The impact of COVID-19 pandemic on lifestyle among the Saudi population.

Background: During COVID-19, major change occurred in the governmental regulations to combat the pandemic. Lifestyle factors are changeable habits and routine behaviors with an impact on physical and mental health. With the pandemic, sudden and radical changes occurred in the lifestyle of people worldwide. The main purpose of the study is to assess the impact of COVID-19 on lifestyle factors including (dietary habits, physical activity, sleeping patterns, smoking, and alcohol use) among the Saudi population. Design and methods: This is a cross-sectional study on a convenient sample of adults residing in Saudi Arabia. An online survey was distributed via social media channels. Descriptive statistics were used to analyze the distribution of demographic variables using Chi-square χ2 tests for categorical variables and t-test for continuous variables. Bowker test, and McNemar's Test were performed to evaluate the effects of lockdown on lifestyle factors. Results: A total of 1051 participants were included in the study. There was a slight decrease in the overall diet score during the pandemic (14.98%) compared to before the pandemic (15.05%) (p-value = 0.02), indicating poorer dietary intake during the lockdown. Approximately one-fourth of the participants (26.1%) reported following specific eating habits or a restricted diet during the pandemic (p-value = 0.0001). There was increased consumption of most components of dietary intake categories, during the lockdown. An increase in physical activities for three or more times was reported. A higher proportion of respondents reported sleeping nine or more hours a day during the lockdown (10.8%). Similarly, a higher percentage of individuals reported smoking daily during the lockdown (12.2%). As of overall health status, higher percentage of respondents reported poor health status during lockdown (6.1%). Conclusion: This study revealed major changes in lifestyle factors, negative shifts were revealed in dietary habits and smoking patterns. Positive changes were shown in physical activity, drinking water, and sleeping patterns. Our findings suggest that COVID-19 played a major role in changing lifestyle factors among adults in Saudi Arabia. Healthcare providers and public health officials are encouraged to increase awareness of healthy lifestyle factors that strengthen the immune system to combat COVID-19. The Saudi population needs increased awareness programs about healthy lifestyles to be prepared during pandemics.

The Impact of COVID-19 on Physical Activity Among Adults in Saudi Arabia: A Cross-Sectional Study.

Background Physical inactivity has been identified as a major factor in developing and progressing chronic non-communicable diseases such as obesity. The Kingdom of Saudi Arabia ranks high worldwide in rates of obesity. During the coronavirus disease 2019 (COVID-19) pandemic, public health measures have been enforced. These included social distancing, masking, reduction of workplace daily hours, prevention of social gatherings, and home quarantine measures. These ultimately restricted the ability to perform regular physical health activities. The aim of this study is to understand the impact of COVID-19 on physical activity among adults in the Kingdom of Saudi Arabia. Methodology A cross-sectional study was conducted among the Saudi population. An online survey was sent through social media to gather data regarding individual physical activity before and after the start of the COVID-19 restrictions. The data were collected from March 20, 2021, until May 20, 2021, and analyzed using chi-square and paired t-test using the SAS software version 9.4. Results In total, 433 participants completed the survey. There were 183 (42.3%) males, and the majority of the participants were Saudi nationals (284, 65.6%). Most of the participants (181, 41.8%) were in the age group 25-35 years and 253 (58%) had bachelor's degrees. Although the results did not show a statistically significant difference between pre- and post-COVID-19 respondents in terms of physical activity, married participants, participants from the eastern province, and participants who did not exercise regularly were all significantly impacted by lack of exercise compared to their counterparts (p < 0.05). Conclusions Taking measures to prevent the spread of COVID-19 is essential. Nonetheless, recommendations should be sought for physical activity during lockdowns, and large-scale research should be conducted to better understand what causes the exaggeration of sedentary lifestyles during lockdowns and how to prevent them. Further studies need to be conducted, and national guidelines should be made available in case of a future lockdown.

Trends in emergency department visits for mental health disorder diagnoses before and during the COVID-19 pandemic: a retrospective cohort study 2018-2021.

BACKGROUND: As the pandemic started, Saudi Arabia applied extreme measures in responses to the pandemic crises, which have adversely affected individuals' mental health. Therefore, the aim of this study is to describe trends in mental health disorder ED visit before and after the pandemic in two medical centers in Saudi Arabia. METHODS: A retrospective cohort study using data from electronic health records in the Ministry of National Guard Health Affairs' (MNG-HA) in Saudi Arabia. Multiple logistic regression model was used to examine the age and sex differences in mental health disorder ED visits before and during the COVID19 pandemic. RESULTS: A total of 1117 ED psychiatric visits, a sharp increase in the number of psychiatric ED visits during the pandemic with an average increase of 25.66% was observed. During the pandemic, psychiatric ED visits were significantly higher in females (adjusted AOR 1.41, 95% CI 1.08, 1.83) than males. During the COVID19 pandemic, generalized anxiety disorder was the most common psychiatric ED disorder with reported increase of visits by 53.34% (p-value 0.005). CONCLUSION: ED psychiatric visits have consistently increased before and during the COVID19 pandemic. Interventions for mental health related disorders are urgently needed for preventing mental health problems among females.

The impact of lockdown strategies on the basic reproductive number of coronavirus (COVID-19) cases in Saudi Arabia.

BACKGROUND & OBJECTIVES: In late December 2019, an outbreak of severe acute respiratory syndrome coronavirus 2 (SARS COV-2) occurred in the city of Wuhan, the capital of the Hubei province in the central part of the People's Republic of China (Ren et al., 2020). In Saudi Arabia, the first case of COVID-19 was reported in March 2, 2020. In March 8, 2020, the Saudi authorities adopted the lockdown strategy to contain the disease. The aim of this study was to determine the effectiveness of the various phases of the lockdown strategy in Saudi Arabia and its impact on the basic reproductive number (R0) of the COVID-19 outbreak. MATERIAL AND METHODS: The timeline of the COVID-19 outbreak in Saudi Arabia was divided into three-time intervals. Google Mobility Community Reports (2020) was used to estimate the changes in community mobility during the various phases of the lockdown. The basic reproductive number (R0) of the COVID-19 outbreak was calculated daily using the Susceptible, Infected and Recovered (SIR) model based on the Saudi Ministry of Health (MOH) daily reports. This is a standard system to determine the spread of the virus on the basis of infection rate, quarantine rate as well as confirmation rate. The mean values of the calculated R0 during each interval were compared using one-way ANOVA test. RESULTS: There was no statistically significant difference between the mean values of the different phases of the lockdown (P > 0.05). Moreover, mean R0 value of the second interval was 0.09 higher than the initial interval with free community mobility. Furthermore, the mean R0 values of the third interval with the full lockdown was 0.28 higher than the initial interval. CONCLUSION: Early implementation of lockdown strategy combined with other social distancing strategies help in containing infectious outbreaks in their early phases. Continuous assessment of such strategies' effectiveness provides decision makers with precious information needed to justify their application when considering their economic impact.

Severity of COVID-19 infection in ACEI/ARB users in specialty hospitals: A retrospective cohort study.

BACKGROUND: The uncertainty about COVID-19 outcomes in angiotensin-converting enzyme inhibitors (ACEI)/angiotensin receptor blockers (ARB) users continues with contradictory findings. This study aimed to determine the effect of ACEI/ARB use in patients with severe COVID-19. METHODS: This retrospective cohort study was done in two Saudi public specialty hospitals designated as COVID-19 referral facilities. We included 354 patients with a confirmed diagnosis of COVID-19 between April and June 2020, of which 146 were ACEI/ARB users and 208 were non-ACEI/ARB users. Controlling for confounders, we conducted multivariate logistic regression and sensitivity analyses using propensity score matching (PSM) and Inverse propensity score weighting (IPSW) for high-risk patient subsets. RESULTS: Compared to non-ACEI/ARB users, ACEI/ARB users had an eight-fold higher risk of developing critical or severe COVID-19 (OR = 8.25, 95%CI = 3.32-20.53); a nearly 7-fold higher risk of intensive care unit (ICU) admission (OR = 6.76, 95%CI = 2.88-15.89) and a nearly 5-fold higher risk of requiring noninvasive ventilation (OR = 4.77,95%CI = 2.15-10.55). Patients with diabetes, hypertension, and/or renal disease had a five-fold higher risk of severe COVID-19 disease (OR = 5.40,95%CI = 2.0-14.54]. These results were confirmed in the PSM and IPSW analyses. CONCLUSION: In general, but especially among patients with hypertension, diabetes, and/or renal disease, ACEI/ARB use is associated with a significantly higher risk of severe or critical COVID-19 disease, and ICU care.

Evaluation of COVID-19 myths in Saudi Arabia.

OBJECTIVES: To examine the awareness level of COVID-19 and to highlight the frequency of myths and misconceptions among Saudi Arabia's population. METHODS: We conducted a cross-sectional study from June 13 to 20, 2020 by distributing a 16-item online Google forms questionnaire among adults (18-65 years old) living in Saudi Arabia. We utilized the convenience sampling. Data analysis was performed using Chi-square and multiple regression analysis on Jamovi. RESULTS: A total of 1436 responses were analyzed with 43.5% males and 56.5% females. Most respondents (89.1%) thought that only the elderly above 60 years old are considered at high risk of contracting COVID-19. Most respondents (86.5%) agreed that people with other health conditions could be more affected by COVID-19. Approximately 97.2% agreed that wearing a mask and avoiding touching eyes, nose, and mouth with unwashed hands was the leading preventive action. Most participants (99.4%) chose fever as an associated symptom. Respondents from the healthcare sector presented statistically higher scores than those in non-healthcare sectors (p<0.001). Higher education and higher salary were important predictors of better COVID-19 knowledge. CONCLUSION: Public health officials need to increase awareness measures on COVID-19 to limit myths and misconceptions and reduce psychological distress associated with it.

Depression and Obsessive-Compulsive Disorders Amid the COVID-19 Pandemic in Saudi Arabia.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) is a global pandemic with significant morbidity and mortality. The Saudi government adopted mandatory home quarantine and curfew hours for all residents, excluding essential service workers. During the lockdown, the public's fear of infection can adversely impact mental health, causing psychological distress. The objective of this research is to assess frequency of depression and obsessive-compulsive disorder (OCD) among the general population during COVID-19 pandemic in Saudi Arabia. METHODOLOGY: This was a cross-sectional study using the Patient Health Questionnaire (PHQ-9) and Obsessive-Compulsive Inventory-Revised assessment test (OCI-R) in Arabic and English languages distributed via social media platforms. Chi-square test was used with significance determined at p<0.005. RESULTS: We received a total of 2187 responses. Our results showed that being female, single, and unemployed had a higher frequency of suffering from depression whereas higher income levels and higher education was associated with less depression frequency. Increasing age, males, married individuals, higher income groups, higher levels of education and employed individuals were more likely to have OCD during COVID-19 pandemic.  Conclusion: The COVID-19 pandemic period is associated with significant mental health risks among the Saudi population. The results can provide further scientific support to better understand the impact of quarantine on psychological distress and mental health during emergency and disaster situations.

COVID-19 pandemic's impact on eating habits in Saudi Arabia.

Background: COVID-19 virus has been reported as a pandemic in March 2020 by the WHO. Having a balanced and healthy diet routine can help boost the immune system, which is essential in fighting viruses. Public Health officials enforced lockdown for residents resulting in dietary habits change to combat sudden changes. Design and Methods: A cross-sectional study was conducted through an online survey to describe the impact of the COVID-19 pandemic on the eating habits, quality and quantity of food intake among adults in Saudi Arabia. SPSS version 24 was used to analyze the data. Comparison between general dietary habits before and during COVID-19 for ordinal variables was performed by Wilcoxon Signed Rank test, while McNemar test was performed for nominal variables. The paired samples t-test was used to compare the total scores for food quality and quantity before and during COVID-19 periods. Results: 2706 adults residing in Riyadh completed the survey. The majority (85.6%) of the respondents reported eating homecooked meals on a daily basis during COVID-19 as compared to 35.6% before (p<0.001). The mean score for the quality of food intake was slightly higher (p=0.002) before the COVID-19 period (16.46±2.84) as compared to the during period (16.39±2.79). The quantity of food mean score was higher (p<0.001) during the COVID-19 period (15.70±2.66) as compared to the before period (14.62±2.71). Conclusion: Dietary habits have changed significantly during the COVID-19 pandemic among Riyadh residents. Although some good habits increased, the quality and the quantity of the food was compromised. Public Health officials must focus on increased awareness on healthy eating during pandemics to avoid negative consequences. Future research is recommended to better understand the change in dietary habits during pandemics using a detailed food frequency questionnaire.