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1.
Int J Environ Res Public Health ; 19(7)2022 Mar 31.
Article in English | MEDLINE | ID: covidwho-1785644

ABSTRACT

OBJECTIVES: To compare neurologists' knowledge, practice, and barriers of pharmacovigilance (PV) process among patients with epilepsy in Poland and Egypt. METHODS: It was an international study that used an online questionnaire e-mailed to neurologists registered to practice in Poland and Egypt. RESULTS: Most of the neurologists were familiar with the definition of PV and adverse drug reactions (ADRs), but relatively few neurologists knew where to report ADRs, especially the Egyptian neurologists. Only 31.11% of the neurologists from Egypt and 39.90% neurologists from Poland declared that they had reported ADRs at least once during their professional practice, and few of them declared the regular reporting of such incidents. The main reason for the neurologists not reporting ADRs was the lack of time and a conviction that reporting ADRs would be an additional burden that would generate extra work. CONCLUSION: The standards of pharmacovigilance process, safety control, and quality are not the same throughout the world. System-regulated PV stabilization in a country translates into the practice of maintaining PV. Monitoring the safety of pharmacotherapy and knowledge of risks associated with ADRs should be included in the academic curricula of physician courses.


Subject(s)
Drug-Related Side Effects and Adverse Reactions , Epilepsy , Adverse Drug Reaction Reporting Systems , Cross-Sectional Studies , Egypt , Epilepsy/drug therapy , Health Knowledge, Attitudes, Practice , Humans , Neurologists , Pharmacovigilance , Poland
2.
Front Endocrinol (Lausanne) ; 13: 814991, 2022.
Article in English | MEDLINE | ID: covidwho-1775656

ABSTRACT

Background: The coronavirus disease 2019 (COVID-19) pandemic has been associated with significant challenges pertaining to the management of children and adolescents with type 1 diabetes (T1D). Issues such as fear of infection and lockdown measures have resulted in delayed and more severe clinical presentations of this disease. Objectives: This study aimed at reporting the frequency and severity of diabetic ketoacidosis (DKA) and the rate of DKA complications in children with diabetes who presented to the emergency unit during COVID-19 pandemic. Furthermore, the purpose of this study was to compare the data collected from the first and second COVID-19 waves with that of the pre-COVID-19 period and describe the challenges encountered during disease management. Methods: This cross-sectional study included all children and adolescents with T1D who presented to the emergency department at Abo El Rish Children's Hospital, Cairo University, during the first and second COVID-19 waves. It also included data collected from the pre-COVID-19 period. Demographic and clinical data, investigations, and management details were collected from the patients' medical records. Results: Three hundred twenty-four Egyptian children and adolescents diagnosed with T1D were recruited. One hundred forty patients (43.2%) presented with severe DKA, and approximately 66% were newly diagnosed with T1D. The participants presented with manifestations suggestive of COVID-19, such as fever (29.5%), respiratory manifestations (7.2%), and gastrointestinal symptoms (14.7%). Thirty-seven patients were tested for severe acute respiratory syndrome coronavirus 2 infection using nasopharyngeal swabs, and four patients tested positive. Around 18% of patients developed hypokalemia during disease management. A comparison between these data and the data from previous years revealed that there was a significant increase in the number of newly diagnosed cases with more severe DKA at presentation and a higher frequency of development of hypokalemia during both COVID-19 waves. Conclusion: An increase in the frequency of newly diagnosed cases was identified during the first and the second COVID-19 waves compared with the pre-COVID-19 period. The patients presented with more severe DKA, probably due to a more delayed presentation. The frequency of hypokalemia development was also significantly higher, and the severity of DKA was associated with a longer ICU admission. Further studies are required to establish a definitive link between the COVID-19 pandemic and the severity of presentation.


Subject(s)
COVID-19 , Diabetes Mellitus, Type 1 , Adolescent , COVID-19/complications , COVID-19/epidemiology , Child , Communicable Disease Control , Cross-Sectional Studies , Diabetes Mellitus, Type 1/complications , Diabetes Mellitus, Type 1/epidemiology , Diabetes Mellitus, Type 1/therapy , Egypt/epidemiology , Humans , Pandemics
3.
PLoS One ; 17(3): e0266175, 2022.
Article in English | MEDLINE | ID: covidwho-1770761

ABSTRACT

OBJECTIVES: COVID-19 is a multisystem disease, and some patients suffer from physical or psychological symptoms for weeks or even months after infection, which is described as post-COVID syndrome. The goal of this study is evaluating the prevalence of post-COVID-19 symptoms among Egyptian patients and detecting the factors associated with the presence of these symptoms. METHODS: An on-line cross-sectional survey using Google Forms was used to conduct the present study, which took place between June and August 2021. RESULTS: Three hundred and ninety-six participants filled in the survey. The mean age of participants was 41.4 years. Most participants had mild to moderate COVID-19 (81.31%). The prevalence of post-COVID-19 symptoms was 87.63%, where the most frequent symptom was fatigue (60.86%). Female sex, the presence of comorbidities, lower degree of education, longer disease duration, as well as severe and critical forms of the disease were significantly associated with the presence of post-COVID symptoms. Using regression analysis, the predictors of post-COVID symptoms were severe and critical forms of the disease and intake of antibiotics and corticosteroids for treatment of COVID-19. CONCLUSIONS: COVID-19 is followed by high prevalence of post-COVID symptoms. To the best of our knowledge, this is the first study to report the relationship between the use of antibiotics and the development of post-COVID symptoms. We recommend further studies to understand this relationship. We also recommend restricting the use of these drugs to indicated cases according to the international guidelines. More studies are needed to gain better understanding of post-COVID symptoms especially in females.


Subject(s)
COVID-19 , Adult , Anti-Bacterial Agents , COVID-19/drug therapy , COVID-19/epidemiology , Cross-Sectional Studies , Egypt/epidemiology , Female , Humans , SARS-CoV-2
4.
BMC Med Educ ; 22(1): 218, 2022 Mar 30.
Article in English | MEDLINE | ID: covidwho-1770524

ABSTRACT

BACKGROUND: The coronavirus (COVID-19) pandemic required a transformation of medical education in Egypt. Public health measures necessitated a rapid shift from traditional face to face lectures to largely online platforms following campus closures. The aim of this study is to characterize medical student use and perception of online medical education in Egypt as well as exploring the efficacy of different e-learning modalities. Additionally, many barriers and opportunities as perceived by students are reviewed to inform future educational improvements. METHODS: A 29-item online survey was created on google forms and distributed by social media to medical students across 26 Egyptian medical schools. The survey was administered from August 20th, 2021, to September 5th, 2021. The survey consisted of a mixture of questions style. The medical students were asked about their experiences with online medical education during the COVID-19 pandemic as well as medical students' anxiety, perceived academic performance, and obstacles related to online education. RESULTS: Of the 4935 responses collected, 43.4% (n = 2140) of respondents were women; 56.6% (n = 2795) were men. Medical students from private medical schools were 13.0% (n = 644), whereas 87.0% (n = 4291) were from public medical schools. 54.6% of students reported that online education is not as effective as face-to-face education. There was a significant rise in hours spent by medical students on online medical education compared to before COVID-19 pandemic. More than half of students (63%) agreed that online recorded video tutorials (e.g., YouTube) were the most effective form of online medical education. CONCLUSION: The shift to online education has significantly impacted medical students in Egypt. Medical students reported various limitations and challenges of online medical education, which must be addressed considering the potential benefits of online platforms over traditional face to face learning. The results of this nationwide study provide a framework for potential areas to implement change to improve the accessibility and structure of online medical education in Egypt.


Subject(s)
COVID-19 , Education, Distance , Education, Medical , Students, Medical , COVID-19/epidemiology , Education, Distance/methods , Egypt/epidemiology , Female , Humans , Male , Pandemics , Schools, Medical
5.
J Clin Res Pediatr Endocrinol ; 14(1): 76-86, 2022 03 03.
Article in English | MEDLINE | ID: covidwho-1766064

ABSTRACT

Objective: Micro RNAs (miRNAs) are gaining acceptance as novel biomarkers for the autoimmune disorders. However, miRNA profiles have not been investigated in individuals at risk of or diagnosed with type 1 diabetes mellitus (T1DM). To study the expression pattern of miRNAs in plasma obtained from patients with T1DM and compare with matched healthy controls. Methods: Equal numbers of patients with T1DM (90) and healthy-matched control children (90) were assessed for the expression profile of plasma miRNAs including miRNA-101-5p, miRNA-146-5p, miRNA-21-5p, miRNA-375, miRNA-126, and Let7a-5p using reverse transcriptase polymerase chain reaction methodology and quantitative real-time testing. Results: Analysis showed that miRNA-101, miRNA-21 and miRNA-375 were highly expressed, whereas, miRNA-146-5p, miRNA-126, and miRNA-Let7a-5p showed significantly low levels of expression in T1DM patients compared to controls (p<0.05). In addition, miRNA-101 and miRNA-146 correlated with age at diagnosis of T1DM and disease duration, respectively. Furthermore, multivariate analysis showed that miRNA-126 and Let7a-5p had a significant negative correlation with mean hemoglobin A1c (HbA1c) values. Conclusion: Dysregulation of the six miRNAs analyzed suggested a possible role as biomarkers in T1DM. miRNA-101 was correlated with age at diagnosis while miRNA-146 correlated with disease duration. Two further miRNAs correlated with the existing biomarker, HbA1c.


Subject(s)
Diabetes Mellitus, Type 1 , Hyperglycemia , MicroRNAs , Biomarkers , Child , Diabetes Mellitus, Type 1/genetics , Egypt , Humans , Hyperglycemia/genetics , MicroRNAs/genetics
6.
BMC Womens Health ; 22(1): 94, 2022 03 27.
Article in English | MEDLINE | ID: covidwho-1765448

ABSTRACT

BACKGROUND: In face of the COVID-19 pandemic, many countries including Egypt implemented stay indoor rules. These regulations slowed the propagation of the coronavirus, meanwhile they contributed to increase mental health issues, particularly the risk of experiencing intimate partner violence (IPV). That might lead to adverse health and social outcomes on the abused women and the children. This study aimed to examine the effect of the COVID-19 pandemic on the incidence of intimate partner violence against married women in Egypt. METHODS: A cross-sectional study enrolled 2068 married women through an electronic survey link. An anonymous self-administered questionnaire was used. It included demographic data and assessed the frequency of exposure to various forms of spousal violence before and after the COVID-19 pandemic. RESULTS: The mean age of respondents was 33.8 ± 6.3 years. The commonest types of violent behaviors that have been increased significantly after the COVID-19 pandemic were: twisting arms/pulling the hair (pre 32.8%, post 75%), leaving the house without informing or giving the wife money (pre 12.2%, post 30.3%), restricting interaction with her family members (pre 26.1, post 40.4%), treating her as a servant (pre 28.7%, post 36.7%) and insulting her in front of others (pre 22.9%, post 30.8%).The associated determinants for higher violence rate were; low women education, young age at marriage, low educational and job rank of husband, husband's tobacco use and reduced family income (p < 0.05). CONCLUSIONS: The overall prevalence of economic and some types of physical and emotionally abusive behaviors have been increased after the emergence of COVID-19 pandemic. Special intervention should be designed to address this issue in collaboration with public health organizations.


Subject(s)
COVID-19 , Domestic Violence , Adult , COVID-19/epidemiology , Child , Cross-Sectional Studies , Egypt/epidemiology , Female , Humans , Marriage , Pandemics
7.
Prim Health Care Res Dev ; 22: e75, 2021 11 25.
Article in English | MEDLINE | ID: covidwho-1721365

ABSTRACT

BACKGROUND: As SARS-CoV-2 infection is sweeping the globe, early identification and timely management of infected patients will alleviate unmet health care demands and ultimately control of the disease. Remote COVID-19 self-assessment tools will offer a potential strategy for patient guidance on medical consultation versus home care without requiring direct attention from healthcare professionals. OBJECTIVE(S): This study aimed to assess the validity and interrater reliability of the initial and modified versions of a COVID-19 self-assessment prediction tool introduced by the Egyptian Ministry of Health and Population (MoHP) early in the epidemic. The scoring tool was released for the public through media outlets for remote self-assessment of SARS-CoV-2 infection connecting patients with the appropriate level of care. METHODS: We evaluated the initial score in the analysis of 818 consecutive cases presenting with symptoms suggesting COVID-19 in a single-primary health care clinic in Alexandria during the epidemic in Egypt (mid-February through July). Validity parameters, interrater agreement and accuracy of the score as a triage tool were calculated versus the COVID-19 polymerase chain reaction (PCR) test. RESULTS: A total of 818 patients reporting symptoms potentially attributable to COVID-19 were enrolled. The initial tool correctly identified 296 of 390 COVID-19 PCR +ve cases (sensitivity = 75.9%, specificity = 42.3%, positive predictive value = 54.5%, negative predictive value = 65.8%). The modified versions of the MoHP triage score yielded comparable results albeit with a better accuracy during the late epidemic phase. Recent history of travel [OR (95% CI) = 12.1 (5.0-29.4)] and being a health care worker [OR (95% CI) = 5.8 (2.8-11.9)] were major predictors of SARS-CoV-2 infection in early and late epidemic phases, respectively. On the other hand, direct contact with a respiratory infection case increased the risk of infection by three folds throughout the epidemic period. CONCLUSION: The tested score has a sufficient predictive value and potential as a triage tool in primary health care settings. Updated implementation of this home-grown tool will improve COVID-19 response at the primary health care level.


Subject(s)
COVID-19 , Egypt , Humans , Primary Health Care , Reproducibility of Results , SARS-CoV-2 , Self-Assessment
8.
Hum Immunol ; 83(1): 10-16, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1719803

ABSTRACT

Genetic differences among individuals could affect the clinical presentations and outcomes of COVID-19. Human Leukocyte Antigens are associated with COVID-19 susceptibility, severity, and prognosis. This study aimed to identify HLA-B and -C genotypes among 69 Egyptian patients with COVID-19 and correlate them with disease outcomes and other clinical and laboratory data. HLA-B and -C typing was performed using Luminex-based HLA typing kits. Forty patients (58%) had severe COVID-19; 55% of these patients died, without reported mortality in the moderate group. The alleles associated with severe COVID-19 were HLA-B*41, -B*42, -C*16, and -C*17, whereas HLA-B*15, -C*7, and -C*12 were significantly associated with protection against mortality. Regression analysis showed that HLA-B*15 was the only allele associated with predicted protection against mortality, where the likelihood of survival increased with HLA-B*15 (P < 0.001). Patient survival was less likely to occur with higher total leukocytic count, ferritin, and creatinine levels. This study provides interesting insights into the association between HLA class I alleles and protection from or severity of COVID-19 through immune response modulation. This is the first study to investigate this relationship in Egyptian patients. More studies are needed to understand how HLA class I alleles interact and affect Cytotoxic T lymphocytes and natural killer cell function.


Subject(s)
COVID-19/genetics , HLA-B15 Antigen/genetics , SARS-CoV-2/pathogenicity , Aged , COVID-19/immunology , COVID-19/mortality , COVID-19/virology , Egypt , Female , Genetic Predisposition to Disease , HLA-B15 Antigen/immunology , Haplotypes , Host-Pathogen Interactions , Humans , Male , Middle Aged , Predictive Value of Tests , Prognosis , Protective Factors , Risk Assessment , Risk Factors , SARS-CoV-2/immunology , Severity of Illness Index , Time Factors
9.
Viruses ; 14(3)2022 02 22.
Article in English | MEDLINE | ID: covidwho-1701375

ABSTRACT

This study was intended to explore sociodemographic, nutritional, and health-related factors on the incidence of COVID-19 infection within the Egyptian population by assessing the frequency and determinants of post-COVID-19 symptoms and complications. A cross-sectional study using a structured survey on 15,166 participants was adopted. The results revealed common symptoms including fever (79.1%), cough (74.5%), anosmia& ageusia (68.4%), and dyspnea (66.9%). The patients were nonsmokers (83.9%), while 9.7% were mild smokers. The percentage of infected patients with comorbidities versus those without comorbidities were 29%, 71%, respectively. The highest incidence of infection was in those patients with hypertension (14.8%) and diabetes (10.9%), especially females with age >50 years and obesity (BMI; 30-39.9). The highest risks were observed for anticoagulants in the age above 50 years, morbid obesity, presence of comorbidities, and being a healthcare worker. The predictors of clot risk were in the age above 50 years, non-educated, and eating meat and eggs. Nonetheless, the highest risk of using antidepressants was in patients >50 years and those who traveled abroad. These findings and similarities within the surrounding region, the Middle East, North Africa, and South Europe, indicate the possibility of sharing the same viral strain and characteristics that may predict a similar vaccine efficacy and response.


Subject(s)
COVID-19 , Africa, Northern , COVID-19/complications , COVID-19/epidemiology , Cross-Sectional Studies , Egypt/epidemiology , Female , Humans , Incidence , Middle Aged
10.
Front Public Health ; 9: 748666, 2021.
Article in English | MEDLINE | ID: covidwho-1690371

ABSTRACT

Introduction: Regular collection and monitoring of data describing the dynamics of the utilization of healthcare services, especially in teaching hospitals (TH), which provide model quality medical services, are critical for COVID-19 pandemic preparedness. Methods: The researchers analyzed data and information derived from service statistics reports from June 1st to July 15th, 2020 in terms of hospital resources, as well as utilization patterns of beds, ICU, and ventilators, for 11 screening hospitals affiliated with the General Organization of Teaching Hospitals and institutes in Egypt assigned by the Ministry of Health and Population to provide medical care for COVID-19 patients. Hospital indicators in terms of COVID-19 screening services, as well as utilization patterns of inpatient beds, ICU beds, and ventilators were computed. Results: A total of 78,869 non-medical personnel and 2,176 medical personnel were presented with COVID-19 triage symptoms. Investigations conducted in the targeted 11 hospitals delineated that 22.2% of non-medical personnel and 27.9% of medical personnel were COVID-19 PCR-confirmed cases. The inpatient bed occupancy rate was 70% for non-medical patients and 67% for medical staff patients. For ICU, the bed occupancy rate was 92 % for non-medical patients and 88% for medical patients. Among the confirmed cases, 38% of medical patients utilized a ventilator vs. 36% of medical personnel cases. Hospital ranking according to utilization pattern among non-medical personnel, Hospital H ranked first in terms of the high load of screening services. Hospital C ranked first regarding the number of confirmed cases, whereas Hospital D ranked first for high ICU utilization among all teaching hospital ICU cases. With respect to medical personnel, Hospital G ranked first for the high load of screening services for the total studied cases. Hospital G ranked first for the number of confirmed cases. Hospital B ranked first regarding high ICU utilization among all teaching hospital ICU cases. Conclusion: Teaching hospitals have demonstrated preparedness for the COVID-19 pandemic by maintaining an inpatient bed occupancy rate of 70% or less and ventilator utilization at <40% of confirmed cases. However, the ICU bed occupancy rate was more than 90% indicating a shortage of resources. In addition, there is variance across hospitals regarding caseload for resource reallocation decisions.


Subject(s)
COVID-19 , Egypt/epidemiology , Hospitals, Teaching , Humans , Intensive Care Units , Needs Assessment , Pandemics/prevention & control , SARS-CoV-2
11.
Afr J Prim Health Care Fam Med ; 14(1): e1-e6, 2022 Jan 31.
Article in English | MEDLINE | ID: covidwho-1687149

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a novel sickness that emerged worldwide as an unprecedented crisis and led to major effects on the daily life of the general public as well as negative impacts on their mental well-being. AIM: This study aimed to assess satisfaction with life and psychological distress during the COVID-19 pandemic in Egypt. SETTING: An online study was conducted in Egypt. METHODS: A cross-sectional online survey was fulfilled by 1056 Egyptian adults from 06 to 13 June 2020. Psychological distress and satisfaction with life were measured by Arabic validated versions of the Kessler Psychological Distress Scale (K10) and the Satisfaction with Life Scale (SWLS). RESULTS: About half of the surveyed respondents (51%) were satisfied with their life, whilst 57.4% experienced severe psychological distress. The independent predictors of satisfaction with life are being married, satisfactory income, low distress, moderate distress and high distress (adjusted odds ratio [AOR] = 1.2, 3.0, 2.5, 6.9, 5.2 and 2.1, respectively). Being a female, having secondary education, secondary education, unsatisfactory income and presence of mental illness are the independent predictors of mental distress (AOR = 2.3, 3.9, 1.9, 1.9, 1.6 and 4.0, respectively). CONCLUSION: The study provides evidence about the high prevalence of psychological distress during the peak period of Egypt's COVID-19 pandemic. The study results highlight the enhancement of development interventions to promote psychological well-being and feeling of satisfaction with life during the pandemic.


Subject(s)
COVID-19 , Psychological Distress , Adult , Cross-Sectional Studies , Egypt/epidemiology , Female , Humans , Pandemics , Personal Satisfaction , SARS-CoV-2
12.
Int J Environ Res Public Health ; 19(4)2022 Feb 15.
Article in English | MEDLINE | ID: covidwho-1686797

ABSTRACT

The COVID-19 pandemic-related measures in the Near East and North Africa (NENA) region have resulted in many lifestyle modifications, including changes in diet and food buying patterns among adults. However, the pandemic has impacted women and men differently and exacerbated existing socio-economic and gender inequalities. Indeed, numerous studies conducted worldwide have shown that the COVID-19 pandemic had a disproportionately negative impact on women compared to males. Therefore, this paper aims to analyze the effects of COVID-19 on women's food behaviors in three countries of the North Africa sub-region, namely, Egypt, Morocco, and Tunisia. The study was based on an online poll conducted by SurveyMonkey from 15 September to 5 November 2020, with 995 participants. The outcomes of the research found that when compared to men, (1) women tend to consume more food out of fear, anxiety, or boredom; (2) women prefer to eat more unhealthy food; (3) women tend to stockpile a greater amount of food; and (4) women tend to modify their shopping habits more often. The findings should inform gender-sensitive strategies and policies to address the negative impacts of the pandemic and foster transition towards healthier diets and resilient food systems during the recovery period.


Subject(s)
COVID-19 , Adult , Africa, Northern/epidemiology , COVID-19/epidemiology , Egypt/epidemiology , Female , Humans , Male , Morocco/epidemiology , Pandemics , SARS-CoV-2 , Tunisia/epidemiology
13.
East Mediterr Health J ; 28(1): 14-22, 2022 Jan 31.
Article in English | MEDLINE | ID: covidwho-1687818

ABSTRACT

Background: Sequelae from COVID-19 are increasingly being reported, but sleep disturbances after recovery from the disease have had little attention. Aims: This study aimed to identify and compare sleep disturbances and associated correlates among adults who have recovered from COVID-19 with those who have never been infected with the disease. Methods: The sample included 85 adults who have recovered from COVID-19 and 85 adults who have never been infected (matched on age, sex, education and socioeconomic level). Individuals were recruited from Zagazig University Hospitals, Egypt from 1 September to 29 November 2020. Participants were interviewed using a sociodemographic and clinical checklist, the Pittsburgh Sleep Quality Index and the Hospital Anxiety Depression Scale. Results: Most (77%) of the recovered cases had experienced sleep disturbances, compared with 46% of controls. Individuals who had recovered from COVID-19 were more likely to have poor subjective sleep quality (odds ratio (OR) 1.5, 95% confidence interval (CI): 1.1-2.1), prolonged sleep latency (OR 1.8, 95% CI: 1.3-2.6), shorter sleep duration (OR 1.6, 95% CI: 1.1-2.2), reduced sleep efficiency (OR 3.8, 95% CI: 2.0-7.1), frequent daytime dysfunction (OR 1.9, 95% CI: 1.2-3.1) and poor global Pittsburgh Sleep Quality Index score (OR 3.0, 95% CI: 1.5-6.0). Depressive (P = 0.002) and anxiety (P = 0.003) symptoms were associated with a poor global Pittsburgh Sleep Quality Index score among recovered female participants (P = 0,034) who had low-to-medium education level (P = 0.004). Conclusions: Further studies (e.g. population-based longitudinal studies) are needed on sleep disturbances as a potential sequelae of COVID-19, because it can impair mental and physical well-being.


Subject(s)
COVID-19 , Adult , Cross-Sectional Studies , Depression/epidemiology , Depression/etiology , Egypt/epidemiology , Female , Humans , SARS-CoV-2 , Sleep
14.
Arab J Gastroenterol ; 23(1): 1-6, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1620447

ABSTRACT

BACKGROUND AND STUDY AIMS: The coronavirus disease 2019 (COVID-19) pandemic has had considerable effects on health care services given the need for re-allocation of resources and interruption of medical care. COVID-19 poses a challenge to patients with liver disease who are at risk of infection and more severe disease course. The current study aimed to assess the incidence of COVID-19 in children with liver diseases and evaluate the extent to which health care delivery was affected during lockdown. PATIENTS AND METHODS: This cross-sectional analytical study conducted at the Pediatric Hepatology Unit, Cairo University Children's Hospital utilized a questionnaire to determine the incidence of COVID-19 in patients with liver diseases and the impact of COVID-19 on the patients' liver condition and health care service delivery. A presumed score was implemented to identify patients with probable COVID-19. RESULTS: Data from 349 children with liver diseases were analyzed. The overall incidence of COVID-19 was 8%. Patients with documented and probable COVID-19 were compared to improbable COVID-19 cases. Notably, COVID-19 cases were younger and had higher incidence rates of cholestatic liver diseases. COVID-19 patients experienced significantly higher rates of hepatic complications (43%) and had significantly greater need for medical services during the lockdown. All COVID-19 patients recovered after a median (IQR) duration of 3 (4) days, except for one patient who succumbed to COVID-19 and hepatic complications. CONCLUSIONS: COVID-19 affected the younger hepatic patients with cholestatic disorders of infancy. Hepatic complications were more common among COVID-19 infected children. Alternative ways of communication require development to prioritize patients who needs a hospital visit and monitoring. Clinical scores may help diagnosis of COVID-19 in low/middle income countries like Egypt to compensate for the deficient laboratory diagnostic facilities.


Subject(s)
COVID-19 , Liver Diseases , COVID-19/epidemiology , Child , Communicable Disease Control , Cross-Sectional Studies , Delivery of Health Care , Egypt/epidemiology , Humans , Incidence , Liver Diseases/epidemiology , Pandemics , SARS-CoV-2
15.
J Public Health (Oxf) ; 43(Suppl 3): iii12-iii18, 2021 12 08.
Article in English | MEDLINE | ID: covidwho-1605198

ABSTRACT

BACKGROUND: To describe demographic, clinical and epidemiological characteristics of pregnant and nonpregnant women with confirmed COVID-19 at reproductive age and determine risk factors of COVID-19 severe outcomes during pregnancy. METHODS: A retrospective study for females aged 18-49 with confirmed COVID-19 by RT-PCR in Egypt, February-July 2020. Data were obtained from Egypt National Surveillance, bivariate and multivariate analysis for demographic and clinical characteristics and outcomes of COVID-19 between pregnant and nonpregnant women including ICU admission, need for ventilator and death was performed. RESULTS: A total of 23 095 females were identified, with mean (SD) age of 35.1 (8.1) year. Of those, 408 (1.8%) were pregnant, with mean (SD) age of 29.3 (8.1) years. Compared to nonpregnant, pregnant patients were more likely to be admitted to hospital (OR = 1.7 CI = 1.4-2.1), ICU (OR = 2.4, CI = 1.3-4.3), need ventilator (OR = 3.9, CI = 2.1-7.4) and have severe outcome (OR = 3.0, CI = 1.9-4.7). Factors associated with severe outcome included: pregnancy, age > 30 years, underlying medical conditions, and living in rural areas. CONCLUSION: Pregnant women with COVID-19 are at higher risk of severe symptoms and outcome including ICU admission, requiring ventilator and death. To reduce risk of severe outcome, counseling about for seeking medical care and health education about COVID-19 preventive measures should be performed.


Subject(s)
COVID-19 , Pregnancy Complications, Infectious , Adult , Egypt/epidemiology , Female , Hospitalization , Humans , Pregnancy , Retrospective Studies , SARS-CoV-2
16.
Infect Genet Evol ; 97: 105191, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1586992

ABSTRACT

Recently, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) resulted in Coronavirus Disease 2019 (COVID-19) outbreak. A new SARS-CoV-2 strain is expected to emerge in late 2020, including B.1.1.7. The high transmission rate of SARS-CoV-2 B.1.1.7 has raised public health concerns in several countries. Hence, in this study, we assessed the sequencing of SARS-COV2 to reveals the prevalence of the SARS-CoV-2 Alpha variant (B 1.1.7) in Egypt. We found that the viral transmission of the alpha variant is expanding. Moreover, based on hospitalizations and case fatality rates, there is a potential for increasing severity. There was no effect on susceptibility to Emergency Use Authorization monoclonal antibody treatments. However, there was minimal impact on neutralization by convalescent and post-vaccination sera. Samples have been clustered into the 20D sub clade for the majority of them. The eight samples shown in our study are considered the first recorded samples with the Alpha variant in Egypt. Therefore, The Egyptian government, represented by the Ministry of Health, must take all measures to examine the compatibility of the currently used vaccines with this new strain and the feasibility of the treatment protocol presently used with such strains developed in the Arab Republic of Egypt.


Subject(s)
COVID-19/epidemiology , Epidemiological Monitoring , Genome, Viral , SARS-CoV-2/genetics , Antibodies, Monoclonal/therapeutic use , Antibodies, Neutralizing/therapeutic use , Antibodies, Viral/therapeutic use , COVID-19/immunology , COVID-19/therapy , COVID-19/transmission , Egypt/epidemiology , Humans , Immunization, Passive , Phylogeny , Prevalence , Public Health , SARS-CoV-2/classification , SARS-CoV-2/pathogenicity , Whole Genome Sequencing
17.
Nurs Health Sci ; 24(1): 204-213, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1583469

ABSTRACT

Few studies have addressed the relationship between the nutritional status of patients with COVID-19 and their disease course. This multicenter prospective study aimed to evaluate the nutritional status of patients hospitalized with COVID-19 and its association with their clinical outcomes. Sociodemographic, physical, clinical, and nutritional data of 121 patients with confirmed COVID-19 were collected upon admission and at discharge from three COVID-19 quarantine hospitals in Egypt via a questionnaire and a standardized scale. The majority (73.6%) of the patients had a reduced dietary intake over the last week before admission, and 57% were severely ill. Overall, 14% had a high risk of malnutrition on admission, increasing to 26.3% at discharge. Malnutrition was present in most (85.7%) of the intensive care unit patients and deaths, compared with recovered patients (14%). We concluded that malnutrition might worsen the clinical outcomes and increase the morbidity and mortality of COVID-19 patients. A multidisciplinary approach is recommended to manage patients with COVID-19, considering their nutritional status before and during infection, with early detection of high-risk patients in order to design and provide the appropriate nutritional support.


Subject(s)
COVID-19 , Malnutrition , COVID-19/complications , Egypt , Hospitalization , Humans , Malnutrition/complications , Nutritional Status , Prospective Studies
19.
Endocr Metab Immune Disord Drug Targets ; 21(10): 1775-1780, 2021.
Article in English | MEDLINE | ID: covidwho-1562450

ABSTRACT

In late 2019, SARS-COV-2 disease was firstly discovered in Wuhan, China and then it infected millions of people worldwide. Later, the World Health Organization (WHO) described COVID-19 as the first pandemic invading the world in the 21st century. The WHO has declared that the emerging infection will last long enough to force adjustments not only in people's lifestyles but also in the health care system. This amendment is expected to spread through many medical practices and specialties. A lot of diagnostic and therapeutic modalities have been proposed for COVID-19 management. The best strategy for the management of patients requires a multi-disciplinary team approach with correct decisions regarding the right timing of each modality of treatment. The participating multidisciplinary team for COVID-19 management includes six infectious diseases experts in Tanta University; one critical care management expert, an emergency medicine expert and two pharmacists in Tanta University. In this review, we reported our multi-disciplinary team experience with up to date literature guidance to propose a valid protocol for the management of COVID-19 patients in a limited resources setting.


Subject(s)
Academic Medical Centers/methods , COVID-19/prevention & control , Developing Countries , Disease Management , Health Resources , Patient Care Team , Academic Medical Centers/economics , COVID-19/economics , COVID-19/epidemiology , Developing Countries/economics , Egypt/epidemiology , Health Resources/economics , Humans , Patient Care Team/economics
20.
Int J Health Serv ; 52(2): 269-275, 2022 04.
Article in English | MEDLINE | ID: covidwho-1556919

ABSTRACT

The coronavirus (COVID-19) pandemic has been spreading around the world, causing a major public health crisis that has already claimed hundreds of thousands of lives. Street-level bureaucrats--health workers, teachers, street cleaners, police officers-, and so forth-are at the forefront in fighting against the pandemic. Of these, public health care workers, due to the nature of their involvement, should know and understand why they are risking their lives to save others during this pandemic. Based on the preliminary data gleaned from interviews with public health care workers in Bangladesh and Egypt, this ongoing research suggests they are risking their lives for reasons such as altruistic behavior, service to profession, adherence to bureaucratic accountability, and a desire to help mankind. The findings contribute to the existing literature about street-level bureaucratic behavior in atypical times such as these of the pandemic. This study is unique in that it comprehends that public health care workers of two culturally and geographically distinct countries are risking their lives for the same public-spirited cause.


Subject(s)
COVID-19 , Bangladesh/epidemiology , COVID-19/epidemiology , Egypt , Health Personnel , Humans , SARS-CoV-2
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