ABSTRACT
The higher education sector is currently facing new challenges that have never been previously experienced because of increased global competitiveness, advances in technology, and the rise in the numbers of universities that offer students a broader range of courses to choose from. Students are the customers and main stakeholders in Higher Education Institutions (HEI) (Abbas, 2020). Hence, it is essential to investigate student perceptions of service quality (SQ) in HEIs. Therefore, this study investigates the effect of COVID-19 pandemic on the SQ in HEIs in Egypt from students' perspectives through the following research question: Has COVID-19 pandemic influenced the different dimensions of service quality in higher educational institutions? The paper aims to shed light on the impact of an unprecedented COVID-19 pandemic on higher education services, as it deliberates on the challenges and responses in the short/medium term through customers' or students' perspectives as the main stakeholders of the educational process. The question that the paper addresses is accompanied by several hypotheses that evaluate the influence of COVID-19 on different dimensions of service quality in the learning context.
ABSTRACT
Background: SARS-CoV-2, the causative agent of COVID-19, continues to cause a worldwide pandemic, with more than 147 million being affected globally as of this writing. People's responses to COVID-19 range from asymptomatic to severe, and the disease is sometimes fatal. Its severity is affected by different factors and comorbidities of the infected patients. Living at a high altitude could be another factor that affects the severity of the disease in infected patients. Methods: In the present study, we have analyzed the clinical, laboratory, and radiological findings of COVID-19-infected patients in Taif, a high-altitude region of Saudi Arabia. In addition, we compared matched diseased subjects to those living at sea level. We hypothesized that people living in high-altitude locations are prone to develop a more severe form of COVID-19 than those living at sea level. Results: Age and a high Charlson comorbidity score were associated with increased numbers of intensive care unit (ICU) admissions and mortality among COVID-19 patients. These ICU admissions and fatalities were found mainly in patients with comorbidities. Rates of leukocytosis, neutrophilia, higher D-dimer, ferritin, and highly sensitive C-reactive protein (CRP) were significantly higher in ICU patients. CRP was the most independent of the laboratory biomarkers found to be potential predictors of death. COVID-19 patients who live at higher altitude developed a less severe form of the disease and had a lower mortality rate, in comparison to matched subjects living at sea level. Conclusion: CRP and Charlson comorbidity scores can be considered predictive of disease severity. People living at higher altitudes developed less severe forms of COVID-19 disease than those living at sea level, due to a not-yet-known mechanism.