Effect of Hydroxychloroquine on Clinical Improvement and Mortality Among Patients with COVID-19 Admitted to Four General Hospitals in Saudi Arabia

Background The use of hydroxychloroquine in coronavirus disease (COVID-19) pandemic raised significant concerns as regards safety and efficacy in hospitalized patients. The objective was to examine the effect of hydroxychloroquine on clinical improvement and mortality among hospitalized patients with COVID-19. Methods A prospective cohort study was conducted at four general hospitals in the Western region, Saudi Arabia. Patients who had absolute or relative contraindication for using hydroxychloroquine were excluded. Patients concomitantly receiving other medications including azithromycin, antivirals, and supportive treatment were not excluded. Results A total 267 patients were included in the current analysis; 185 (69.3%) on hydroxychloroquine and 82 (30.7%) on non-hydroxychloroquine treatments. The average age was 46.0±13.3 years and 78.3% of the patients were males. Approximately 95.9% of the patients were symptomatic with mild (50.6%), moderate (32.6%), severe (8.2%), or ARDS symptoms (4.5%). Compared with no hydroxychloroquine, those on hydroxychloroquine had significantly longer length of stay (11.5±7.1 versus 7.8±4.3 days, p<0.001), more ICU admission (22.7% versus 9.8%, p=0.012), and more intubation (12.4% versus 3.7%, p=0.026). Improvement of symptoms (84.3% versus 81.7%, p=0.595) and hospitalization death (7.0% versus 1.2%, p=0.071) were not significantly different between groups. With exception of length of stay, the association of hydroxychloroquine with the above negative outcomes disappeared after adjustment for several factors including disease severity and concomitant use of azithromycin. Conclusions Hydroxychloroquine is not associated with better improvement of symptoms compared with other treatments. Moreover, it is associated with longer length of stay but not mortality or ICU admission in adjusted analysis.

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Impact of Covid-19 on asthmatic patients in Western region in Saudi Arabia

10.5742/mewfm.2021.94161 ◽

2021 ◽

Vol 20 (11) ◽

Author(s):

Abdulrhman Nasser Zaher AlGhamdi ◽

Amal Mohammed Albaqami ◽

Areej Mohammed Abdullah ◽

Doha Abdulrahmman Alsukhayri ◽

Hamad Albulrahman Alawi ◽

...

Keyword(s):

Saudi Arabia ◽

Data Entry ◽

Cross Sectional Study ◽

Western Region ◽

Poor Control ◽

Key Words Asthma ◽

Cross Sectional ◽

Icu Admission ◽

Asthmatic Patients ◽

The Impact

Background: Respiratory symptoms are a characteristic feature present in covid-19 patients, and they usually range from mild to severe. Asthma is a chronic disease involving the airways that carry air in and out of the lungs. However, there is limited resources that discuss the relation between asthma and prevalence of COVID-19. Aims: Identify the impact of covid19 on asthmatic patients. Methodology: This is a descriptive cross-sectional study that was conducted to study the impact of COVID-19 on asthmatic patients, which was conducted using a prepared questionnaire which was distributed online among 300 patients with asthma. After collecting the data, MS Excel was used for data entry while SPSS version 24 was used for data analysis. Results: In this study, we were able to collect data from 311 asthmatic patients in response to our questionnaire. Most of the asthmatic patients were females (67.2%) with a ratio of females: males of 2:1. Moreover, most patients thought that they control their asthma well and only 13.5 % indicated that they had frequent emergency visits because of asthma. The prevalence of COVID-19 in asthmatic patients was 64.3 % where a third of patients needed to go to hospital because of their bad condition, 12.6 % needed to be hospitalized in ICU and 56.4 % needed oxygen. Moreover, severity of COVID-19 symptoms and outcomes are related to the control of asthma where better control of asthma was associated with better outcomes including lower need for ICU admission and oxygen need. Conclusion: Prevalence of COVID-19 in asthmatic patients was much higher than the general population especially in female patients aged between 31-40 years old. Moreover, COVID-19 had more severe outcomes in asthmatic patients including higher prevalence of ICU admission and oxygen need. Poorer outcomes of COVID-19 were associated with poor control of asthma. Key words: Asthma, Covid-19, Western Region, Saudi Arabia

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Pattern of Infectious Diseases in the Western Region of Saudi Arabia; A Study of 495 Hospitalized Patients

Journal of King Abdulaziz University-Medical Sciences ◽

10.4197/med.16-2.1 ◽

2009 ◽

Vol 16 (2) ◽

pp. 3-15 ◽

Cited By ~ 1

Author(s):

Aisha Alghamdi ◽

Omer Alamoudi ◽

Tawfik Ghabrah ◽

Mohammed Al-Kassimi

Keyword(s):

Saudi Arabia ◽

Infectious Diseases ◽

Hospitalized Patients ◽

Western Region ◽

The Western Region

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Abstract 16173: Clinical Characteristics and Short-term Outcomes of Hospitalized Patients With Sars-cov-2 Infection and Reduced Left Ventricular Ejection Fraction

Circulation ◽

10.1161/circ.142.suppl_3.16173 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Gatha G Nair ◽

Joanne Michelle M Gomez ◽

Setri S Fugar ◽

Jeanne du Fay de Lavallaz ◽

Max Ruge ◽

...

Keyword(s):

Length Of Stay ◽

Ejection Fraction ◽

Clinical Outcomes ◽

Left Ventricular ◽

Hospitalized Patients ◽

Hospital Length Of Stay ◽

Left Ventricular Ejection ◽

Short Term ◽

Ventricular Ejection Fraction ◽

Icu Admission

Introduction: Early studies of coronavirus disease 2019 (COVID-19) patients suggested that heart failure (HF) may lead to poorer prognosis. We evaluated demographics and short-term clinical outcomes of patients with evidence of left ventricular systolic dysfunction (LVSD) in comparison to those with preserved LV systolic function (PSF). Methods: In this retrospective study of patients hospitalized for COVID-19 between March and June 2, 2020 at Rush Health Systems in Metro Chicago, demographics, comorbidities and clinical outcomes of patients who demonstrated LVSD (ejection fraction [EF] <50%) on transthoracic echocardiogram (TTE) were compared to that of controls with PSF. Results: Out of 1,312 hospitalized patients, 225 underwent TTE, and 44 patients showed LVSD. Demographics were similar between two groups, with exception of a higher prevalence of African American (AA) race (48 % vs. 29%; p=0.03) in the LVSD group. While 82% of patients in the LVSD cohort had history of chronic HF, only 26% of patients in the PSF had pre-existing HF (p<0.001). Underlying comorbidities were similar between groups: obesity (39% vs. 36%; p=0.86), diabetes (57% vs. 57%; p=1.0), hypertension (70% vs. 66%; p=0.72) and end-stage renal disease (20% vs. 19%; p=0.83). Coronary artery disease trended toward a higher frequency (50% vs. 34%; p=0.058) in the LVSD group. Troponin elevation (18% vs. 12%; p=0.43), vasopressor use (57% vs. 56%; p=1.0), endotracheal intubation (59% vs. 57%; p=0.87), myocardial infarction (30% vs. 23%; p=0.43), ICU admission (75% vs. 75%; p=1.0), hospital length of stay (median 11 days vs. 15 days; p=0.4), and death (25% vs. 23%; p=0.84) were similar between groups. Patients with LVSD had higher incidence of sustained ventricular tachycardia or fibrillation than those with PSF (18% vs. 6%; p=0.016). Conclusions: In our COVID-19 admissions, LVSD was more common in AA patients. Patients with LVSD had a higher risk of ventricular arrhythmias. However, there were no differences between need for ICU admission or intubation, vasopressor requirements, length of stay or death between patients with LVSD and those without. Longitudinal follow-up studies are needed to identify differences in long-term sequelae of COVID-19 infection with evidence for LVSD.

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Assessment of disaster preparedness at general hospitals in Al-Madinah Al-Munawarah Province, Western Region of Saudi Arabia

Saudi Medical Journal ◽

10.15537/smj.2021.42.5.20200804 ◽

2021 ◽

Vol 42 (5) ◽

pp. 537-542

Author(s):

Anas Khan ◽

Jalal Alowais ◽

Abdullah Nofal ◽

Tareef Alama

Keyword(s):

Saudi Arabia ◽

Disaster Preparedness ◽

Western Region ◽

General Hospitals

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Manifestations of renal system involvement in hospitalized patients with COVID-19 in Saudi Arabia

PLoS ONE ◽

10.1371/journal.pone.0253036 ◽

2021 ◽

Vol 16 (7) ◽

pp. e0253036

Author(s):

Khaled S. Allemailem ◽

Ahmad Almatroudi ◽

Amjad Ali Khan ◽

Arshad H. Rahmani ◽

Ibrahim S. Almarshad ◽

...

Keyword(s):

Acute Kidney Injury ◽

Saudi Arabia ◽

Demographic Data ◽

Multivariable Analysis ◽

Laboratory Data ◽

Kidney Injury ◽

Hospitalized Patients ◽

System Involvement ◽

Icu Admission ◽

Renal System

Background Although COVID-19 is an acute disease that usually resolves rapidly in most cases, the disease can be fatal and has a mortality rate of about 1% to 56%. Alveolar injury and respiratory failure are the main causes of death in patients with COVID 19. In addition, the effect of the disease on other organs is not fully understood. Renal system affection has been reported in patients with COVID 19 and is associated with a higher rate of diverse outcomes, including mortality. Therefore, in the present work, we reported the clinical characteristics and laboratory data of hospitalized patients with COVID-19 and analyzed the manifestations that indicated renal system involvement and their impact on clinical outcomes. Materials and methods This was an observational retrospective study conducted at King Fahd Specialist Hospital, Buraydah, Saudi Arabia. All patients with COVID-19 who were admitted to this Hospital from April to December 2020 were included in the study. The patients’ findings at presentation were recorded. Demographic data and laboratory results (hematuria, proteinuria, urinary sediment cast and pus cell presence, and kidney function tests) were retrieved from electronic patient records. Results One hundred and ninety-three patients with confirmed COVID 19 were included in the study. Dipstick examinations of all urine samples showed proteinuria and hematuria in 53.9% and 22.3% of patients, respectively, whereas microscopic examination revealed the presence of pus and brown muddy granular casts in 33.7% and 12.4% of samples, respectively. Acute kidney injury was reported in 23.3% of patients. A multivariable analysis demonstrated that hematuria was associated with acute kidney injury (AKI) (OR, 2.4; 95% CI, 1.2–4.9; P = 0.001), ICU admission (OR, 3.789; 95% CI, 1.913–7.505; P = 0.003), and mortality (OR, 8.084; 95% CI, 3.756–17.397; P = 0.002). Conversely, proteinuria was less significantly associated with the risk of AKI (OR, 1.56; 95% CI, 1.91–7.50; P = 0.003), ICU admission (OR, 2.493; 95% CI, 1.25–4.72; P = 0.001), and mortality (OR, 2.764; 95% CI, 1.368–5.121; P = 0.003). Patients with AKI had a higher probability for mortality than did those without AKI (OR, 14.208; 95% CI, 6.434–31.375; P = 0.003). Conclusion The manifestations of the involvement of the renal system are not uncommon in COVID-19. These manifestations included proteinuria, hematuria, and AKI and were usually associated with a poor prognosis, including high incidences of both ICU admission and mortality.

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