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1.
Nutrients ; 15(11)2023 May 30.
Article in English | MEDLINE | ID: covidwho-20231876

ABSTRACT

Lifestyle factors such as dietary habits, perceived weight, sleep, and physical activity worsened during the COVID-19 pandemic. Through this study, we aimed to understand the impact of COVID-19 on these lifestyle factors in Bahrain. A cross-sectional study was conducted among 1005 adult Bahrainis. Data were collected online using a structured and validated questionnaire for the assessment of eating habits, physical activity, and lifestyle during the COVID-19 pandemic. Participants were snowballed through those who agreed to answer the online questionnaire. There was a higher consumption of fast food, and a higher dependence on takeaways during the COVID-19 pandemic. About 63.5% of the participants consumed >4 meals per day, compared to 36.5% before the COVID-19. About 30% reported consumption of sugar sweetened beverages from two to three times a day. Weight loss was predominantly observed in persons exercising 1-3 times a week. The consumption of sugar-sweetened beverages was also high, with about 19% reporting drinking sweet beverages once every day, 10.6% from two to three times a day, and 40.4% from one to four times a week. A higher proportion of the participants reported poor sleep quality during the pandemic (31.2%) compared to before (12.2%), and 39.7% of the participants reported feeling lazy. Screen time use also doubled during the pandemic, with participants spending more than five hours per day on screens for entertainment, which went from 22.4% before to 51.9% during the pandemic. The lifestyle and dietary habits changed drastically for our study participants during the pandemic. The increased reliance on processed fast food instead of healthier options is a challenge to be tackled in any future pandemic situation. Future research needs to focus on strategies to promote healthier lifestyle modifications during situations such as the COVID-19 pandemic.


Subject(s)
COVID-19 , Adult , Humans , Bahrain/epidemiology , COVID-19/epidemiology , COVID-19/prevention & control , Cross-Sectional Studies , Pandemics , Communicable Disease Control , Life Style , Internet , Feeding Behavior
2.
Hum Resour Health ; 20(1): 67, 2022 09 05.
Article in English | MEDLINE | ID: covidwho-2038777

ABSTRACT

BACKGROUND: Women make up a significant proportion of workforce in healthcare. However, they remain underrepresented in leadership positions relating to healthcare for a multitude of reasons: balancing personal and work duties, favoritism toward men, lack of support from colleagues and mentors, as well as other factors. This study aims to recognize the contribution made by women in the Bahraini healthcare sector by determining the gender distribution in Bahrain's medical schools, government hospitals, Ministry of Health, and National Health Regulatory Authority. METHODS: Data were collected from the Bahraini Ministry of Health, National Health Regulatory Authority, Salmaniya Medical Complex, King Hamad University Hospital, Bahrain Defence Force Royal Medical Services, the College of Medicine and Medical Sciences in the Arabian Gulf University, and the Royal College of Surgeons in Ireland-Bahrain. Only physicians who held a Bachelor of Medicine and Surgery and a valid license to practice from NHRA were eligible to participate. Descriptive statistics were used to derive the frequencies and percentages of physicians with the following leadership positions: (1) top administrative positions (e.g., Chief executive officer); (2) heads of departments; (3) heads of committees; and (4) academic positions (e.g., Professor). Data were also collected from the two medical schools in Bahrain to see the trend in female enrollment into medical schools since 2004. RESULTS: The results of the study indicated that leadership positions were mostly held by males in Bahrain (59.4% vs. 40.6%). However, Bahraini males and females equally dominated academic positions. Male physicians also dominated surgical specialties; however, female Bahraini physicians slightly surpassed male Bahraini physicians at the specialist and consultant levels (female to male: 11.9% vs. 10.4% and 33.2% vs. 30.4%, respectively). Furthermore, more females were reported to have general licenses. A trend analysis since 2004 showed that female medical students' representation was higher than males over the years. CONCLUSIONS: This study highlights the increasing trend of women's participation and contribution to medicine in Bahrain. The data indicated continued growth in the number of female medical students and physicians. As such, it is likely that females will have a bigger impact on healthcare in the future with potential to hold more leadership positions in Bahrain.


Subject(s)
Leadership , Physicians, Women , Bahrain , Female , Humans , Male , Schools, Medical , Workforce
3.
Cairo; World Health Organization. Regional Office for the Eastern Mediterranean; 2022-06. (WHO-EM/BAH/001/E).
in English | WHOIRIS | ID: gwh-361598
4.
Front Immunol ; 13: 812606, 2022.
Article in English | MEDLINE | ID: covidwho-1902974

ABSTRACT

Background: B.1.1.7 (alpha) and B.1.617.2 (delta) variants of concern for SARS-CoV-2 have been reported to have differential infectivity and pathogenicity. Difference in recovery patterns across these variants and the interaction with vaccination status has not been reported in population-based studies. Objective: The objective of this research was to study the length of stay and temporal trends in RT-PCR cycle times (Ct) across alpha and delta variants of SARS-CoV-2 between vaccinated and unvaccinated individuals. Methods: Participants consisted of patients admitted to national COVID-19 treatment facilities if they had a positive RT-PCR test for SARS-CoV-2, and analysis of variants was performed (using whole genome sequencing). Information on vaccination status, age, sex, cycle times (Ct) for four consecutive RT-PCR tests conducted during hospital stay, and total length of hospital stay for each participant were ascertained from electronic medical records. Results: Patients infected with the delta variant were younger (mean age = 35years vs 39 years for alpha, p<0.001) and had lesser vaccination coverage (54% vs 72% for alpha, p<0.001). RT-PCR Ct values were similar for both variants at the baseline test; however by the fourth test, delta variant patients had significantly lower Ct values (27 vs 29, p=0.05). Length of hospital stay was higher in delta variant patients in vaccinated (3 days vs 2.9 days for alpha variant) as well as in unvaccinated patients (5.2 days vs 4.4 days for alpha variant, p<0.001). Hazards of hospital discharge after adjusting for vaccination status, age, and sex was higher for alpha variant infections (HR=1.2, 95% CI: 1.01-1.41, p=0.029). Conclusion: Patients infected with the delta variant of SARS-CoV-2 were found to have a slower recovery as indicated by longer length of stay and higher shedding of the virus compared to alpha variant infections, and this trend was consistent in both vaccinated and unvaccinated patients.


Subject(s)
COVID-19/virology , SARS-CoV-2/pathogenicity , Adult , Age Factors , Bahrain/epidemiology , COVID-19/epidemiology , COVID-19/prevention & control , Female , Humans , Length of Stay/statistics & numerical data , Male , Middle Aged , SARS-CoV-2/genetics , Vaccination/statistics & numerical data
5.
Ann Ig ; 34(4): 398-409, 2022.
Article in English | MEDLINE | ID: covidwho-1893301

ABSTRACT

Background: The severe, acute respiratory syndrome COVID-19 that was first reported in China in December 2019 quickly became a global pandemic that has resulted in over 100 million infections and more than 2 million deaths. Study Design: This study aimed to assess the awareness level of university students regarding the possibility of becoming infected with COVID-19. In order to achieve this objective, we assessed the students' knowledge, attitudes, and behaviors using an online survey questionnaire offered to a total of 300 students. Results: A positive response regarding awareness of COVID-19 symptoms was registered by more than 70% of the students, whereas 62% felt that wearing a mask did not give full protection against infection, approximately 30% agreed that antibiotics and antivirals did not treat COVID-19, and 62% agreed that vitamin C was helpful in treating common symptoms of COVID-19. Moreover, around 31% of the students believed that COVID-19 is a man-made virus. Students who had gotten infected with SARS-CoV-2 believed that wearing a mask gives full protection (p=0.018). In response to survey questions related to attitude, 80% of students cancelled and postponed meetings with friends, and 90% agreed that mask-wearing is the most precautionary measure used to prevent the infection. In addition, 82% avoided coughing in public, 82% avoided contact if they felt flu-like symptoms and 80% washed their hands far more often due to the pandemic. Interestingly, 76% carried hand sanitizer, 66.5% avoided shaking hands, and 42.7% were taking vitamin C supplements. Conclusions: This study showed that the participants had a positive awareness of COVID-19 transmission, symptoms, and treatments misconceptions and mistaken beliefs related to treatments and the origin of the virus were also common and should be addressed. This study thus provides a baseline for a population-based surveillance program that could help local authorities to improve pandemic preparation plans, particularly with regard to governmental education and media campaigns.


Subject(s)
COVID-19 , Ascorbic Acid , Bahrain , COVID-19/prevention & control , Health Knowledge, Attitudes, Practice , Humans , SARS-CoV-2 , Students , Surveys and Questionnaires , Universities
6.
Sci Rep ; 12(1): 9236, 2022 06 02.
Article in English | MEDLINE | ID: covidwho-1873544

ABSTRACT

With the emergence of new SARS-Cov2 variants, critical questions have arisen about: (1) the effectiveness of the available COVID-19 vaccines developed to protect against the original Wuhan (wild type) variant and (2) the magnitude and clinical consequences of post-vaccination infections in the context of the Delta variant of SARS-Cov2. While some "real world" experiences with various vaccines have been reported, to our knowledge, few have examined comparative outcomes of various vaccines in one country as new SARS-CoV-2 variants have emerged. Here we present an analysis of COVID-19 related outcomes from a national database in Bahrain, a country with a total population of 1.51 million, where four vaccines were deployed (total vaccinated = 1,003,960 adults): AstraZeneca (AZ/Covishield), Pfizer/BioNtech, Sinopharm and Sputnik V. We compare the four vaccines, based on the following post-vaccination outcomes: SARS-CoV-2 infections, hospitalisations, ICU admissions and deaths, compared to unvaccinated individuals. We conclude that the four vaccines used in Bahrain were effective in significantly reducing all four COVID-19 related outcomes compared to unvaccinated individuals, prior to, and during the period when the Delta variant predominated in the country. However, compared to the three other vaccines, individuals vaccinated with Sinopharm vaccine had a higher risk of post-vaccination infections, hospitalisations and ICU admissions (e.g., 6.94%, 2.24%, 1.99% and 1.52% of COVID-19 cases of Sinopharm, Sputnik V, Pfizer and Covishield recipients, respectively, required hospitalisation versus 13.66% of COVID-19 cases among unvaccinated individuals); however, given the confounding factors, this needs to be confirmed by further studies. We find no evidence of biased selection for any vaccine, but note waning protection of the Pfizer/BioNtech vaccine during the January to June 2021 period in the age > 60 y cohort; however, this cannot be distinguished from the overall fall in hospitalisations overall. Our findings support the value of vaccination in preventing COVID-19 related outcomes, provide real world estimates on the outcomes and frequencies of post-vaccination infections for the four vaccines, which may inform vaccine selection in the context of the Delta variant across the globe.


Subject(s)
COVID-19 , Influenza Vaccines , Adult , Bahrain/epidemiology , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , ChAdOx1 nCoV-19 , Humans , RNA, Viral , SARS-CoV-2/genetics , Vaccination
7.
Medicine (Baltimore) ; 101(2): e28479, 2022 Jan 14.
Article in English | MEDLINE | ID: covidwho-1625754

ABSTRACT

ABSTRACT: To facilitate the understanding of the interaction between severe acute respiratory syndrome coronavirus 2 causing the corona virus disease 2019 (COVID-19) and other pathogens causing respiratory system affection we investigated the effect of influenza vaccination on the incidence and severity of COVID-19 among members of staff working in the Bahrain Defense Force Hospital.All staff members working in the hospital between February 2020 and March 2021 were divided into 2 main groups based on whether or not they received influenza vaccination. None of the participants had received any of the COVID-19 vaccines throughout this time period. The records of each were scrutinized to see the effect of influenza vaccination on incidence and severity of COVID-19. Severity measures were: need for hospital and intensive care unit admission and total length of hospital stay.Incidence of affection with COVID-19 was much lower in the vaccinated group (3.7% vs 8.1%, P < .001). Influenza vaccination also reduced total length of hospital stay (6.2 days vs 12.7 days, P < .05) and need for intensive care unit admission among the patients.Influenza vaccine reduces both the incidence of affection as well as the overall burden of COVID-19. This is of particular importance for people working in the healthcare field during the serious COVID-19 pandemic.


Subject(s)
COVID-19 , Health Personnel/statistics & numerical data , Influenza Vaccines/administration & dosage , Influenza, Human/prevention & control , Adult , Bahrain/epidemiology , Female , Hospitals , Humans , Incidence , Influenza, Human/epidemiology , Male , Middle Aged , Pandemics , SARS-CoV-2 , Vaccination
8.
PLoS One ; 16(9): e0257253, 2021.
Article in English | MEDLINE | ID: covidwho-1443836

ABSTRACT

OBJECTIVES: Studies have shown that acute kidney injury (AKI) occurrence post SARS-CoV-2 infection is complex and has a poor prognosis. Therefore, more studies are needed to understand the rate and the predications of AKI involvement among hospitalized COVID-19 patients and AKI's impact on prognosis while under different types of medications. PATIENTS AND METHODS: This study is a retrospective observational cohort study conducted at Bahrain Defence Force (BDF) Royal Medical Services. Medical records of COVID-19 patients admitted to BDF hospital, treated, and followed up from April 2020 to October 2020 were retrieved. Data were analyzed using univariate and multivariate logistic regression with covariate adjustment, and the odds ratio (OR) and 95% confidence (95% CI) interval were reported. RESULTS: Among 353 patients admitted with COVID-19, 47.6% developed AKI. Overall, 51.8% of patients with AKI died compared to 2.2% of patients who did not develop AKI (p< 0.001 with OR 48.6 and 95% CI 17.2-136.9). Besides, deaths in patients classified with AKI staging were positively correlated and multivariate regression analysis revealed that moderate to severe hypoalbuminemia (<32 g/L) was independently correlated to death in AKI patients with an OR of 10.99 (CI 95% 4.1-29.3, p<0.001). In addition, 78.2% of the dead patients were on mechanical ventilation. Besides age as a predictor of AKI development, diabetes and hypertension were the major risk factors of AKI development (OR 2.04, p<0.01, and 0.05 for diabetes and hypertension, respectively). Also, two or more comorbidities substantially increased the risk of AKI development in COVID-19 patients. Furthermore, high levels upon hospital admission of D-Dimer, Troponin I, and ProBNP and low serum albumin were associated with AKI development. Lastly, patients taking ACEI/ARBs had less chance to develop AKI stage II/III with OR of 0.19-0.27 (p<0.05-0.01). CONCLUSIONS: The incidence of AKI in hospitalized COVID-19 patients and the mortality rate among AKI patients were high and correlated with AKI staging. Furthermore, laboratory testing for serum albumin, hypercoagulability and cardiac injury markers maybe indicative for AKI development. Therefore, clinicians should be mandated to perform such tests on admission and follow-up in hospitalized patients.


Subject(s)
Acute Kidney Injury/epidemiology , COVID-19/complications , Acute Kidney Injury/metabolism , Acute Kidney Injury/physiopathology , Adult , Aged , Bahrain/epidemiology , COVID-19/physiopathology , Cohort Studies , Comorbidity , Female , Hospital Mortality , Hospitalization/trends , Hospitals , Humans , Incidence , Intensive Care Units , Male , Middle Aged , Prognosis , Respiration, Artificial/adverse effects , Retrospective Studies , Risk Factors , SARS-CoV-2/metabolism , SARS-CoV-2/pathogenicity
9.
Sci Total Environ ; 801: 149642, 2021 Dec 20.
Article in English | MEDLINE | ID: covidwho-1364457

ABSTRACT

Coronavirus disease 2019 (COVID-19) is not only a great matter of concern from a medical and health perspective, but it is a serious threat to the environment in terms of waste generated during the prevention and cure of COVID-19. The world has so far compromised more than 3 million human lives, and millions are being infected. Environmental threat is most serious because it can cause secondary complications. As per our knowledge, the amount of waste generated during the pandemic and its estimated quantity has not been assessed, thereby keeping the scientific community, Government authorities and public ignorant of its adverse effects. In this context, we have evaluated the waste generated by the Kingdom of Bahrain, estimated to be 35.480 kg/day (face masks), 1894 kg/day (PPEs) by the selected health facilities, 16,633.505 kg (vaccination-related) and 53,551.240 kg (related to tests conducted so far) in the Kingdom of Bahrain.


Subject(s)
COVID-19 , Medical Waste , Bahrain/epidemiology , Humans , Masks , SARS-CoV-2
10.
Environ Sci Pollut Res Int ; 29(1): 1106-1116, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1340479

ABSTRACT

The COVID-19 pandemic has significantly impacted the global lifestyle, and the spreading of the virus is unprecedented. This study is aimed at assessing the association between the meteorological indicators such as air temperature (°C), relative humidity (%), wind speed (w/s), solar radiation, and PM2.5 with the COVID-19 infected cases in the hot, arid climate of Bahrain. Kendall and Spearman rank correlation coefficients and quantile on quantile regression were used as main econometric analysis to determine the degree of the relationship between related variables. The dataset analysis was performed from 05 April 2020, to 10 January 2021. The empirical findings indicate that the air temperature, humidity, solar radiation, wind speed indicators, and PM2.5 have a significant association with the COVID-19 newly infected cases. The current study findings allow us to suggest that Bahrain's relatively successful response to neighboring GULF economies can be attributed to the successful environmental reforms and significant upgrades to the health care facilities. We further report that a long-term empirical analysis between meteorological factors and respiratory illness threats will provide useful policy measures against future outbreaks.


Subject(s)
COVID-19 , Meteorological Concepts , Bahrain/epidemiology , COVID-19/epidemiology , Desert Climate , Disease Outbreaks , Humans , Pandemics , SARS-CoV-2
11.
BMC Infect Dis ; 21(1): 688, 2021 Jul 16.
Article in English | MEDLINE | ID: covidwho-1314252

ABSTRACT

BACKGROUND: Being able to use COVID-19 RT-PCR Ct values as simple clinical markers of disease outcome or prognosis would allow for the easy and proactive identification and triaging of high-risk cases. This study's objective was thus to explore whether a correlation exists between COVID-19 viral loads, as indicated by RT-PCR Ct values, and disease severity, as indicated by respiratory indices. RESULTS: A multi-centre cross-sectional retrospective study was conducted, using data obtained from Bahrain's National COVID-19 Task force's centralised database. The study period ranged from May 2, 2020 to July 31, 2020. A multivariable logistic regression was used to assess for a correlation using data from a total of 1057 admitted COVID-19 cases. The covariates adjusted for included sex, age, presentation, and comorbidities. In our cohort, Ct value showed no statistical significance for an association with requirement for oxygenation on admission (Odds ratio 1.046; 95%CI 0.999 to 1.096, p = 0.054). CONCLUSION: Viral load, as indicated by Ct values, did not seem to be associated with requirement for oxygenation on admission in our cohort. We postulate however that time since onset of symptom may have acted as an unaccounted-for confounder. As such, RT-PCR Ct values may not be a useful prognostic clinical tool in isolation.


Subject(s)
COVID-19/diagnosis , COVID-19/pathology , SARS-CoV-2/physiology , Viral Load/physiology , Adult , Aged , Bahrain/epidemiology , COVID-19/epidemiology , COVID-19/virology , Cohort Studies , Comorbidity , Cross-Sectional Studies , Female , Hospitalization/statistics & numerical data , Humans , Lung/pathology , Lung/virology , Male , Middle Aged , Prognosis , Retrospective Studies , Reverse Transcriptase Polymerase Chain Reaction , SARS-CoV-2/genetics , SARS-CoV-2/isolation & purification , Serologic Tests , Severity of Illness Index , Viral Load/statistics & numerical data
12.
Microb Pathog ; 158: 105086, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1306443

ABSTRACT

BACKGROUND: In order to impart immunity against SARS COV 2 in the community, the oil rich countries of the Gulf Cooperation Council (GCC) provided citizens and expatriates with free vaccination. Different types of vaccination brands were utilized for this purpose. The purpose of this study is to determine the efficacy of the different types of vaccinations used. METHODS: This is an observational analytical case study of one Bahraini family who were vaccinated with 1st, 2nd or no dose. RESULTS: Out of 22 double dose recipients of SARS COV2 vaccine, 20 were infected. Those 20 were vaccinated against SARS COV 2 using Sinopharm, the rest (2) were in direct contact with the source but were vaccinated against SARS COV 2 using other type of vaccine. Out of 26 single dose recipients of Sinopharm vaccine, 23 were infected. The other three were not in direct contact with the infected source. Social gathering has been the main source of transmission. The infection has been mild with headache, chest pain. From 20 cases with double dose vaccinations only one had a lung infection and needed hospitalization. Out of 23 cases with single dose vaccinations 10 were hospitalized due to lung infections. All family members who were not vaccinated were infected, three were hospitalized one of which was deceased due to diabetes mellitus complications. CONLCUSION: Sinopharm provides partial protection against SARS COV 2 infection. That might be due to lack of its potential to detect recent variations in the protein structure of spike(S) protein of virus.


Subject(s)
COVID-19 , Vaccines , Bahrain/epidemiology , COVID-19 Vaccines , Disease Outbreaks , Humans , RNA, Viral , SARS-CoV-2
13.
J Infect Public Health ; 14(8): 1045-1050, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1275495

ABSTRACT

BACKGROUND: Following declaration of Corona Virus Disease 19 (COVID-19) as a global outbreak by the WHO with recommendation to do nasopharyngeal swabs for diagnosis. Many countries started to take different measures of precautions. The Kingdom of Bahrain COVID team (National Taskforce for Combating the Coronavirus) has introduced different protocols for different categories. OBJECTIVE: The aim of this study is to; determine the efficiency of the recent National Taskforce for Combating the Coronavirus (COVID-19) Protocol 5-day nasopharyngeal swab from diagnosis; by evaluating the period of time needed for a patient to retain a negative polymerase chain reaction result and to determine the number of patients who failed to retain a negative result. In addition to, evaluating the cycle threshold values of persistent positive and its relation to current evidence in literature. This study also aims to determine the number of patients that needed urgent medical care [i.e. shifting to an intensive care unit (ICU) facility] in that time frame. MATERIALS & METHODS: Data were collected from the daily index master sheets present in the facility from medical database systems; ALCARE by Royal Medical Services and ORACLE Reports by iSEHA. Search engines used were PubMed/MEDLINE, Oxford Academic Database, Cochrane Database system. The duration of study was from 1-July 2020 to 31-August 2020. RESULTS: The sample included 7196 male patients from ages 18-65 years. Median age was 36. Out of 7196 patients, 3506 retained a negative result on 5th day from diagnosis, 1594 retained a negative result on 7th day from diagnosis, and 1343 retained negative result on 9th day from diagnosis. While 618 patients failed to retain a negative result. CONCLUSION: This study estimated the efficiency of testing protocol based on the current prevalence state of COVID-19. They found that the current protocol was not enough for the clinical data. In addition, 7-day nasopharyngeal swab was an effective testing method. Among the patients with Ct value >24, negative infected persons should be paid close attention.


Subject(s)
COVID-19 , Adolescent , Adult , Aged , Bahrain , Humans , Intensive Care Units , Male , Middle Aged , Real-Time Polymerase Chain Reaction , SARS-CoV-2 , Young Adult
14.
Microb Pathog ; 157: 104955, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1246089

ABSTRACT

The challenges imposed by the ongoing outbreak of severe acute respiratory syndrome coronavirus-2 affects every aspect of our modern world, ranging from our health to our socio-economic needs. Our existence highly depends on the vaccine's availability, which demands in-depth research of the available strains and their mutations. In this work, we have analyzed all the available SARS-COV2 genomes isolated from the Kingdom of Bahrain in terms of their variance and origin analysis. We have predicted various known and unique mutations in the SARS-COV2 isolated from Bahrain. The complexity of the phylogenetic tree and dot plot representation of the strains mentioned above with other isolates of Asia indicates the versatility and multiple origins of Bahrain's SARS-COV2 isolates. We have also identified two high impact spike mutations from these strains which increase the virulence of SARS-COV2. Our research could have a high impact on vaccine development and distinguishes the source of SARS-COV2 in the Kingdom of Bahrain.


Subject(s)
COVID-19 , SARS-CoV-2 , Asia , Bahrain/epidemiology , Humans , Phylogeny , RNA, Viral
15.
Biomark Med ; 15(8): 541-549, 2021 06.
Article in English | MEDLINE | ID: covidwho-1229135

ABSTRACT

Aim: COVID-19 pandemic continues and dearth of information remains considering the utility of various inflammatory biomarkers. We carried out the present study to delineate the roles of these biomarkers in various strata of patients with coronavirus infection. Materials & methods: A retrospective study was carried out after obtaining approval from the relevant Ethics Committee. Patients established with COVID-19 infection as shown by positive real-time quantitative PCR test were included. Details on their demographics, diagnosis, whether they received tocilizumab, and the values of the following biomarkers were obtained: IL-6, C-reactive protein (CRP), serum ferritin, D-dimer, procalcitonin, fibrinogen, lactate dehydrogenase and creatinine kinase. Receiver operating characteristic curves were plotted and correlation of biomarkers with IL-6 were estimated. Results: One-hundred and three patients were recruited. We observed that serum ferritin followed by D-dimer had better predictive accuracy in identifying patients with pneumonia compared with asymptomatic; and CRP in addition to the earlier markers had better accuracy for predicting severe illness compared with mild-moderate. Serum IL-6 levels were significantly higher in patients with severe illness admitted in intensive care unit. Significantly, higher levels of IL-6 and serum ferritin were observed in patients receiving tocilizumab. A trend of increased IL-6 levels was observed immediately following the initiation of tocilizumab therapy followed by a drop thereafter. Conclusion: We observed serum ferritin, D-dimer and CRP to accurately predict patients developing severe COVID-19 infections as well as those at risk of developing COVID pneumonia. A trend in IL-6 levels was observed in patients on tocilizumab therapy.


Subject(s)
Biomarkers/blood , C-Reactive Protein/analysis , COVID-19 Testing , COVID-19/diagnosis , Fibrin Fibrinogen Degradation Products/analysis , Procalcitonin/blood , SARS-CoV-2/isolation & purification , Bahrain/epidemiology , COVID-19/blood , COVID-19/epidemiology , COVID-19/virology , Female , Hospitalization , Humans , Inflammation Mediators/blood , Male , Middle Aged , ROC Curve , Retrospective Studies , Severity of Illness Index
16.
BMJ Open ; 11(5): e044102, 2021 05 11.
Article in English | MEDLINE | ID: covidwho-1225706

ABSTRACT

OBJECTIVE: To generate cross-national forecasts of COVID-19 trajectories and quantify the associated impact on essential critical care resources for disease management in Gulf Cooperation Council (GCC) countries. DESIGN: Population-level aggregate analysis. SETTING: Bahrain, Kuwait, Oman, Qatar, United Arab Emirates (UAE) and Saudi Arabia. METHODS: We applied an extended time-dependent SEICRD compartmental model to predict the flow of people between six states, susceptible-exposed-infected-critical-recovery-death, accounting for community mitigation strategies and the latent period between exposure and infected and contagious states. Then, we used the WHO Adaptt Surge Planning Tool to predict intensive care unit (ICU) and human resources capacity based on predicted daily active and cumulative infections from the SEICRD model. MAIN OUTCOME MEASURES: Predicted COVID-19 infections, deaths, and ICU and human resources capacity for disease management. RESULTS: COVID-19 infections vary daily from 498 per million in Bahrain to over 300 per million in UAE and Qatar, to 9 per million in Saudi Arabia. The cumulative number of deaths varies from 302 per million in Oman to 89 in Qatar. UAE attained its first peak as early as 21 April 2020, whereas Oman had its peak on 29 August 2020. In absolute terms, Saudi Arabia is predicted to have the highest COVID-19 mortality burden, followed by UAE and Oman. The predicted maximum number of COVID-19-infected patients in need of oxygen therapy during the peak of emergency admissions varies between 690 in Bahrain, 1440 in Oman and over 10 000 in Saudi Arabia. CONCLUSION: Although most GCC countries have managed to flatten the epidemiological curve by August 2020, trends since November 2020 show potential increase in new infections. The pandemic is predicted to recede by August 2021, provided the existing infection control measures continue effectively and consistently across all countries. Current health infrastructure including the provision of ICUs and nursing staff seem adequate, but health systems should keep ICUs ready to manage critically ill patients.


Subject(s)
COVID-19 , Severe Acute Respiratory Syndrome , Bahrain/epidemiology , Critical Care , Humans , Kuwait/epidemiology , Oman/epidemiology , Pandemics , Qatar , SARS-CoV-2 , Saudi Arabia/epidemiology , United Arab Emirates/epidemiology
18.
Drugs ; 81(4): 495-501, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1120188

ABSTRACT

BNT162b2 (Comirnaty®; BioNTech and Pfizer) is a lipid nanoparticle-formulated, nucleoside-modified mRNA vaccine for the prevention of the novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. BNT162b2 encodes the SARS-CoV-2 spike protein, the expression of which elicits immune responses against the antigen in recipients. In early December 2020, BNT162b2 received a temporary emergency use authorization (EUA) in the UK and, subsequently, a series of approvals or authorizations for emergency use in Bahrain, Canada, Mexico, Saudi Arabia and the USA. Soon after, BNT162b2 received conditional marketing authorizations in Switzerland (19 December 2020) and the EU (21 December 2020) for active immunization to prevent COVID-19 caused by SARS-CoV-2 in individuals 16 years of age and older. BNT162b2 is administered intramuscularly in a two-dose regimen. This article summarizes the milestones in the development of BNT162b2 leading to these first approvals for the prevention of COVID-19.


Subject(s)
COVID-19 Vaccines/therapeutic use , COVID-19/prevention & control , Drug Approval , BNT162 Vaccine , Bahrain , Canada , Clinical Trials as Topic , Drug Development , European Union , Humans , Mexico , SARS-CoV-2/genetics , SARS-CoV-2/immunology , Saudi Arabia , Spike Glycoprotein, Coronavirus/genetics , Spike Glycoprotein, Coronavirus/immunology , Switzerland , United Kingdom , United States , Vaccines, Synthetic , World Health Organization
19.
Int J Infect Dis ; 105: 656-661, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1108328

ABSTRACT

PURPOSE: The COVID-19 pandemic has led to over 92 million cases and 1.9 million deaths worldwide since its outbreak. Public health responses have focused on identifying symptomatic individuals to halt spread. However, evidence is accruing that asymptomatic individuals are infectious and contributing to this global pandemic. METHODS: Observational data of 320 index cases and their 1289 positive contacts from the National COVID-19 Database in Bahrain were used to analyze symptoms, infectivity rate and PCR Cycle threshold (Ct) values. RESULTS: No significant difference (p = 1.0) in proportions of symptomatic (n = 160; 50.0%) and asymptomatic index cases (n = 160; 50.0%) were seen; however, SARS-CoV-2 positive contact cases were predominantly asymptomatic (n = 1127, 87.4%). Individuals aged 0-19 years constituted a larger proportion of positive contact cases (20.8%) than index cases (4.7%; p < 0.001). A total of 22% of the positive contacts were infected by symptomatic male index cases aged between 30-39 years. The total numbers of exposed contacts (p = 0.33), infected contacts (p = 0.81) and hence infectivity rate (p = 0.72) were not different between symptomatic and asymptomatic index cases. PCR Ct values were higher in asymptomatic compared to symptomatic index cases (p < 0.001), and higher in asymptomatic compared to symptomatic positive contacts (p < 0.001). No differences between the infectivity rates of index cases with Ct values <30 and values ≥30 were observed (p = 0.13). CONCLUSION: These data reveal that the high asymptomatic incidence of SARS-CoV-2 infection in Bahrain and subsequent positive contacts from an index case were more likely to be asymptomatic, showing the high "silent" risk of transmission and need for comprehensive screening for each positive infection to help halt the ongoing pandemic.


Subject(s)
Asymptomatic Infections/epidemiology , COVID-19/transmission , Adolescent , Adult , Bahrain/epidemiology , COVID-19/epidemiology , COVID-19/physiopathology , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Incidence , Infant , Infant, Newborn , Male , Middle Aged , Pandemics , Prevalence , SARS-CoV-2 , Young Adult
20.
Int J Infect Dis ; 102: 285-288, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1059669

ABSTRACT

BACKGROUND: The frequency of asymptomatic SARS-CoV-2 infection with viral spread is unclear. Asymptomatic SARS-CoV-2 infection development and progression was investigated in subjects undergoing mandatory quarantine on airport arrival. METHODS: 2714 subjects were tested for SARS-CoV-2 and all were quarantined for 2 weeks. Viral retesting was undertaken on symptom development and routinely at 14 days if asymptomatic. Asymptomatic, positive patients underwent viral testing every 2 days to determine viral clearance. RESULTS: 188/2714 (6.9%) patients became SARS-CoV-2 positive. On arrival, 136/188 tested positive, with 44/188 (23.4%) symptomatic and 92/188 (48.9%) asymptomatic. All 92 patients remained asymptomatic and were retested every 2 days until viral clearance. 2526 quarantined subjects remained virus free at 14 days. Viral clearance did not differ between symptomatic and asymptomatic patients (12.6 ± 1.0 days and 12.1 ± 0.4 days, respectively). Of the 52/188 (27.7%) testing negative on arrival, 27/52 subsequently became positive and developed symptoms 2-13 days after arrival. 25/188 (13.3%) remained asymptomatic and tested positive at day 14, with viral testing undertaken every 2 days in these subjects; of these, 24 remained asymptomatic, with viral clearance at 9.4 ± 0.7 days - less than for those who were asymptomatic on arrival (p < 0.002). CONCLUSION: Asymptomatic patients with COVID-19 were more prevalent than those exhibiting symptoms, and are an infection reservoir.


Subject(s)
Asymptomatic Infections/epidemiology , COVID-19/epidemiology , Quarantine , SARS-CoV-2 , Adult , Aged , Aged, 80 and over , Bahrain/epidemiology , COVID-19/diagnosis , COVID-19/prevention & control , COVID-19 Testing , Cohort Studies , Female , Humans , Male , Middle Aged , Prevalence
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