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Background: Healthcare systems have modified their strategies to manage their staff, supplies, and space to deal systematically with the COVID-19 pandemic. This research aimed to explore the nature of hospital adjustments and the concerns of healthcare providers and administrative staff working in Governmental and private hospitals throughout the Qassim Region of the Kingdom of Saudi Arabia (KSA) during the pandemic. Methods: A qualitative phenomenological study using semi-structured in-depth interviews were conducted with 75 purposively selected healthcare providers and administrative staff working at three main hospitals in the Qassim Region, KSA. The maximum variation sampling technique was utilized. Recruitment of participants was continued until data saturation was reached. All interviews were audiotaped, transcribed verbatim, and analyzed thematically. Results: Four core themes were identified in this paper: (1) changes in hospital policy and procedures, (2) workforce management, (3) the well-being of the workforce, and (4) apprehensions and expectations of the workforce. The participants showed satisfaction with timely administrative decisions and new policies during the COVID-19 pandemic. Furthermore, the psychological health of healthcare professionals was affected more than their physical state. Finally, the providers perceived the emergence of multiple concerns in the coming months. Conclusion: Although healthcare providers were initially overwhelmed, they gradually accepted new administrative policies. Numerous innovative interventions effectively reduced their physical workload and increased their productivity, but they remained significantly affected by a wide range of psychological disorders, with a high prevalence of obsessive-compulsive disorder. There were some concerns about the new SARS-CoV-2 variant, but the majority were optimistic.
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COVID-19 , Humans , COVID-19/epidemiology , SARS-CoV-2 , Saudi Arabia/epidemiology , Pandemics , Health Personnel/psychology , Attitude of Health PersonnelABSTRACT
Introduction: Covid-19 pandemic had significant impact on stroke care management and reduced the number of stroke admissions. A delay in treatment resulted in a more severe stroke with higher morbidity and mortality. Objective(s): To determine impact of Covid- 19 on the total number of admissions of stroke patients, compare ischemic stroke standard of care and outcome before and during Covid-19 pandemic. Methodology: A retrospective record review study. Data of patients with radiologically and - /or clinically confirmed AIS in HUSM who were diagnosed from 1st March 2019-28th February 2021 were recorded. Those who fulfilled the criteria were included in the study. Result(s): 229 patients were involved in this study;114 (49.8%) patients in the pre-Covid-19 period, and 115 (50.2%) patients during Covid-19 period. NIHSS score was similar, 5.3 +/- (4.18) in 2019 and 5.9 +/- (4.42) in 2020. There was no difference in terms of onset to door time between the two groups. However, we noticed a significant delay of onset to door time in both groups: 1875.2 min (31.25) hours in pre- Covid-19 vs. 1827.1 (30.45) hours during Covid-19 group (t. test 0.17, p = 0.863). The waiting time to see an ED (in minutes) dropped from 25.3 (30.21) during pre -Covid-19 period vs. 22.6 (16.48) in Covid- 19 group (t. test 0.48, p = 0.402). Door to CT brain time was 83.8 (58.91) vs 92.4 (120.20) during pre-Covid and Covid group (t. test -0.69, p = 0.493). There was a sharp decrease in patients who seek thrombolytic therapy from 7(6.1%) during pre-covid-19 to 4 (3.5%) during Covid-19 period (p = 0.354). As physiotherapy, occupational therapy, speech therapy assessment, the results are as follows;(77.2% vs. 81.7% p = 0.372), (76.3% vs. 81.7% p = 0.334), (50% vs. 59.1% p = 0.185), (43.9% vs. 45.2% p = 0.894) respectively. The duration of hospital stay was (6.4 +/- 4.5 vs. 7.5 +/- 6.74 (t. test -1.36, p = 0.175). MRS score at discharge was [2.8 (1.38) vs 2.9 (1.49)] (t. test -0.33 p = 0.742) for pre-Covid-19 and during Covid-19 group. Conclusion(s): The Covid-19 pandemic had no significant impact on stroke management and neurological outcomes for patients seeking treatment in HUSM.Copyright © 2023
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Safe, effective, and accessible vaccines are urgently needed to end tuberculosis (TB) by 2030. The 6th Global Forum on TB Vaccines, convened virtually 22–25 February 2022, was hosted by Toulouse, France, under the high patronage of President Emmanuel Macron, and the patronages of Minister for Solidarity and Health, Olivier Véran, and Minister for Higher Education, Research and Innovation, Frédérique Vidal. The theme for the meeting, "New horizons for TB vaccines”, reflected the changing landscape in which TB vaccine research and development (R&D) is being conducted: TB vaccines advancing into late-stage clinical trials and toward licensure, innovative research toward diversifying the TB vaccine pipeline and developing the next generation of candidates, increasing political, civil society, and community support for TB vaccines, and the ongoing COVID-19 pandemic. In this report, we summarize key themes and findings from the meeting, highlighting progress and gaps in the TB vaccine field.
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BACKGROUND: COVID-19 pandemic has affected all dimensions of day to day life across the world and medical education was no exception. With this study, we aimed to understand the effect of nationwide restrictions on medical education in Qatar, the models of education adopted during this period and perceptions of participants to the same. METHODS: We conducted a cross-sectional study utilizing an online questionnaire distributed via convenience sampling between April-October 2020. Study participants were faculty and trainees in governmental undergraduate and postgraduate medical education institutes. Two sets of questionnaires were designed for each group. They were asked a series of questions to assess pre- and post-COVID pandemic educational practices, their preferred teaching methods, and their familiarity with electronic teaching platforms. Faculty respondents were asked about their perceived barriers to delivery of medical education during the pandemic and their agreement on a 5-point Likert scale on specific elements. Trainees were asked a series of multiple-choice questions to characterize their pre- and post-COVID pandemic educational experiences. Both groups were asked open-ended questions to provide qualitative insights into their answers. Data were analysed using STATA software version 12.0. RESULTS: Majority of trainees (58.5%) responded that the pandemic has adversely affected medical education at both the undergraduate and postgraduate levels. Trainees (58.5%) and faculty (35.7%) reported an increased reliance on e-learning. Trainees preferred face-to-face education, while faculty preferred a combination of models of education delivery (33.5% versus 37.1%, p = 0.38). Although 52.5% of the faculty had no previous experience of delivering education through e-learning modalities, 58.9% however felt confident in using e-learning software. CONCLUSIONS: Faculty and trainees agree that the COVID-19 pandemic has had a significant impact on the provision of medical education and training in Qatar, with an increased dependence on e-learning. As trainee's prefer face-to-face models of education, we may have to consider restructuring of medical curricula in order to ensure that optimum learning is achieved via e-learning, while at the same time enhancing our use, knowledge and understanding of the e -learning methods. Further research is warranted to assess if these changes have influenced objective educational outcomes like graduation rates or board scores.
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COVID-19 , Education, Medical , COVID-19/epidemiology , Cross-Sectional Studies , Humans , Pandemics , Qatar/epidemiologyABSTRACT
Background. Point-of-care antigen-detecting rapid diagnostic tests (RDTs) to detect Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) represent a scalable tool for surveillance of active SARS-CoV-2 infections in the population. Data on the performance of these tests in real-world community settings will be paramount for their implementation to combat the COVID-19 pandemic. Methods. We evaluated the performance characteristics of the CareStartTM COVID-19 Antigen Test (CareStart) in a community testing site in Holyoke, Massachusetts. We compared CareStart to a SARS-CoV-2 reverse transcriptase quantitative polymerase chain reaction (RT-qPCR) reference, both using anterior nasal swab samples. We calculated the sensitivity, specificity, and the expected positive and negative predictive values at different SARS-CoV-2 prevalence estimates. Results. We performed 666 total tests on 591 unique individuals. 573 (86%) were asymptomatic. There were 52 positive tests by RT-qPCR. The sensitivity of CareStart was 49.0% (95% Confidence Interval (CI): 34.8 - 63.4) and specificity was 99.5% (95% CI: 98.5 - 99.9). Among positive RT-qPCR tests, the median cycle threshold (Ct) was significantly lower in samples that tested positive on CareStart. Using a Ct less than or equal to 30 as a benchmark for positivity increased the sensitivity of the test to 64.9% (95% CI: 47.5 - 79.8). Performance characteristics of CareStart test results benchmarked against the RT-qPCR gold standard (excluding undetermined results). Examples of images of CareStart rapid test showing variable band intensities. N2 gene RT-qPCR Cycle threshold (Ct) values corresponding to positive and negative CareStart rapid antigen test results for all RT-qPCR positive samples (n=52). Conclusion. Our study shows that CareStart has a high specificity and moderate sensitivity. The utility of RDTs, such as CareStart, in mass implementation should prioritize use cases in which a higher specificity is more important, such as triage tests to rule-in active infections in community surveillance programs.
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INTRODUCTION: SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2;causes coronavirus disease [COVID-19]). Alcohol Use Disorder (AUD) comorbid with COVID-19 (AUD+COVID-19) could present with severe symptoms, if the pre-existing proinflammatory state of AUD were aggravated by the inflammation of COVID-19. However, the exacerbation of clinical and laboratory markers is understudied in COVID-19 patients with excessive alcohol drinking. We previously reported two patients with alcohol-associated hepatitis and COVID who died. Thus, we aimed to evaluate the impact of alcohol use in the inflammatory response in patients with COVID-19. Methods: We conducted a retrospective study of 238 patients with COVID-19 from a single hospital registry who had a known drinking history. Patients were grouped by their reported amount of alcohol consumption: alcohol abstainers (AlcA, n= 183, 77 % as disease controls);social drinkers (SD, drank < 4, if females, and < 5, if males, drinks/week, n=37 [16%] as intermediate responders of alcohol intake);and excessive drinkers (ExD, drank >4, if females, and > 5, if males, drinks/week n=16 [7%] as the comorbid condition). Clinical and laboratory markers were compared between the groups for identifying any key differences. Results: Mean age of the patients was 43 yrs. in this study. Among the patients, 37% were African American, 37.5% Caucasians and 23% Hispanics. Only 18 patients had an underlying liver disease. Males represented 46 % of the total population, there were no other demographic differences. The lymphocyte count was significantly elevated, (p=0.008) in the in SD compared to AlcA. Discussion: Lymphopenia and increased levels of inflammatory and injury markers has been associated with disease severity inCOVID-19. Inonemeta-analysis, potential biomarkers were examined for correlation with severity of COVID-19. Severe COVID-19 cases were found to have significantly lower lymphocyte count. We found a significant difference in lymphocyte count in patients with alcohol consumption as compared to non-drinkers. Lymphopenia has previously been correlated with alcohol use. Conclusion: Determination of lymphocyte count could potentially be useful in determining and distinguishing the severity of inflammation/injury in COVID- 19 patients comorbid with excessive drinking. This study is underpowered, but is potentially useful for the care of COVID patients with excessive drinking. (Table presented.)
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This study explores the level and frequency of anxiety about COVID-19 infection in some Middle Eastern countries, and differences in this anxiety by country, gender, workplace, and social status. Another aim was to identify the predictive power of anxiety about COVID-19 infection, daily smartphone use hours, and age in smartphone addiction. The participants were 651 males and females from Jordan, Saudi Arabia, the United Arab Emirates, and Egypt. The participants' ages ranged between 18 and 73 years (M 33.36, SD = 10.69). A questionnaire developed by the authors was used to examine anxiety about COVID-19 infection. Furthermore, the Italian Smartphone Addiction Inventory was used after being translated, adapted, and validated for the purposes of the present study. The results revealed that the percentages of participants with high, average, and low anxiety about COVID-19 infection were 10.3%, 37.3%, and 52.4%, respectively. The mean scores of anxiety about COVID-19 infection in the four countries were average: Egypt (M = 2.655), Saudi Arabia (M = 2.458), the United Arab Emirates (M = 2.413), and Jordan (M = 2.336). Significant differences in anxiety about COVID-19 infection were found between Egypt and Jordan, in favor of Egypt. Significant gender differences were found in favor of females in the Jordanian and Egyptian samples, and in favor of males in the Emirati sample. No significant differences were found regarding workplace and social status. The results also revealed a significant positive relationship between anxiety about COVID-19 infection, daily smartphone use hours, and age on the one hand, and smartphone addiction on the other. The strongest predictor of smartphone addiction was anxiety about COVID-19 infection, followed by daily use hours. Age did not significantly contribute to the prediction of smartphone addiction. The study findings shed light on the psychological health and cognitive aspects of anxiety about COVID-19 infection and its relation to smartphone addiction.
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Behavior, Addictive , COVID-19 , Adolescent , Adult , Aged , Anxiety/epidemiology , Behavior, Addictive/epidemiology , Demography , Female , Humans , Internet Addiction Disorder , Male , Middle Aged , SARS-CoV-2 , Smartphone , Young AdultABSTRACT
RATIONALE: Several studies have identified risk factors for increased mortality due to the COVID-19 infection. However, few have assessed whether these risks have changed between each wave of the pandemic, particularly with the introduction of new treatment options. We analyzed the differences in risk factors associated with mortality in each individual surge of the pandemic. METHODS: A single center retrospective chart review of COVID-19 positive patients (n=310) treated at the University of Louisville Hospital was performed from March 2020. Surge periods were divided March 1st - May 31st (wave 1) and June 1st - August 31st (wave 2) to identify risk factors for outcomes between periods. A spearman correlation analysis was performed, and odds ratios were calculated using the Fisher-exact test (p ≤ 0.05). Partial Least Squares and Random Forest classification models were trained using mortality as the primary outcome and validated with 100 resampling iterations of 5-fold cross validation. RESULTS: This analysis included 124 patients for wave 1 and 152 patients in wave 2. During the first wave, significant risk factors that predicted mortality included patients treated with convalescent plasma or hydroxychloroquine, a prior history of hyperlipidemia, or type 2 diabetes mellitus. Significant odds ratios for mortality included the same variables in addition to the presence of altered mental status, on admission, a history of hypertension, and treatment with azithromycin for COVID-19. In the second wave of infections, initial blood pressure and sex were the most predictive variables for mortality. Significant odds ratios were a prior history of neoplastic disease in the previous year and, again, the presence of altered mental status. CONCLUSION: Comparison between these two periods show a possible epidemiological transition from adults less than 65 years with multiple comorbidities to patients greater than 65 years, nursing home residents, and with immunocompromised states. Predictive factors for mortality in the first wave appear to be related to the use of experimental therapies and comorbidities, while clinical symptoms were more pertinent during the second wave. These results show that predicting overall mortality may have changed over the course of the pandemic. This may be due to the availability of novel treatment options and a better understanding of the approach to supportive care. As hospitals continue to be overwhelmed by the rising incidence and mortality related to COVID-19, identifying patients at a higher risk of mortality may improve overall healthcare cost and utilization by appropriately triaging therapy.