Recovery from severe novel coronavirus infection

We describe the third confirmed case of novel coronavirus infection in a resident of the Arabian Peninsula. Our patient presented, as did 2 prior cases, with severe pneumonia and renal dysfunction requiring intensive care support including assisted ventilation. However, unlike the earlier cases, and despite underlying chronic disease and a single kidney, he survived his infection and has been discharged home. The Ministry of Health continues active surveillance for additional cases. As this case report goes to press, 2 additional confirmed cases have been identified in Riyadh, Saudi Arabia. Contact investigations are in progress. Future work will focus not only on the origin of the virus and mechanisms of transmission, but also the host factors that influence pathogenesis and prognosis

Causes of hospitalization of pilgrims during the Hajj period of the islamic year 1423 [2003]

Approximately 2 to 3 million pilgrims perform Hajj every year. Planning for health care requires knowledge of the pattern of diseases, complications, and outcome of pilgrims who require hospitalization during the Hajj period. In a cross-sectional study we compiled data on all patients admitted to 1487 beds in four hospitals in Mena [793 beds] and three hospitals in Arafat [694 beds] from the seventh to the thirteenth day of the Hajj season of the Islamic year 1423, corresponding to 8 to 14 February 2003. Of 808 patients hospitalized, most [79%] were older than 40 years. There was no sex preponderance. A total of 575 [71.2%] patients were admitted to medical wards, 105 [13.0%] to surgical wards, and 76 [9.4%] to intensive care units. Most patients [84.8%] had one acute medical problem. Pneumonia [19.7%], ischemic heart disease [12.3%], and trauma [9.4%] were the most common admitting diagnoses. More than one third [39%] had co-morbid conditions. A total of 644 [79.7%] patients were discharged from the hospital in stable condition to continue therapy in their residential camps, 140 [17.3%] were transferred to other hospitals in Makkah for specialized services or further care, 19 [2.3%] were discharged against medical advice, and 5 [0.7%] patients died. This study provided information on the most common causes of hospitalization, pattern of diseases, and required medical services for pilgrims in Hajj. It is hoped that this data will be of help to health sector planners and officials to provide optimal and cost-effective health care services to pilgrims in Hajj

Mycobacterium tuberculosis susceptibility in Saudi Arabia

To present the available susceptibility data of Mycobacterium tuberculosis [M. tuberculosis] isolates from the Kingdom of Saudi Arabia [KSA] published in peer-reviewed journals. In a meta-analysis, studies published between 1966 and 2001 were included. Publication sites include Medline-indexed and non-indexed. Numbers of grown and resistant isolates were tabulated for first-line anti-tuberculosis agents. Twelve studies met the pre-set criteria. Data on 6,316 isolates between 1979 and 2000 were available. Resistance to at least one agent of the first-line anti-tuberculosis agents was 18.4%. Monoresistance to a single first-line agent was found in 10.9%, while polyresistance was noted in 7.6%. Multidrug-resistant M. tuberculosis was noted in 5.7% of all isolates. Resistance to isoniazid was most common noted in 11% of isolates. Resistance rates to other agents were: rifampin 9.7%, streptomycin 9.1%, pyrazinamide 3.1%, and ethambutol 2.5%. The overall resistance rate to at least one agent was not statistically different in isolates grown between 1979-1991 [18.5%] and 1989-2000 [18.3%]. There were large regional variations and higher resistance rates in the Western and Southern regions. Mycobacterium tuberculosis resistance rates to first-line antituberculosis agents and multidrug-resistant M. tuberculosis are high in KSA. A survey and monitoring program for drug-resistant tuberculosis will determine resistance rates at the community level