since February 2020, new cases are reported in Saudi Arabia, and regulations have been imposed to control the spread of the disease and raise awareness. This study aimed to assess the knowledge and attitudes of the Kingdom's residents toward coronavirus disease 19 during the early stages of the pandemic. METHOD: A cross-sectional study of 2071 participants who were recruited from various cities in Saudi Arabia. An online questionnaire was shared through social media, which contained questions about demographic data, general knowledge of coronavirus disease 19, and participants' attitudes. RESULTS: The mean age of the study population was 34 ± 12.4 years. Most of the participants agreed that coronavirus disease 19 is a pandemic and is more serious than seasonal influenza. More than 90% believed that handwashing and social distancing are effective in preventing disease transmission. No significant results were observed when comparing the knowledge of high-risk participants and the normal population. More than half of the cohort were strictly compliant with curfew regulations, handwashing, and face mask. Around 80% of the population is following coronavirus disease 19 news and information through official authorities' press releases. CONCLUSION: The Kingdom of Saudi Arabia residents showed decent knowledge of coronavirus disease 19. Nevertheless, some information needs emphasizing and proper education. Frequent communication between healthcare authorities and the public is highly recommended.
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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a broad spectrum of manifestations. A variety of dermatological manifestations were described. We present a case of an immunocompetent middle-aged man who presented with novel coronavirus disease 2019 (COVID-19) and later developed herpes zoster (HZ). The case highlights the possibility of COVID-19-related HZ. The highest infection control measures must be abided when managing patients with cutaneous complaints until COVID-19 is ruled out.
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Introduction The extravascular lung water content is determined by the use of lung ultrasound (LUS) which is represented as B-lines. The aim of this study was to investigate whether the LUS measurement of extravascular lung water was correlated to changes in oxygenation. Methods This prospective cohort study was comprised of 73 patients with an average age of 56 (range: 18 to 87 years) who underwent elective cardiac surgery using cardiopulmonary bypass. The LUS score was performed preoperatively, time zero (T0), at one hour (T1), and at 24 hours (T2) post-surgery. Additionally, arterial oxygen partial pressure and fraction of inspired oxygen (PaO2/FiO2) ratio were measured at each time and the time-to-extubation. Results A negative correlation was found between the LUS score and PaO2/FiO2 at T1 (p < 0.004). Extubation time and changes in the lung ultrasound score at T0 - T2 were positively correlated (p < 0.03). Plus, there was a positive correlation between fluid balance and lung ultrasound score at T2 (p < 0.03). Conclusion We found three significant correlations that support the use of LUS in cardiac surgery: 1) the more B-lines, the lower the oxygenation; 2) the more B-lines, the longer the period of ventilation; 3) the more B-lines, the more positive the fluid balance. LUS is a non-invasive bedside investigation that can be used to judge extravascular lung water, providing useful information in the management of patient oxygenation, fluid balance, and extubation.