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Background: Pregnant women with the novel coronavirus disease (COVID-19) are more likely than non-pregnant women to develop severe COVID-19 complications. In addition, COVID-19 is linked to unfavorable pregnancy outcomes. Due to the lack of effective COVID-19 treatment, it is critical to assess geographic differences and trends in current clinical care and the effect of COVID-19 on pregnant women. This review aims to evaluate maternal and neonatal outcomes in COVID-19 pregnancies. We searched the Medline database for research papers from January 2019 to December 31, 2021. Eleven studies of systematic, meta-analysis, review, and cohort designs were included with searched keywords {Pregnancy AND COVID [MeSH Terms]}. This study summarizes the maternal characteristics, vertical Transmission, maternal and neonatal outcomes, the rate of cesarean section, comorbidities, mechanical ventilation, ICU admission rate, mode of delivery, type of anesthesia, the average hospital length of stay (HLOS), the extracorporeal membrane oxygenation (ECMO), preeclampsia, pregnancy-induced hypertension, chest x-ray and CT scan findings, treatments, and outcomes over time. © 2020 The author (s).
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Background:The new pandemic, COVID-19, is posing an enormous threat to people and huge workload to emergency departments (EDs) worldwide. Purpose: To study the impact of COVID-19 pandemic on preventing trauma patients from visiting Emergency departments. Methods: A cross sectional study was conducted using an electronic survey, all the patients who live in the eastern province and had to visit the Emergency departments and either delayed or decided not to visit ED due to COVID-19 pandemic were targeted. Results: A total of 390 out of 809 respondents (48%) in the Eastern region suffered from an orthopedic injury during lockdown due to covid-19 pandemic. A total of 244 (62.6%) respondents were afraid to visit hospital during lockdown. The main reasons for that were being afraid of being infected with covid-19. Conclusion: The COVID-19 pandemic resulted in preventing orthopedic trauma patients from visiting emergency departments which delayed them from receiving proper management.
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Introduction: The use of the interleukin-6 blocker tocilizumab in critically-ill mechanically ventilated patients with coronavirus disease 2019 (COVID-19) is less well studied. Research Question or Hypothesis: Is tocilizumab effective in mechanically ventilated COVID-19 patients. Study Design: A multicenter retrospective study conducted in six Saudi Arabian hospitals. Methods: Patients admitted between March 2020 to January 2021 were screened. Confirmed COVID-19 mechanically ventilated adult patients (≥18 years old) were included. Mortality after mechanical ventilation was the primary outcome and rate of extubation rate was the secondary outcome. To achieve balance in the data, we implemented inverse propensity score weighting (IPSW) and propensity score matching (PSM). In addition to performing survival analysis on the primary outcome, Cox proportional modeling with time dependency covariance was used to account for immortal bias. For the secondary outcome, competing risk analysis was implemented with death while intubated being the competing risk. Results: A total of 889 patients were screened and 456 patients were eligible for inclusion (tocilizumab, n=193, control, n= 263). The mean age (±SD) for tocilizumab arm was 59.3(±14.2) and 58.5(±13.7) years for the control arm. Adequate balance in covariates of interest was achieved in the IPSW and PSM analyses. In the IPSW analysis, tocilizumab was associated with lower mortality (HR=0.37, 95%CI=0.55-0.69) but not in the PSM analysis with (HR=0.80, 95%CI=0.57-1.12). After accounting for immortal time bias both the IPSW (HR=0.82, 95%CI=0.62-1.10) and the PSM (HR=0.86, 95%CI=0.64-1.16,) analyses showed no difference in overall mortality. Conversely, tocilizumab was associated with a higher rate of extubation (33.6%) versus the control arm (11.9%) with subdistributional hazards (SHR= 3.1, 95%CI=1.86-5.16). Conclusion: Tocilizumab was not effective in reducing mortality in mechanically ventilated COVID-19 patients. However, a higher extubation rate was observed. A large randomized controlled trial in this population is needed.
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Background: Anxiety is seen among students even during normal times. The COVID-19pandemic is believed to have increased anxiety and depression among the students. Purpose: An investigation was done to assess the anxiety levels and coping strategies of nursing students in Saudi Arabia. The influence of demographics on the anxiety levels and coping strategies were also determined. Methods: A cross-sectional study was conducted using a questionnaire through Google forms. The questionnaire had items related to demographics such as age, sex, etc., along with a question to know about the confidence of students to work as nurses. A GAD-7 scale was used to assess anxiety levels and BriefCope was used to determine coping strategies. Statistics were performed using non-parametric tests, factorial analysis, and linear regression. Results: More than half of the participating students experienced moderate to severe anxiety. The anxiety levels were not influenced significantly by demographics except the young age. More than 50% of the students were reluctant to work as nurses and this affected the anxiety score significantly. Factorial analysis grouped variables into six factors. Linear regression showed a positive correlation of these factors with anxiety. Conclusion: Anxiety score revealed that Saudi nursing students had moderate to severe anxiety. The combined number of students reluctant or scared to work was more than those who were confident to work as nurses. A positive association was observed between factor variables with mild and moderate anxiety.
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Background: COVID-19 is newly emerging infectious disease that spread globally at unpredictable and unique pattern to the extent that the World Health Organization announced COVID-19 as a pandemic in the first couple months of 2020. This study aims to describe clinical and demographic features of COVID-19 patients and the influence of various risk factors on the severity of disease. Methods: This research is a retrospective study based on Saudi Arabia's ministry of health's Covid-19 data. The analysis relies on data of all COVID-19 patients recorded in Riyadh between 1st, March 2020 and 30th, July 2020. Statistical analyses were performed to investigate the effect of demographic characteristic, clinical presentation, and comorbidities on infection severity. Results: A total number of 1026 COVID-19 patients were identified based on the demographic data as follows: 709 cases (69% of cases) were males and 559 cases (54% of cases) were Saudi. Most of patients were diagnosed with mild signs and symptoms 697 (68% of cases), while 164 patient (16% of cases) demonstrated moderate signs and symptoms, and 103 cases (10%) were severe and 62 (6%) had critical febrile illness. Fever, cough, sore throat, and shortness of breath were the most common symptoms among patients with COVID-19. Among studied comorbidities in COVID-19 patients, diabetes mellitus and hypertension were the most prevalent. The results from the bivariate logistic regression analysis revealed that older age, diabetes mellitus, asthma, smoking, and fever are associated with severe or critically ill cases. Conclusion: The findings of this study show that old age, fever, and comorbidities involving diabetes mellitus, asthma, and smoking were significantly associated with infection severity. (c) 2021 The Author(s). Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).