The Impact of COVID-19 Infection on Patients with Chronic Diseases Admitted to ICU: a Cohort Retrospective Study.

The coronavirus disease (COVID-19) infection is causing significant morbidity and mortality rates worldwide. A comprehensive investigation of the disease characteristics, especially among vulnerable disease groups, could help better manage the disease and reduce the pathogen's effect. This retrospective study examined the impact of COVID-19 infection on three groups of patients with chronic diseases. We investigated the clinical characteristics and outcomes of 535 COVID-19 patients with cardiovascular diseases (CVD), chronic kidney diseases (CKD), and Cancer that were admitted to the Intensive Care Unit (ICU). Of the total cases, 433 patients (80.93%) were discharged from the ICU, and 102 patients (19.06%) were declared dead. Patients' symptoms, their clinical laboratory findings, number and type of medications, length of ICU stay, and outcome were collected and analyzed. Most COVID-19 patients included in our study were associated with other comorbidities such as diabetes mellitus, hypertension, and heart disease and failure. Upon ICU admission, the main COVID-19-related symptoms in CVD, CKD, and cancer patients were cough (55.73, 50.42, and 50.5%, respectively), Shortness of Breath (SOB) (59.38, 43.1, and 43.7%, respectively), and fever (41.15%, 48.75%, and 28.2%, respectively). In terms of lab findings, D-dimer, LDH, and inflammatory markers, in particular, were outside the normal range. Treatment options for patients with COVID-19 in ICU were mainly antibiotics, synthetic glucocorticoids, and Low Molecular Weight Heparin (LMWH). Furthermore, CKD patients had a longer ICU stay (13.93 ± 15.87 days) which illustrates the poorer outcome in this group of patients compared with the others. In conclusion, our results highlighted the significant risk factors among COVID-19 patients within the three groups. This can guide physicians in prioritizing ICU admission and help in the management of critically ill patients with COVID-19.

The impact of the COVID-19 pandemic on rehabilitation services provided for cochlear implant recipients in Saudi Arabia.

OBJECTIVE: This study examines the impact of the COVID-19 pandemic on cochlear implantation (CI) recipients in Saudi Arabia. The impact was measured using the results of an online survey that investigated challenges related to access to re/habilitation and programming services, increased dependence on virtual interaction, and emotional impact. METHODS: The cross-sectional online survey reached 353 pediatric and adult CI recipients between April 21st and May 3rd 2020, during the first weeks of implementing the lockdown strategy and the transitioning to virtual settings. RESULTS: It was revealed that overall access to aural re/habilitation was considerably affected during the pandemic, and that the impact of this disruption was significantly greater for pediatric recipients than for adults. On the other hand, overall access to programming services was not affected. Results also revealed that CI recipients' performance at school or work was negatively impacted by the transition to a virtual communication. In addition, participants noticed a decline in their auditory performance, language skills, and speech understanding. They also registered feelings of anxiety, social isolation, and fear related to sudden changes in their CI function. Finally, the study revealed a gap between CI clinical/non-clinical support provided during the pandemic and the expectations of CI recipients. CONCLUSION: Collectively, outcomes from this study highlight the importance of shifting towards a more patient -centered model that offers empowerment and self-advocacy. In addition, the outcomes also emphasize the importance of developing and adapting emergency protocols. This will ensure continuation of services provided to CI recipients during scenario disasters like a pandemic.Key messagesPediatric aural re/habilitation was subjected to a significantly greater interruption, compared to adult aural re/habilitation, duringthe COVID-19 shutdown.Cochlear Implant (CI) recipients expressed feelings of anxiety, social isolation, and fear. These feelings were related to sudden changes in their CI functioning, caused by interruption of support services during the pandemic.Patient -centered model can offer emergency protocols that ensure a smooth continuation of cochlear implant-related re/habilitation and services during disaster scenarios such as the COVID-19 pandemic.