SARS-CoV-2 seroprevalence among healthcare workers from a tertiary care center in Riyadh, Saudi Arabia.

OBJECTIVES: To calculate the seroprevalence of asymptomatic healthcare workers (HCWs) in our institution. METHODS: We conducted a cross-sectional study among asymptomatic HCWs in a large hospital during the peak of the pandemic (from July to August 2020 and followed them up until February 2021) in Riyadh, Saudi Arabia. We collected the data in a Microsoft Word document after collecting a single serum sample for detection of antibodies from each participant then we compared the results statically in Microsoft Excel tables. RESULTS: We enrolled 188 participants and measured their IgG antibodies from venous blood samples using CLIA. Six (3.2%) had positive antibodies despite being asymptomatic. Most of these were from non-COVID-19 working areas (4 out of 6), but all had an exposure with a positive COVID-19 patient at some point in the preceding 2 months. CONCLUSIONS: Our results are consistent with similar local studies showing low seroprevalence among HCWs while most positive cases are from non-COVID-19 areas. Despite this low seroprevalence, HCWs are still considered a high-risk group; hence, there is a need to encourage strict implementation and adherence to infection control measures and vaccination among HCWs, especially when these measures are relaxed on the national level.

Efficacy of tocilizumab in patients with severe COVID-19: Survival and clinical outcomes.

BACKGROUND: SARS-CoV-2 is associated with a severe inflammatory response contributing to respiratory and systemic manifestations, morbidity, and mortality in patients with coronavirus disease 2019 (COVID-19). METHODS: Tocilizumab (TCZ) efficacy on mortality and length of hospital stay was retrospectively evaluated in patients who received TCZ and compared with that in controls with a similar severity of COVID-19. The primary endpoint was survival probability on day 28. The secondary endpoints included survival at day 14 and length of hospital stay. RESULTS: Of the 148 patients included in the study, 62 received TCZ and standard of care, whereas 86 served as a control group and received only standard of care. The two groups were similar, although TCZ-treated patients were more likely to exhibit hypertension (46.7% vs. 29.8%), chronic kidney disease (14.5% vs. 1.1%), and high Charlson score (1.18 vs. 1.00; p = 0.006) and less likely to receive corticosteroid treatment (48.5% vs. 93.0%). TCZ was associated with lower mortality on both day 28 (16.1% vs. 37.2%, p = 0.004) and day 14 (9.7% vs. 24.4%, p = 0.022). The hospital stay was longer in the TCZ-treated than in the control group (15.6 ± 7.59 vs.17.7 ± 7.8 days, p = 0.103). Ten patients (16.0%) in the TCZ-treated group developed infections. CONCLUSION: TCZ was associated with a lower likelihood of death despite resulting in higher infection rates and a non-significant longer hospital stay.

Reinfection, recurrence, or delayed presentation of COVID-19? Case series and review of the literature.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-cov-2), first described in December 2019, has now infected more than 28 million cases with almost one million deaths. Reinfection is not definitely established however disease recurrence is increasingly reported. CASES PRESENTATION: Four patients presented with a second episode of coronavirus disease 2019 (COVID-19) occurring 27-85 following their first illness. The initial episode was mild or asymptomatic while the second attack was severe requiring hospital admission. All four patients had a SARS-CoV-2 PCR test positive in the second episode. The chest-X-ray and/or computerized tomography (CT) scan showed bilateral alveolar shadows. Furthermore, the inflammatory markers were raised in the four patients. Three patients recovered following treatment with favipravir in addition tocilizumab and/or dexamethasone. CONCLUSION: Covid19 reinfection Recurrent COVID-19 is increasingly reported. However; other etiologies including superadded infection or pulmonary embolism should be ruled out, particularly if recurrence occurs less than 3 weeks.