Seroprevalence of SARS-CoV-2 antibodies in the general population of Oman: results from four successive nationwide sero-epidemiological surveys.

OBJECTIVE: To assess the seroprevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in Oman and longitudinal changes in antibody levels over time within the first 11 months of the coronavirus disease 2019 (COVID-19) pandemic. METHODS: This nationwide cross-sectional study was conducted as a four-cycle serosurvey using a multi-stage stratified sampling method from July to November 2020. A questionnaire was used and included demographics, history of acute respiratory infection and list of symptoms, COVID-19 contact, previous diagnosis or admission, travel history and risk factors. RESULTS: In total, 17,457 participants were surveyed. Thirty percent were female and 66.3% were Omani. There was a significant increase in seroprevalence throughout the study cycles, from 5.5% (4.8-6.2%) in Cycle 1 to 22% (19.6-24.6%) in Cycle 4. There was no difference in seroprevalence between genders, but significant differences were found between age groups. There was a transition of seroprevalence from being higher in non-Omanis than Omanis in Cycle 1 [9.1% (7.6-10.9%) vs 3.2% (2.6-3.9%)] to being higher in Omanis than non-Omanis in Cycle 4 [24.3% (21.0-27.9%) vs 16.8% (14.9-18.9%)]. There was remarkable variation in the seroprevalence of SARS-CoV-2 according to governorate. Close contacts of people with COVID-19 had a 96% higher risk of having the disease [adjusted odds ratio (AOR) 1.96, 95% confidence intervals (CI) 1.64-2.34]. Labourers had 58% higher risk of infection compared with office workers (AOR 1.58, 95% CI 1.04-2.35). CONCLUSION: This study showed a wide variation in the spread of SARS-CoV-2 across governorates in Oman, with higher estimated seroprevalence in migrants in the first two cycles. Prevalence estimates remain low and are insufficient to provide herd immunity.

Clinical Characteristics of Confirmed Cases of COVID-19 Admitted at Al Nahdha Hospital, Oman: A Cross-Sectional Descriptive Study.

Background and objective Coronavirus disease 2019 (COVID-19) has become a public health emergency of international concern. Several characteristics of hospitalised cases, including variations in symptoms as well as radiological and laboratory findings, have been described. However, the exact clinical spectrum of hospitalised patients with COVID-19 in Oman is currently unclear. The objective of this paper was to describe the sociodemographic, clinical, laboratory, and radiological characteristics, as well as the treatment and clinical outcomes of the confirmed cases of COVID-19 at Al Nahdha Hospital, Oman. Additionally, factors associated with the severity of the disease were identified. Methodology This was a cross-sectional descriptive study of hospitalised COVID-19 patients. The required data were retrieved from the electronic health information system for the period from 3rd March to 9th May 2020. Information was recorded in a bespoke sheet and exported to SPSS Statistics (IBM, Armonk, NY) for analysis. Results A total of 102 admissions were included in this study. The mean age of the cohort was 49.9 (14.7) years. The majority were males (77.5%), and more than half were expatriates (56.9%). Diabetes and hypertension were found in 39.2% and 36.3% of the study population, respectively. Common symptoms encountered were dry cough (78.3%), fever (76.5%), and shortness of breath (SOB) (69.6%). Radiologically, bilateral infiltrations were present in 73.5% of the patients. Only 19 cases required critical care (18.6%), and those were mostly older [54.1 (13.4) years], males (89.5%), and non-nationals (63.2%). Significant factors associated with requiring critical care were symptoms of SOB (89.5% vs 65.1%, p=0.03), diabetes (68.4% vs 32.5%, OR=1.5, p=0.004), chronic artery disease (15.8% vs 3.6%, OR=1.7, p=0.04), and diagnosis of acute respiratory distress symptoms (63.2% vs 6.0%, p<0.001). Additionally, the mean ferritin levels were significantly higher in cases requiring critical care [2350.4 (423.8) vs 795.7 (554.3), p=0.005]. Depending on disease severity, the treatment included antibacterials, antivirals, heparin, and steroids. The utilisation of steroids was significantly higher in the cases requiring critical care (63.2% vs 26.5%, p=0.001). Among cases that required critical care (n=19), nine died (death rate=47.4%). Conclusions This study has provided fundamental information about the clinical characteristics of confirmed COVID-19 cases in Oman, including factors associated with the disease's severity. Results from this study can be utilised to update the COVID-19 management guidelines for hospitalised patients.

Reporting at Least One Adverse Effect Post-COVID-19 Vaccination From Primary Health Care in Muscat.

Introduction Vaccinations against COVID-19 were licensed with limited testing assurances to the public triggering a widespread hesitancy around expected adverse reactions. Limited data was reported from Arabian Gulf countries on vaccine adverse effects. Objectives This study looked at the rate of reporting at least one side effect post-COVID-19 vaccination and its associated factors (sociodemographic characteristics, clinical condition, and type of vaccines). Additionally, questions about safety and willingness to recommend them were included. Study design Phone interviews on post-COVID-19 vaccination adverse effects were utilized to record responses related to reporting at least one side effect post vaccinations across the studied variables. Data collection continued for two months (from 1st March to 30th April 2021). Methodology Participants were adults (Omani citizens and non-citizens) who received AstraZeneca (AZ) or Pfizer (PF) vaccines from primary care facilities in Muscat and were randomly selected from the health information system. Responses were saved in a bespoke Google form/questionnaire. Chi-squared tests were utilized to determine potential factors associated with the dependent variable. Results A total of 753 participants completed the phone interviews. The mean age was 52 (3.5), males (54.1%), and 65.1% were Omanis. Hypertension (39.7%), diabetes (34.1%), and asthma (16.7%) were the commonest comorbidities. AZ and PF were administered to 78% and 22% of the participants. Of them, 49.8% reported at least one adverse effect post-COVID-19 vaccination. The proportion of participants with at least one adverse effect was significantly more in individuals who were younger, females, with more than secondary education, and employed (p value < 0.001, 0.01, <0.001, and <0.001, respectively). There was no severe reaction (anaphylactic shock) to the vaccines, and most adverse effects were mild-moderate. The proportion of individuals who reported adverse effects were higher with AZ vs PF (53% vs 38.6, p = 0.001). The most common reported localized adverse effects were pain and tenderness (28.3% and 12.1%). Fever and body aches were the commonly reported systemic adverse effects (33.5% and 29.2%). The safety of COVID-19 vaccines was well perceived, and most participants were willing to recommend them to others. Conclusions The current study confirms findings from existing literature on the mild to moderate adverse effects of AZ and PF vaccines. Despite the subjective nature of this study, it is reassuring that the studied COVID-19 vaccines can be administered safely. However, more longitudinal studies are needed to test their efficacy in disease prevention.