Ramadan fasting outcome among high-risk patients.

BACKGROUND: There is a growing literature on guidelines regarding Ramadan fasting for chronic kidney disease (CKD) patients. However, most studies only consider the impact of fasting on renal function. This study additionally aims to assess factors influencing Ramadan fasting in patients with CKD. METHOD: This is a prospective before and after cohort study. CKD patients were counseled regarding fasting and followed-up post-Ramadan for renal function status, actual fasting behavior, and other relevant outcomes. RESULTS: Of the 360 patients who attended the pre-Ramadan consultation, 306 were reachable after Ramadan of whom 55.3% were female. Of these 306 67.1% reported that they had fasted, 4.9% had attempted to fast but stopped, and 28% did not fast at all. Of these 74 has a post-fasting kidney test. Of the patients, 68.1% had stage 3A CKD, 21.7% had stage 3B, 7.9% stage 4, and only 2% stage 5. Of those who fasted, 11.1% had a drop in Glomerular Filtration Rate (eGFR) of 20% or more. Those who did not fast (16.7%) presented a similar drop. Conversely, among the few who attempted to fast and had to stop, half showed a drop in eGFR of more than 20%. In linear regression, fasting was not associated with post-Ramadan eGFR, when controlling for age and baseline eGRF. There were 17 (5.6%) significant events, including one death. More significant events occurred among the group who fasted some of Ramadan days, 26.7% of the subjects experienced an adverse event-while 4.7% of the group who did not fast had a significant adverse event compared to 4.4% among those who fasted all Ramadan. CONCLUSION: Fasting was not a significant determining factor in renal function deterioration in the study's population, nor did it have any significant association with adverse events.

Risk Factors for SARS-CoV-2 Infection Severity in Abu Dhabi.

BACKGROUND: Prediction models are essential for informing screening, assessing prognosis, and examining options for treatment. This study aimed to assess the risk of SARS-CoV-2 infection severity in the Abu Dhabi population. METHODS: This is a mixed retrospective cohort study and case-control study to explore the associated factors of receiving treatment in the community, being hospitalized, or requiring complex hospital care among patients with a diagnosis of SARS-CoV-2. Of 641 patients included, 266 were hospitalized; 135 were hospitalized and either died or required complex care, i.e., required ICU admission, intubation, or oxygen and 131 did not develop severe disease requiring complex care. The third group ("controls") were 375 patients who were not hospitalized. Logistic regression analyses were used to study predictors of disease severity. RESULTS: Among hospitalized patients older age and low oxygen saturation at admission were the consistent and strongest predictors of an adverse outcome. Risk factors for the death in addition to age and low oxygen saturation were elevated white blood count and low reported physical activity. Chronic kidney disease and diabetes were also associated with more severe disease in logistic regression. The mortality rate among those with less than 30 min per week of physical activity was 4.9%, while the mortality rate was 0.35% for those with physical activity > 30 min at least once a week. The interval from the onset of symptoms to admission and mortality was found to have a significant inverse relationship, with worse survival for shorter intervals. CONCLUSION: Oxygen saturation is an important measure that should be introduced at screening sites and used in the risk assessment of patients with SARS-CoV-2. In addition, an older age was a consistent factor in all adverse outcomes, and other factors, such as low physical activity, elevated WBC, CKD, and DM, were also identified as risk factors.

Knowledge, Attitude, and Practices Toward SARS-COV-2 Infection in the United Arab Emirates Population: An Online Community-Based Cross-Sectional Survey.

Population's preventive practices and self-isolation is determinantal in the prevention and mitigation. This study explored the adult population's knowledge, attitude, and practice toward COVID-19 in UAE between the 4th and 14th of April 2020. The study was a community-based, cross-sectional study using a self-administered electronic questionnaire covering five different aspects: demographics, knowledge, practice, attitude, source, and trust of information, and a patient health questionnaire (PHQ-2) for depression screening. Results were analyzed using frequencies, cross-tabulation, and regression analysis. A total of 1,867 people responded to the survey. The mean age of participants was 36.0 years S.D. 10.8. Males were 19.3% and female (80.7%). Knowledge was significantly better in people with higher educational levels (B 0.17, P-value < 0.001), good preventive practice (B 0.12, P-value < 0.001), and higher perceived risk scores (B 0.053, P-value = 0.025). The best practice scores were shown by participants with older age (B 0.097, P-value < 0.05), with good knowledge (B 0.086, P-value < 0.05), were of non-UAE nationalities (B -0.08, P-value < 0.05), with jobs that cannot be practiced from home, military and health care employees (B -0.104, P-value < 0.05), had a personal history of contact with COVID-19 patients (B 0.053, P-value < 0.05), higher educational levels (B 0.052, P-value < 0.05), and a positive attitude toward taking a vaccine (B 0.088, P-value < 0.05). Depression risk was significantly higher in men, non-UAE nationals, in those with lower knowledge scores, and younger ages. The most followed practices were staying home, handwashing, avoiding social gatherings, limiting three people per vehicle, and avoiding public transportation. The least practiced measures were covering the face while sneezing or coughing and wearing masks. Although staying home was reported by 92.5% of participants, 22.6% mentioned that they were visited by more than two people and visited others in 18.4% during the last week. Social media was the source of information for 82.1% of the participants and most trusted doctors and healthcare providers. Depression risk was present in 18.9% of the participants, and most respondents (89%) agreed that SARS-COV-2 infection would be finally be successfully controlled. An encouraging finding is the willingness of two-third of the participants (64.5%) to take the COVID-19 vaccine and if it was developed, although it was very early in the pandemic. Only 14.6% said they would not take the vaccine, and 20.9% were not sure. The obtained results on knowledge and practices, although satisfactory, could be insufficient to prevent this pandemic from being contained. Therefore, we recommend the intensification of awareness programs and good practices. In addition, mental health is an area worth further studies.