Middle East respiratory syndrome coronavirus in Al-Madinah City, Saudi Arabia: Demographic, clinical and survival data

Background: Middle East respiratory syndrome coronavirus [MERS-CoV], is an emerging virus respiratory infection. It has a high mortality rate and a wide spectrum of clinical features. This study describes the clinical characteristics and outcome of MERS infected patients

Methods: A retrospective study was conducted of all confirmed MERS-CoV infections from March 2014 to May 2014 at two tertiary care hospitals in Al-Madinah region [Saudi Arabia]. We gathered data about demographic, clinical presentation, and factors associated with severity and mortality

Results: A total of 29 cases were identified; 20 males [69%] and nine females [31%], age 45 +/- 12 years. The death rate was higher for men [52%] than for women [23%]. Initial presentation was fever in 22 [75%] cases, cough in 20 [69%] cases, and shortness of breath in 20 [69%] cases. Associated comorbidities were diabetes mellitus in nine [31%] patients and chronic kidney disease [CKD] in eight [27%] patients. Duration of symptoms before hospitalization ranged from 2.9 days to 5 days. Elevated liver enzymes were present in 14 [50%] patients and impaired renal profile present in eight [27%] patients. We also describe in this study radiological patterns and factors associated with mortality

Conclusion: MERS-CoV infection transmission continues to occur as clusters in healthcare facilities. The frequency of cases and deaths is higher among men than women and among patients with comorbidities

Venous thromboembolism risks and prophylaxis in King Fahad Hospital, Madinah, Saudi Arabia

Objective: To evaluate the risk factors, physician's compliance, and implementation of the American College of Chest Physicians [ACCP] guidelines for venous thromboembolism [VTE] prophylaxis at our hospital

Methods: A retrospective cohort study was conducted in King Fahad Hospital, Madinah, Saudi Arabia, from July 2015 to September 2015. We used the ACCP 2012 guidelines to assess the VTE risk and to determine whether patients had received the recommended prophylaxis. All hospital inpatients aged 14 years or older were assessed for risk of VTE by reviewing the hospital chart/The primary endpoint was the rate of appropriate thromboprophylaxis

Results: A total of 414 patients were studied. Their mean age was 47.74 +/-20.4 years, and 208 [50.2%] were female. There were 292 [70.5%] patients at high risk and 73 [17.6%] at moderate risk. As per the ACCP criteria, 375 [90.5%] patients were at risk for VTE and qualified for prophylaxis. Although 227 [60.5%] received some form of prophylaxis, only 144 [38.4%] of them received ACCP-recommended VTE prophylaxis

Conclusion: In our hospital, most of the patients are at high risk for developing VTE. The VTE prophylaxis guideline is not properly implemented and is underutilized. Strategies should be developed and implemented to ensure patient safety