Medical Students and Faculty Perceptions About Online Learning During COVID-19 Pandemic: Alfaisal University Experience.

Background and Objectives: Off-campus online learning methods abruptly increased and gained popularity during the COVID-19 pandemic. Previous studies have highlighted the limitations of online learning mode; however, further studies on the experiences of medical students are needed. This study aimed to investigate the preclinical medical students and faculty members' experiences with online education and learning. Subjects and Methods: In this cross-sectional study, data were collected using convenience sampling. Two hundred nine students and 13 faculty members who participated in the online courses offered during the spring semester of 2019-2020 completed an online questionnaire. A 30-item questionnaire for the students and a 25-item questionnaire for the faculty were used in this cross-sectional study. Results: Overall, 30% of the student sample was satisfied; importantly, high-achieving students (GPA > 3.5) were less satisfied (25 vs. 32%; p = 0.006). Satisfaction was also low (35%) for student-faculty interaction opportunities. About half of the student sample agreed that small-group interactive sessions would improve learning (53%). The most favored course format was the blended mode (43%), followed by traditional (40%) and online modes (17%). Six out of 13 (46%) faculty members were satisfied with their online experiences. Most of them found virtual teaching applications convenient (77%). Conversely, few faculty members agreed to interact effectively (54%), while 69% favored a blended format. Conclusions: The level of satisfaction in fully online courses offered during the COVID-19 pandemic remained low, especially among high-achieving students. Both students and faculty favored the blended format for future purposes. Small group active-learning strategies and web-based interactive tools may facilitate engagement and student-faculty interactions.

Severe COVID-19 Associated With Liver Injury in Patients Without Preexisting Liver Disease.

OBJECTIVE: Coronavirus disease 2019 (COVID-19) is known to disturb liver function tests (LFTs). Not much literature is available regarding the effect of COVID-19 on LFTs in patients without preexisting liver disease. The study aimed to find the effect of COVID-19 in these patients. METHODS:  This was a single-center, observational study with 142 patients who were admitted with COVID-19 during three months. Seven patients were excluded due to the presence of chronic liver disease.  Results: A total of 135 patients were included in the study aged between 18 and 95 years (mean 57.7 ± 15.6); among them, 93 were males (68.9%). Hypertension was present in 74 patients (54.8%), and diabetes was present in 48 patients (35.6%). Fever was the chief complaint in 112 patients (83%), followed by dyspnea in 93 patients (68.9%) and cough in 79 patients (58.5%). Elevated aspartate aminotransferase (AST) was seen in 35 patients (26%), gamma-glutamyl transferase (GGT) in 43 patients (32%), alanine transaminase (ALT) in 18 patients (24%), alkaline phosphatase in 19 patients (14%), bilirubin in six patients (4%), and low albumin in 27 patients (20%). Severe COVID-19, when compared with mild to moderate disease, was associated with elevated AST > two-time upper limit normal (2ULN) (p = 0.002), GGT > 2ULN (0.026), and lower albumin (p = 0.020), higher systemic inflammatory response syndrome (SIRS) (0.045), raised procalcitonin (p = 0.045), higher ferritin (p = 0.005), lower pO2 (p = 0.044), and higher Sequential Organ Failure Assessment score (SOFA) (p = 0.002) pointing to the inflammatory response as cause of liver injury. Factors predicting mortality with COVID-19 were assessed, which showed that direct bilirubin (p = 0.001), low albumin (p = 0.013), tachypnea (0.002), and leukocytosis (<0.001) were independently associated with increased COVID-19-related mortality. CONCLUSION:  Patients suffering from COVID-19 have evidence of liver injury, which appears to be secondary to an inflammatory response that correlates with the severity of COVID-19.