Blood Products Management and Safety During COVID-19: a Public Health Challenge.

BACKGROUND: Blood products are essential therapeutics that are pivotal in saving and improving millions of lives worldwide. A sufficient and safe blood supply is necessary for efficient healthcare services to provide effective patient care in various acute and chronic conditions. Blood donations are the main source of blood products in almost all nations of the world. The coronavirus 2019 (COVID-19) pandemic negatively impacted blood product management worldwide and has added stress to the already stressed healthcare system. Most of the earlier months of 2020 witnessed a decrease in blood donations as donors were highly apprehensive about their safety, and the isolation practices implemented to contain the virus spread discouraged donor participation. Because of the spread of the virus, blood collection centers and regulatory bodies have undertaken numerous strategic steps to prevent any viral transmission at the blood collection centers while aiming to increase donor participation. Maintaining extra sterilization in all the processes involved in blood product management and the modified criteria for participating donors changed the entire paradigm of blood product management. This review discusses various challenges and modifications adopted by different roles of participants involved in blood product availability to maintain an adequate and safe blood supply during the emerging COVID-19 pandemic. METHODS: An extensive online search was done to obtain the necessary information regarding various scenarios concerning blood product crises, advisories, and availability. RESULTS: A change in how the blood supply chain works that has overcome and prevented a crisis in blood demand and supply during the COVID-19 pandemic world over was observed. CONCLUSIONS: Blood products are critical for medical and surgical procedures. The COVID-19 pandemic has led to a crisis in the availability of blood products with decreased participation of donors. It has become the prime re-sponsibility of the blood collection centers and government agencies to change strategies, so that blood stocks do not become exhausted and create another crisis.

GENERAL DENTISTS' AWARENESS ON CHLORHEXIDINE HYPERSENSITIVITY IN SAUDI ARABIA. A CROSS-SECTIONAL STUDY

[...]daily mouthwashes can be used as a prophylactic measure, since they are effective antiplaque agents. [...]they help prevent dental caries [5]. Besides mouthwash, other variants of CHX used in dentistry are toothpaste containing chlorhexidine and CHX gels, the former being used as a topical antiseptic to treat peri-implant mucositis or for periodontitis prevention after scaling [12], while CHX chips which are used locally, in less severe periodontal cases [13]. According to these retrospective studies, hypersensitivity to CHX mouthwash can occur, therefore, every general dentist should consider this side effect capable to diagnose and treat an allergic reaction when it occurs. Validity and reliability The self-administered questionnaire distributed to participants included questions about independent demographic variables such as gender, years of clinical experience, place of work (governmental or private), and most frequently prescribed mouthwashes. [...]there were questions about dentists' awareness and knowledge on CHX hypersensitivity.

The impact of the COVID-19 pandemic on parents' behavior toward scheduled pediatric vaccinations in Saudi Arabia.

INTRODUCTION: Coronavirus disease (COVID-19) is caused by a newly discovered coronavirus and has resulted in a global pandemic. The World Health Organization recommended avoiding any delay or disruption of immunization services, as this could result in increases in outbreak-prone vaccine-preventable diseases. This study aimed to determine the impact of the COVID-19 pandemic on parents' behaviour towards their children's scheduled vaccinations. METHODOLOGY: This web-based cross-sectional study recruited 1,143 parents/guardians of children below six years of age living in Saudi Arabia between May 1 and May 30, 2020 via social media platforms. A self-developed online questionnaire consisting of eight items was used. Simple and multiple binary logistic regression was used to determine the factors associated with vaccine delay during the COVID-19 pandemic. RESULTS: The parents/guardians were aged 20-60 years; 82% were aged between 20 and 39 years. It was found that 26% of parents did not vaccinate their children on time according to the national immunization schedule in regular situations, and 38% of parents reported delaying vaccination due to the COVID-19 pandemic. The multiple logistic regression analysis found that having two or more children, living in Riyadh or the Western region or not vaccinating children during regular situations were associated with an increased risk of vaccine delay during the COVID-19 pandemic. CONCLUSIONS: Delaying children's vaccinations during the COVID-19 pandemic was influenced most by living in regions with high COVID-19 prevalence and having two or more children.

Case Report: Hyperbilirubinemia in Gilbert Syndrome Attenuates Covid-19-Induced Metabolic Disturbances.

Gilbert syndrome (GS) is a liver disorder characterized by non-hemolytic unconjugated hyperbilirubinemia. On the other hand, Coronavirus disease 2019 (Covid-19) is a recent viral infectious disease presented as clusters of pneumonia, triggered by the severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2). Little is known on the association between SARS-CoV-2 and GS, despite different studies have recently stated a link between hyperbilirubinemia and SARS-CoV-2 severity. In this case-report study we described a 47-year-old man, a known case of GS since the age of 4, presented to the emergency department with fever (39.8°C), dry cough, dyspnea, headache, myalgia, sweating and jaundice diagnosed with Covid-19-induced pneumonia. Interestingly, GS patient exhibited a rapid clinical recovery and short hospital stay compared to other SARS-CoV-2 positive patient, seeming that hyperbilirubinemia may exert a protective effect of against Covid-19 induced-cardiometabolic disturbances. Data obtained here underlines that the higher resistance against Covid-19 evidenced by the GS patient seems to be due to the antioxidant, anti-inflammatory, and antiviral effects of unconjugated bilirubin.

Infection and mortality of healthcare workers worldwide from COVID-19: a scoping review (preprint)

Objectives To estimate COVID-19 infections and deaths in healthcare workers (HCWs) from a global perspective. Design Scoping review. Methods Two parallel searches of academic bibliographic databases and grey literature were undertaken. Governments were also contacted for further information where possible. Due to the time-sensitive nature of the review and the need to report the most up-to-date information for an ever-evolving situation, there were no restrictions on language, information sources utilised, publication status, and types of sources of evidence. The AACODS checklist was used to appraise each source of evidence. Outcome measures Publication characteristics, country-specific data points, COVID-19 specific data, demographics of affected HCWs, and public health measures employed Results A total of 152,888 infections and 1413 deaths were reported. Infections were mainly in women (71.6%) and nurses (38.6%), but deaths were mainly in men (70.8%) and doctors (51.4%). Limited data suggested that general practitioners and mental health nurses were the highest risk specialities for deaths. There were 37.17 deaths reported per 100 infections for healthcare workers aged over 70. Europe had the highest absolute numbers of reported infections (119628) and deaths (712), but the Eastern Mediterranean region had the highest number of reported deaths per 100 infections (5.7). Conclusions HCW COVID-19 infections and deaths follow that of the general world population. The reasons for gender and speciality differences require further exploration, as do the low rates reported from Africa and India. Although physicians working in certain specialities may be considered high-risk due to exposure to oronasal secretions, the risk to other specialities must not be underestimated. Elderly HCWs may require assigning to less risky settings such as telemedicine, or administrative positions. Our pragmatic approach provides general trends, and highlights the need for universal guidelines for testing and reporting of infections in HCWs.