The Psychological Impact of COVID-19 Pandemic on Persons with Multiple Sclerosis in Saudi Arabia.

OBJECTIVES: To evaluate, in a Saudi Arabian context, how the COVID-19 pandemic psychologically impacted persons with multiple sclerosis (PwMS). METHODS: A cross-sectional study was undertaken during the period from October 2021 to March 2022. 738 participants resident in the Kingdom of Saudi Arabia (KSA) completed a self-administered online questionnaire. The research focused on persons diagnosed with MS. RESULTS: Participant ages spanned from 18 to over 55. The mean was 36.1±12.9 years old. Four hundred eighty-nine (66.3%) of the 738 participants were female. Two hundred sixty-four (35.8%) were single. Four hundred twelve (55.8%) were married. Six hundred eighty-five (92.8%) had received a COVID-19 vaccine. Regarding MS duration, 117 (15.9%) had been diagnosed for less than 2 years, 171 (23.2%) for 2-5 years, while 251 (34%) had the condition for 10 or more years. Regarding psychological health, 11.2% of participants complained of minimal/no depression, 33.3% of mild depression, 28.3% of moderate depression, and 27.1% of moderately severe to severe depression symptoms. Concerning anxiety, 17.2% of participants reported minimal anxiety, 36.9% mild, 23.3% moderate, while 22.6% suffered from severe anxiety symptoms. CONCLUSION: A high prevalence of depression and anxiety was found, along with high prevalence of co-occurrence of these disorders among PwMS.

Chronic Bilateral Anterior Shoulder Fracture-Dislocation Following Febrile Seizure After COVID-19 Vaccine: A Case Report.

Although the shoulder is one of the most commonly dislocated joints in the body, bilateral gleno-humeral joint dislocation is considered rare. Due to its complexity and paucity of cases reported in the literature, it represents both a diagnostic and therapeutic challenge. We report a rare case of an adolescent boy who suffered chronic bilateral anterior shoulder dislocations with proximal humerus fracture and Hill-Sachs lesion after febrile seizure following COVID-19 vaccination. An 18-year-old male presented with bilateral proximal humerus fracture with anterior shoulder dislocation following a first-time seizure. He was managed with a bilateral Latarjet procedure and proximal humerus interlocking osteosynthesis (PHILOS) on the left side, and the right-side fracture was fixed with two 3.5 mm cannulated screws. After one year, the patient had a somewhat satisfactory outcome with a DASH (disabilities of the arm, shoulder, and hand) score of 31.8. Bilateral anterior shoulder dislocation with associated proximal humerus fracture remains one of the rare orthopedic injuries. Recurrent shoulder dislocations lead to chronic glenoid bone loss, which needs fixation along with fracture.

Side Effects of Mixing Vaccines against COVID-19 Infection among Saudi Population.

BACKGROUND: Mixing two different vaccines has been utilized to minimize the impact of any supply chain interruptions and to combat the COVID-19 pandemic in Saudi Arabia. We conducted this study to evaluate the side effects, if any, associated with the mixed vaccination approach. METHODS: An online survey study was administered among COVID-19 vaccine recipients in Saudi Arabia. Symptoms post vaccination were assessed in 311 vaccinated participants with two matched doses of either Oxford-AstraZeneca or Pfizer-BioNTech vaccines, or two mixed doses, respectively. RESULTS: After the second dose, around 31% of the matched vaccine group reported no symptoms, while only 6% of the mixed vaccine group reported no symptoms. Most of the side effects after the second dose associated with matched vaccines were injection site pain (46%), while the mixed vaccines group reported significantly more symptoms compared with the matched vaccine group, which included fever (41%), fatigue (66%), muscle pain (44%), chills (17%) and injection site pain (60%). CONCLUSION: The data suggest the overall safety of the mixed vaccination protocol; however, it might be associated with side effects such as fever, fatigue, muscle pain, chills, and injection site pain. Further studies with a larger cohort size could shed more light on this aspect, which would be imperative for deciding to utilize a mixed vaccination approach.

Bacterial Coinfections Increase Mortality of Severely Ill COVID-19 Patients in Saudi Arabia.

Coronavirus disease 19 (COVID-19) is an ongoing global pandemic that is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The severity and mortality rates of COVID-19 are affected by several factors, such as respiratory diseases, diabetes, and hypertension. Bacterial coinfections are another factor that could contribute to the severity of COVID-19. Limited studies have investigated morbidity and mortality due to microbial coinfections in COVID-19 patients. Here, we retrospectively studied the effects of bacterial coinfections on intensive care unit (ICU)-admitted patients with COVID-19 in Asir province, Saudi Arabia. We analyzed electronic medical records of hospitalized patients with COVID-19 at Asir Central Hospital. A total of 34 patients were included, and the clinical data of 16 patients infected with SARS-CoV-2 only and 18 patients coinfected with SARS-CoV-2 and bacterial infections were analyzed in our study. Our data showed that the length of stay at the hospital for patients infected with both SARS-CoV-2 and bacterial infection was 35.2 days, compared to 16.2 days for patients infected with only SARS-CoV-2 (p = 0.0001). In addition, higher mortality rates were associated with patients in the coinfection group compared to the SARS-CoV-2-only infected group (50% vs. 18.7%, respectively). The study also showed that gram-negative bacteria are the most commonly isolated bacteria in COVID-19 patients. To conclude, this study found that individuals with COVID-19 who presented with bacterial infections are at higher risk for a longer stay at the hospital and potentially death. Further studies with a larger population are warranted to better understand the clinical outcomes of COVID-19 with bacterial infections.