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2.
J Infect Public Health ; 15(2): 261-269, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1620857

ABSTRACT

INTRODUCTION: To mitigate morbidity, mortality, and impacts of COVID-19 on health, it was essential to implement a comprehensive framework for COVID-19 control and prevention. A well-recognized tool from the field of injury prevention known as the Haddon matrix was utilized. The matrix states that any accident is affected by the host, agent, and environment. Another well-recognized tool used by the national fire protection association known as the Community risk reduction tool (CRR). The (CRR) tool utilizes the Five E's of Community Risk Reduction. AIM OF THE STUDY: To describe the risk factors that increase the susceptibility and the severity of COVID-19 infection based on the Haddon matrix and the proposed prevention strategies by the CRR tool by using the combined model. METHODOLOGY: We reviewed the literature to assess known factors contributing to COVID-19 susceptibility, infection, and severity of infection. We then used the Haddon matrix to structure, separating human factors from technical and environmental details and timing. We then used the community risk reduction (CRR) model to set all responses and control measures for each element obtained from the Haddon matrix tool. Subsequently, we incorporated both tools to develop the combined model. CONCLUSION: we proposed and implemented a combined model that utilizes the CRR model as the systematic strategy for the more theoretical framework of Haddon's matrix. Combining both models was practical and helpful in planning the preparedness and control of the COVID-19 pandemic in Saudi Arabia that can be generalized to national and international levels.


Subject(s)
COVID-19 , Humans , Pandemics/prevention & control , Risk Factors , Risk Reduction Behavior , SARS-CoV-2
3.
East Mediterr Health J ; 27(11): 1109-1113, 2021 Dec 01.
Article in English | MEDLINE | ID: covidwho-1566971

ABSTRACT

BACKGROUND: The prevalence of Middle East respiratory syndrome coronavirus (MERS-CoV) infection during the period of coronavirus disease 2019 (COVID-19) remains uncertain. AIMS: This study aimed to provide an update on the epidemiology of MERS-CoV in Saudi Arabia from January 2019 to October 2020. METHODS: Data on all laboratory-confirmed cases of MERS-CoV infection in Saudi Arabia from January 2019 to 20 October 2020 were retrieved from the Health Electronic Surveillance Network of the Ministry of Health of Saudi Arabia. Data collected were: demographic characteristics of cases, clinical course of the infection, related mortality and association with exposure to confirmed cases or camels. RESULTS: In total, 299 cases of MERS-CoV infection were reported in the study period. The mean age of cases was 52.4 years. Most of the cases were males (78.9%) and had comorbidities (72.7%), and 11.9% of cases were health care providers. Of the 299 cases, 83 (27.7%) died. Older age and having comorbidities were associated with higher mortality. Exposure to camels was associated with lower mortality. Health care providers also had a lower mortality rate than non-health care providers. Compared with COVID-19, MERS-CoV infection still has a higher mortality rate but with a more predictable pattern and an anticipated deterioration. CONCLUSION: MERS-CoV infection remains a public health concern. The percentage of cases that were health care providers (11.9%) is lower than previously reported (19.1-25.0%), possibly due to the various preventive measures put in place to control COVID-19.


Subject(s)
COVID-19 , Middle East Respiratory Syndrome Coronavirus , Aged , Humans , SARS-CoV-2 , Saudi Arabia/epidemiology
4.
East Mediterr Health J ; 27(11): 1114-1124, 2021 Dec 01.
Article in English | MEDLINE | ID: covidwho-1566970

ABSTRACT

BACKGROUND: With the spread of coronavirus disease 2019 (COVID-19), most countries rushed to take early measures to control this disease. AIMS: This paper describes and evaluates the Saudi Arabian strategic preparedness and response plan on COVID-19 up to 31 December 2020. METHODS: Saudi Arabia adopted the World Health Organization's guidelines on response to COVID-19, which are based on nine pillars of public health preparedness and response. The measures Saudi Arabia took are assessed against these pillars. RESULTS: In response to COVID-19, Saudi Arabia prepared public and private institutions to deal with the pandemic. Saudi authorities established a governance system comprised of responsible committees to continuously monitor national and international updates, trace contacts, screen the population, raise awareness and take proper actions to contain the spread of this disease. After the announcement of the first case in Saudi Arabia, all schools, social events, sports activities, domestic travel and international flights were suspended. Restrictions on social movement, social and religious gatherings, travel and businesses were imposed ahead of the first 100 confirmed COVID-19 cases. The Hajj pilgrimage for 2020 was scaled down to limit participants and no cases of COVID-19 were detected among pilgrims. The country maintained all basic health services and immunization programmes and supported all proposals for COVID-19 drugs and vaccines. The country is working to develop its capacity to produce these products and achieve self-sufficiency. CONCLUSION: Saudi Arabia took extreme measures to respond to COVID-19 which contributed to limiting the spread and effect of the disease.


Subject(s)
COVID-19 , Humans , SARS-CoV-2 , Saudi Arabia , Travel , Vaccination
5.
Infection ; 2021 Dec 08.
Article in English | MEDLINE | ID: covidwho-1562335

ABSTRACT

BACKGROUND: The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection had been investigated utilizing serology. MATERIALS AND METHODS: This community-based sero-survey was carried out in the neighborhoods of three cities in Saudi Arabia. RESULTS: Of 5629 participants, 2766 (49.1%) were women; and 2148 (38.1%) were 18-34 years of age, and 3645 (64.7%) were from South East Asia. Positive serology was seen in 2825 (50.2% (95% CI: 48.8-51.5%) for SARS-CoV-2 anti-S1 IgG antibodies by ECLIA. Being in the age category of 18-34 years and being from Eastern Mediterranean Region (country A) were associated with higher COVID-19 seropositivity with estimated odds ratio of 1.3 [95% CI 1.1-1.8] and 2.5 [95% CI 1.1.5-4.2] respectively. Gender, social status, education, nationality, symptoms, presence of comorbidities and activity style were positively associated with increased seropositivity. Factors associated negatively with the rate of seropositivity were higher education and having outdoor activity with estimated OR of 0.92 [95% CI 0.46-0.95] and 0.59 [95% CI 0.47-0.74], respectively. CONCLUSION: The study showed high seroprevalence of SARS-CoV-2 among high density population. Health education campaigns should target middle-aged, those with low education, those living in lower standards and indoor workers.

6.
Front Immunol ; 12: 727989, 2021.
Article in English | MEDLINE | ID: covidwho-1450808

ABSTRACT

BACKGROUND: A growing number of experiments have suggested potential cross-reactive immunity between severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and previous human coronaviruses. We conducted the present retrospective cohort study to investigate the relationship between previous Middle East respiratory syndrome-coronavirus (MERS-CoV) infection and the risk of SARS-CoV-2 infection as well as the relationship between previous MERS-CoV and COVID-19-related hospitalization and mortality. METHODS: Starting in March 2020, we prospectively followed two groups of individuals who tested negative for COVID-19 infection. The first group had a previously confirmed MERS-CoV infection, which was compared to a control group of MERS-negative individuals. The studied cohort was then followed until November 2020 to track evidence of contracting COVID-19 infection. FINDINGS: A total of 82 (24%) MERS-positive and 260 (31%) MERS-negative individuals had COVID-19 infection. Patients in the MERS-positive group had a lower risk of COVID-19 infection than those in the MERS-negative group (Risk ratio [RR] 0.696, 95% confidence interval [CI] 0.522-0.929; p =0.014). The risk of COVID-19-related hospitalization in the MERS-positive group was significantly higher (RR 4.036, 95% CI 1.705-9.555; p =0.002). The case fatality rate (CFR) from COVID-19 was 4.9% in the MERS-positive group and 1.2% in the MERS-negative group (p =0.038). The MERS-positive group had a higher risk of death than the MERS-negative group (RR 6.222, 95% CI 1.342-28.839; p =0.019). However, the risk of mortality was similar between the two groups when death was adjusted for age (p =0.068) and age and sex (p =0.057). After controlling for all the independent variables, only healthcare worker occupation and >1 comorbidity were independent predictors of SARS-CoV-2 infection. INTERPRETATION: Individuals with previous MERS-CoV infection can exhibit a cross-reactive immune response to SARS-CoV-2 infection. Our study demonstrated that patients with MERS-CoV infection had higher risks of COVID-19-related hospitalization and death than MERS-negative individuals.


Subject(s)
COVID-19/epidemiology , COVID-19/mortality , Cross Reactions/immunology , Middle East Respiratory Syndrome Coronavirus/immunology , SARS-CoV-2/immunology , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Hospitalization/statistics & numerical data , Humans , Infant , Infant, Newborn , Male , Middle Aged , Prospective Studies , Retrospective Studies , Saudi Arabia/epidemiology , Young Adult
7.
Risk Manag Healthc Policy ; 14: 3923-3934, 2021.
Article in English | MEDLINE | ID: covidwho-1443915

ABSTRACT

INTRODUCTION: The novel coronavirus (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a single-chain ribonucleic acid (RNA) virus. As of March 25, 2021, the total number of positive cases and fatalities in the Kingdom of Saudi Arabia (KSA) had reached 386,300 and 6624, respectively, with a case fatality rate of 1.71%. The KSA was among the leading nations to heed the advice of WHO officials and put strict precautionary and preventive measures in place to curb the early spread of COVID-19 before it was declared a global pandemic. METHODOLOGY: This was an uncontrolled before-after study following a mixed-method approach for data collection. National and regional data were extracted from the Health Electronic Surveillance Network (HESN), a centralized public health collection system for quantitative and statistical data. Quantitative and qualitative methods have been utilized in studying data derived from tech media. RESULTS: The Saudi authorities utilized different technological tools to aid in managing and combating the COVID-19 pandemic. In the case of Al Madinah Al Mounawarah, after the implementation of several technologies, the most important being Tawakkalna, the number of active daily cases decreased by 61%. CONCLUSION: The use of the Tawakkalna application was proven to be a successful method in fighting the COVID-19 pandemic in the KSA. This vital and essential experience warrants the use of different digital technology that offers a personalized profile displaying the person's status (affected, vaccinated, or no history of infection). This application played and will continue to play a crucial and effective role in pandemic containment in Saudi Arabia.

8.
Travel Med Infect Dis ; 43: 102119, 2021.
Article in English | MEDLINE | ID: covidwho-1267935

ABSTRACT

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARSCoV- 2) emerged in Wuhan City, China. The SARS-CoV-2 crossed borders and quickly transformed into a "Public health emergency of international concern". Countries around the globe are in the race to achieve herd immunity. We describe the steps taken by Saudi Arabia to achieve this goal.


Subject(s)
COVID-19 Vaccines , COVID-19 , Humans , SARS-CoV-2 , Saudi Arabia , Vaccination
9.
Disaster Med Public Health Prep ; : 1-7, 2021 Apr 19.
Article in English | MEDLINE | ID: covidwho-1191546

ABSTRACT

OBJECTIVES: To assess the hospital beds and intensive care unit (ICU) beds with a ventilator surge capacity of the health system in Kingdom of Saudi Arabia (KSA) during the coronavirus disease (COVID-19) pandemic. METHODS: This study used relevant data from the National Health Emergency Operation Center to estimate general hospital and ICU bed surge capacity and tipping points under 3 distinct transmission scenarios. RESULTS: The study results reveal that hospitals in the KSA need to be supplied with additional 4372 hospital beds to care for COVID-19 positive cases if the pandemic continues over a 6 months' period. At the same time, it requires additional 2192 or 1461 hospital beds if the pandemic persists over a 12- or 18-month period, respectively, to manage hospitalized COVID-19 overloads. The health system surge capacity would suffer from a shortage of 1600, 797, and 540 ICU beds under the 3 transmission scenarios to absorb critical and intensive care COVID-19 cases. CONCLUSION: Our findings highlight the urgent need for additional hospital and ICU beds in the face of critical COVID-19 cases in KSA. The study recommends further assessment measures to the health system surge capacity to keep the Saudi health system prepared during the COVID-19 pandemic.

10.
Risk Manag Healthc Policy ; 14: 779-790, 2021.
Article in English | MEDLINE | ID: covidwho-1117623

ABSTRACT

PURPOSE: The novel coronavirus (COVID-19), declared a pandemic by WHO in March 2020, is an unprecedented occurrence in our recent history. Effective risk communication by health authorities, through relaying reliable and authoritative information, is imperative in combating the spread of the outbreak. We aimed to measure the effectiveness of risk communication campaign and overall awareness during COVID-19 pandemic among the general population in Saudi Arabia. PATIENTS AND METHODS: A cross-sectional survey of 5472 individuals in Saudi Arabia was conducted to assess several factors regarding the risk communication messages during the COVID-19 pandemic, including the knowledge and response of the general population toward COVID-19 and MoH efforts. The questionnaire was divided into five main sections: general knowledge of COVID-19, channels and social media platforms used perceived risk and stress or panic toward COVID-19, satisfaction and community perception, most trusted source of information, and type of information received. RESULTS: A total of 5472 individuals participated in the study residing in Saudi Arabia. Overall knowledge of COVID-19 was determined to be above average (0.58 + 0.159). Of the general population, 57.1% perceived that the risk of getting sick with COVID-19 is low, while nearly half of the respondents (45.7%) have a high level of stress and panic toward COVID-19. The majority of responders to the questionnaire reinforced that MoH was their most trusted source of information for the COVID-19 pandemic (91.7%). CONCLUSION: This study showed that the risk communication campaign by healthcare authorities during the COVID-19 pandemic has improved the awareness among the general population in Saudi Arabia, where the overwhelming majority placed high trust in the MoH as its main reference for COVID-19 information.

11.
Int J Infect Dis ; 104: 452-457, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1071447

ABSTRACT

BACKGROUND: Serologic testing provides better understanding of SARS-CoV-2 prevalence and its transmission. This study was an investigation of the prevalence of antibodies to SARS-CoV-2 among blood donors in Saudi Arabia. OBJECTIVE: To estimate the seroprevalence of anti-SARS-CoV-2 antibodies among blood donors in Saudi Arabia during the early phase of the COVID-19 pandemic. METHODS: Serology results and epidemiological data were analyzed for 837 adult blood donors, with no confirmed SARS-CoV-2 infection, in Saudi Arabia from 20th to 25th May 2020. Seroprevalence was determined using electrochemical immunoassay to detect anti-SARS-CoV-2 antibodies. RESULTS: The overall seroprevalence of anti-SARS-CoV-2 antibodies was 1.4% (12/837). Non-citizens had higher seroprevalence compared with citizens (OR 13.6, p = 0.001). Secondary education was significantly associated with higher seroprevalence compared with higher education (OR 6.8, p = 0.005). The data showed that the highest seroprevalence was in Makkah (8.1%). Uisng Makkah seroprevalence as the reference, the seroprevalence in other areas was: Madinah 4.1% (OR 0.48, 95% CI 0.12-1.94), Jeddah 2.3% (OR 0.27, 95% CI 0.31-2.25), and Qassim 2.9 % (OR 0.34, 95% CI 0.04-2.89) and these were not statistically different from seroprevalence in the Makkah region. CONCLUSIONS: At the early months of the COVID-19 pandemic in Saudi Arabia, the seroprevalence of antibodies to SARS-CoV-2 among blood donors was low, but was higher among non-citizens. These findings may indicate that non-citizens and less educated individuals may be less attentive to preventive measures. Monitoring seroprevalence trends over time require repeated sampling.


Subject(s)
Antibodies, Viral/blood , Blood Donors , COVID-19/immunology , SARS-CoV-2/immunology , Adolescent , Adult , Aged , COVID-19/epidemiology , Cross-Sectional Studies , Female , Humans , Immunoassay , Immunoglobulin G/blood , Male , Middle Aged , Saudi Arabia/epidemiology , Seroepidemiologic Studies , Young Adult
12.
Diagn Microbiol Infect Dis ; 99(3): 115273, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1065006

ABSTRACT

Healthcare workers (HCWs) stand at the frontline for fighting coronavirus disease 2019 (COVID-19) pandemic. This puts them at higher risk of acquiring the infection than other individuals in the community. Defining immunity status among health care workers is therefore of interest since it helps to mitigate the exposure risk. This study was conducted between May 20th and 30th, 2020. Eighty-five hospitals across Kingdom of Saudi Arabia were divided into 2 groups: COVID-19 referral hospitals are those to which RT-PCR-confirmed COVID-19 patients were admitted or referred for management (Case-hospitals). COVID-19 nonaffected hospitals where no COVID-19 patients had been admitted or managed and no HCW outbreak (Control hospitals). Next, seroprevalence of severe acute respiratory syndrome coronavirus 2 among HCWs was evaluated; there were 12,621 HCWs from the 85 hospitals. There were 61 case-hospitals with 9379 (74.3%) observations, and 24 control-hospitals with 3242 (25.7%) observations. The overall positivity rate by the immunoassay was 299 (2.36%) with a significant difference between the case-hospital (2.9%) and the control-group (0.8%) (P value <0.001). There was a wide variation in the positivity rate between regions and/or cities in Saudi Arabia, ranging from 0% to 6.31%. Of the serology positive samples, 100 samples were further tested using the SAS2pp neutralization assay; 92 (92%) samples showed neutralization activity. The seropositivity rate in Kingdom of Saudi Arabia is low and varies across different regions with higher positivity in case-hospitals than control-hospitals. The lack of neutralizing antibodies (NAb) in 8% of the tested samples could mean that assay is a more sensitive assay or that neutralization assay has a lower detection limits; or possibly that some samples had cross-reaction to spike protein of other coronaviruses in the assay, but these were not specific to neutralize severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).


Subject(s)
COVID-19/epidemiology , Health Personnel , Hospitals , SARS-CoV-2/isolation & purification , Antibodies, Neutralizing/blood , Antibodies, Viral/blood , COVID-19/blood , COVID-19/virology , Case-Control Studies , Humans , Infection Control , Odds Ratio , Risk Factors , SARS-CoV-2/immunology , Saudi Arabia/epidemiology , Seroepidemiologic Studies
13.
Front Public Health ; 8: 606385, 2020.
Article in English | MEDLINE | ID: covidwho-1063369

ABSTRACT

A highly accelerating number of people around the world have been infected with novel Coronavirus disease 2019 (COVID-19). Mass screening programs were suggested by the World Health Organization (WHO) as an effective precautionary measure to contain the spread of the virus. On 16 April 2020, a COVID-19 mass screening program was initiated in Saudi Arabia in multiple phases. This study aims to analyze the number of detected COVID-19 cases, their demographic data, and regions most affected in the initial two phases of these mass screening programs. A retrospective cross-sectional study was conducted among the high-risk population as part of the COVID-19 mass screening program across all regions in Saudi Arabia during April and May 2020. A Chi-square-test was used to determine the associations between positive cases and various demographic variables. Out of 71,854 screened individuals, 13.50% (n = 9701) were COVID-19 positive, of which 83.27% (n = 59,835) were males. Among positive cases, in the 30-39 years age group, 6.36% were in the active phase, and 2.19% were in the community phase. Based on our experience, launching mass screening programs is crucial for early case detection, isolation, and pattern recognition for immediate public interventions.


Subject(s)
COVID-19/epidemiology , Mass Screening , Adult , Cross-Sectional Studies , Female , Humans , Infection Control , Male , Middle Aged , Retrospective Studies , SARS-CoV-2/isolation & purification , Saudi Arabia/epidemiology , Sex Factors
14.
J Infect Public Health ; 14(4): 437-443, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1032455

ABSTRACT

BACKGROUND: The aim of this study is to describe the clinical and demographic characteristics of COVID-19 patients, and the risk factors associated with death in Saudi Arabia to serve as a reference to further understand this pandemic and to help in the future decisions and control of this global crisis. METHODS: This multicenter, retrospective, observational, cross-sectional study was conducted on 240,474 patients with confirmed COVID-19 in Saudi Arabia. Data was collected retrospectively through the Health Electronic Surveillance Network at the Ministry of Health. Patients were classified based on their outcome as recovered, dead, or active with no definite outcome. We must specify the date period. RESULTS: As of 20th of June 2020, 79.7% of COVID-19 cases were young and middle-aged, ranging between 20-59 years. There was evidently a difference in the sex ratio, where males constituted 71.7% of cases. The majority were non-Saudi nationals, representing 54.7% of cases. Furthermore, the contraction of COVID-19 was travel-related in 45.1% of cases. Signs and symptoms were reported in 63% of cases, the most common of which were fever; 85.2%, and cough; 85%. Deaths occurred more frequently in patients 40-49 years, 50-59 years, and 60-69 years, representing 19.2%, 27.9%, and 21.3% of deaths, respectively. Additionally, the case fatality rate (CFR) was higher in older age-groups, reaching 10.1% in those ≥80 years. Moreover, the CFR of males was higher than that of females, with 0.95% and 0.62%, respectively. As for nationality, Saudis had a CFR of 0.46% versus 1.19% in non-Saudis. CONCLUSION: The total number of positive COVID-19 cases detected constitute 0.7% of the Saudi population to date. Older age, non-Saudi nationalities, being male, travelling outside Saudi Arabia, and the presence of symptoms, as opposed to being asymptomatic were considered risk factors and found to be significantly more associated with death in patients with COVID-19.


Subject(s)
COVID-19/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/mortality , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Retrospective Studies , Risk Factors , Saudi Arabia/epidemiology , Sex Ratio , Travel , Young Adult
16.
East Mediterr Health J ; 26(12): 1570-1575, 2020 Dec 09.
Article in English | MEDLINE | ID: covidwho-995096

ABSTRACT

BACKGROUND: During the 2019 Hajj, the Ministry of Health in Saudi Arabia implemented for the first time a health early warning system for rapid detection and response to health threats. AIMS: This study aimed to describe the early warning findings at the Hajj to highlight the pattern of health risks and the potential benefits of the disease surveillance system. METHODS: Using syndromic surveillance and event-based surveillance data, the health early warning system generated automated alarms for public health events, triggered alerts for rapid epidemiological investigations and facilitated the monitoring of health events. RESULTS: During the deployment period (4 July-31 August 2019), a total of 121 automated alarms were generated, of which 2 events (heat-related illnesses and injuries/trauma) were confirmed by the response teams. CONCLUSION: The surveillance system potentially improved the timeliness and situational awareness for health events, including non-infectious threats. In the context of the current COVID-19 pandemic, a health early warning system could enhance case detection and facilitate monitoring of the disease geographical spread and the effectiveness of control measures.


Subject(s)
COVID-19/epidemiology , Communicable Disease Control/organization & administration , Disease Outbreaks/prevention & control , Islam , Public Health Administration/methods , Public Health Surveillance/methods , Crowding , Health Planning/organization & administration , Humans , Mass Behavior , Mediterranean Region/epidemiology , Pandemics , SARS-CoV-2 , Saudi Arabia/epidemiology , Sentinel Surveillance , Travel
17.
Health Secur ; 19(2): 133-139, 2021.
Article in English | MEDLINE | ID: covidwho-954140

ABSTRACT

The Hajj pilgrimage, held in the Kingdom of Saudi Arabia, is among the largest mass gatherings in the world. More than 2.5 million Muslim pilgrims assemble from over 180 countries worldwide to perform Hajj. The Saudi government recognized the potential risks associated with this event since the first novel coronavirus disease 2019 (COVID-19) case was detected in the country on March 2, 2020. The return of possibly infected pilgrims to their countries after this huge mass gathering event could have turned Hajj into a superspreading event during the global COVID-19 pandemic. A multidisciplinary Saudi team from governmental sectors, including the Global Center for Mass Gatherings Medicine, shared in the assessment, planning, execution, and success of this holy event to prevent the spread of disease. The World Health Organization welcomed the Saudi government's decision to protect the wellbeing and safety of pilgrims and strengthen regional and global health security. A total of 1,000 pilgrims from 160 different countries were randomly selected to perform the rituals. Of all the pilgrims, healthcare personnel, and nonmedical employees facilitating the rituals, no confirmed cases of COVID-19 were identified during or after Hajj. This article highlights the success of the risk mitigation plan in place during the Hajj pilgrimage in 2020 (1441 Hijri year) during the COVID-19 pandemic and the efforts of the Saudi government to prevent associated outbreaks.


Subject(s)
COVID-19/prevention & control , Communicable Disease Control/organization & administration , Islam , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , COVID-19/epidemiology , Ceremonial Behavior , Humans , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , SARS-CoV-2 , Saudi Arabia/epidemiology , Travel
18.
East Mediterr Health J ; 26(11): 1371-1380, 2020 Nov 11.
Article in English | MEDLINE | ID: covidwho-940512

ABSTRACT

BACKGROUND: The rapid emergence of the novel coronavirus disease 2019 (COVID-19) has resulted in millions of infected patients and hundreds of thousands of deaths worldwide. Health care services delivery is being compromised due to the surge in the number of infected patients during this pandemic. AIMS: This study aimed to assess the risk factors associated with poor prognosis among COVID-19 patients in Saudi Arabia. METHODS: This was a multi-centre retrospective cohort study that included all laboratory-confirmed COVID-19 cases with definitive outcomes in Saudi Arabia during March 2020. Demographic, clinical history, comorbidity and outcomes data were retrieved from the National Health Electronic Surveillance Network (HESN) database. We used logistic regression models to calculate crude and adjusted odds ratios (OR) to explore risk factors for critical outcomes (intensive care unit admission or death) among COVID-19 cases. RESULTS: We included 648 COVID-19-positive patients with a median age of 34 years. Of these, 11.9% were in the critical group. Risk factors associated with worse outcomes included males (OR=1.92), age >60 years (OR=3.65), cardiac diseases (OR=3.05), chronic respiratory diseases (OR=2.29), and cases with two or more comorbidities (OR=2.57) after adjusting for age and sex; all had significant P-values <0.05. CONCLUSIONS: Independent risk factors for critical outcomes among COVID-19 cases include old age, males, cardiac patients, chronic respiratory diseases, and the presence of two or more comorbidities. We recommend designing a unique multi-item scale system to prognosticate COVID-19 patients.


Subject(s)
COVID-19/epidemiology , Intensive Care Units/statistics & numerical data , Adolescent , Adult , Age Factors , Aged , COVID-19/mortality , COVID-19/physiopathology , Child , Child, Preschool , Comorbidity , Heart Diseases/epidemiology , Humans , Infant , Logistic Models , Middle Aged , Pandemics , Prognosis , Retrospective Studies , Risk Factors , SARS-CoV-2 , Saudi Arabia/epidemiology , Sex Factors , Socioeconomic Factors , Young Adult
19.
N Engl J Med ; 383(17): 1645-1656, 2020 10 22.
Article in English | MEDLINE | ID: covidwho-834967

ABSTRACT

BACKGROUND: Whether combined treatment with recombinant interferon beta-1b and lopinavir-ritonavir reduces mortality among patients hospitalized with Middle East respiratory syndrome (MERS) is unclear. METHODS: We conducted a randomized, adaptive, double-blind, placebo-controlled trial that enrolled patients at nine sites in Saudi Arabia. Hospitalized adults with laboratory-confirmed MERS were randomly assigned to receive recombinant interferon beta-1b plus lopinavir-ritonavir (intervention) or placebo for 14 days. The primary outcome was 90-day all-cause mortality, with a one-sided P-value threshold of 0.025. Prespecified subgroup analyses and safety analyses were conducted. Because of the pandemic of coronavirus disease 2019, the data and safety monitoring board requested an unplanned interim analysis and subsequently recommended the termination of enrollment and the reporting of the results. RESULTS: A total of 95 patients were enrolled; 43 patients were assigned to the intervention group and 52 to the placebo group. A total of 12 patients (28%) in the intervention group and 23 (44%) in the placebo group died by day 90. The analysis of the primary outcome, with accounting for the adaptive design, yielded a risk difference of -19 percentage points (upper boundary of the 97.5% confidence interval [CI], -3; one-sided P = 0.024). In a prespecified subgroup analysis, treatment within 7 days after symptom onset led to lower 90-day mortality than use of placebo (relative risk, 0.19; 95% CI, 0.05 to 0.75), whereas later treatment did not. Serious adverse events occurred in 4 patients (9%) in the intervention group and in 10 (19%) in the placebo group. CONCLUSIONS: A combination of recombinant interferon beta-1b and lopinavir-ritonavir led to lower mortality than placebo among patients who had been hospitalized with laboratory-confirmed MERS. The effect was greatest when treatment was started within 7 days after symptom onset. (Funded by the King Abdullah International Medical Research Center; MIRACLE ClinicalTrials.gov number, NCT02845843.).


Subject(s)
Coronavirus Infections/drug therapy , Interferon beta-1b/therapeutic use , Lopinavir/therapeutic use , Ritonavir/therapeutic use , Administration, Oral , Adult , Aged , Coronavirus Infections/mortality , Double-Blind Method , Drug Combinations , Drug Therapy, Combination , Female , Hospitalization , Humans , Injections, Subcutaneous , Interferon beta-1b/adverse effects , Kaplan-Meier Estimate , Lopinavir/adverse effects , Male , Middle Aged , Ritonavir/adverse effects , Statistics, Nonparametric , Time-to-Treatment
20.
Emerg Infect Dis ; 26(7): 1571-1574, 2020 07.
Article in English | MEDLINE | ID: covidwho-610771

ABSTRACT

During March 2016-March 2019, a total of 200,936 suspected cases of Middle East respiratory syndrome coronavirus infection were identified in Saudi Arabia; infections were confirmed in 698 cases (0.3% [0.7/100,000 population per year]). Continued surveillance is necessary for early case detection and timely infection control response.


Subject(s)
Coronavirus Infections/epidemiology , Population Surveillance/methods , Adolescent , Adult , Aged , Child , Child, Preschool , Contact Tracing , Disease Outbreaks , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Middle East Respiratory Syndrome Coronavirus , Saudi Arabia/epidemiology , Young Adult
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