ABSTRACT
BACKGROUND: Patients with underlying heart failure (HF) in the setting of COVID-19 who require admission to the intensive care unit (ICU) might present with a unique set of challenges. This study aims to extensively describe the characteristics and outcomes of patients with HF who were admitted to ICU with COVID-19. METHODS: We conducted a multicenter retrospective analysis for all adult patients with HF and an objectively confirmed diagnosis of COVID-19 who were admitted to ICUs between March 1 and August 31, 2020, in Saudi Arabia. RESULTS: A total of 723 critically ill patients with COVID-19 were admitted into ICUs during the study period: 59 patients with HF and 664 patients with no HF before admission to ICU. Patients with HF had statistically significant more comorbidities, including diabetes mellitus, hypertension, dyslipidemia, atrial fibrillation, and acute coronary syndrome. Moreover, higher baseline severity scores (APACHE II & SOFA score) and nutritional risk (NUTRIC score) were observed in HF patients. Overall, patients with HF had more in-hospital and ICU deaths in comparison to patients without HF: (64.3% vs. 44.6%, P-value <0.01) and (54.5% vs. 39%, P-value = 0.02), respectively. Patients with HF had a similar incidence of thrombosis, ICU length of stay, duration of mechanical ventilation, and hospital length of stay compared to patients with no HF. CONCLUSION: In this study, patients with HF had more in-hospital and ICU deaths than patients with no HF. Thus, history of HF could be used to help direct case management during hospitalization and possibly dictate proactive COVID-19 care.
ABSTRACT
PURPOSE: Objective structured clinical examination (OSCE) is an effective tool for learners' assessment that require hands-on performance. During the COVID-era, many schools decided to minimize all forms of in-person communication between faculty members and students to mitigate the risk of COVID-19 transmission. We aimed to describe our experience in conducting physical OSCEs during the COVID-19 era. We also reported students' satisfaction during this time. MATERIALS AND METHODS: Descriptive cohort study by comparing the 2019-2020 cohort to the 2020-2021 cohort. Descriptive framework for the feasibility of conducting physical OSCEs in the college of pharmacy at King Saudi Bin Abdulaziz University for Health Sciences in Riyadh, Saudi Arabia. RESULTS: There were no reported cases of COVID-19 transmission among students and faculty members during the OSCE assessments. Overall, the 2020-2021 cohort reported increased satisfaction compared to their peers in the 2019-2020 cohort; p < 0.05. We observed an increased need for coordination to ensure students' and staff safety while adopting machine learning applications as a public measure when possible. CONCLUSION: Owing to the implementation of clear and strong measures, it was feasible to conduct OSCEs, and there were no reported cases of COVID-19 transmission. Other universities may adopt a similar approach so as to provide an optimal educational experience while ensuring the safety of their staff and faculty.