ABSTRACT
BACKGROUND: The efficacy of corticosteroid use in patients with acute respiratory illness due to coronavirus disease-2019 (COVID-19) is unclear. In this study, we describe the clinical course of COVID-19 patients who received early course of corticosteroid treatment in patients with severe respiratory distress secondary to COVID-19. MATERIALS AND METHODS: The clinical course of 30 COVID-19 patients admitted to King Fahad Military Medical Complex in Dhahran from the period of late March 2020 till June 2020 was assessed and described. All the 30 patients received steroids. Data on demographics, medical history, laboratory findings, chest radiology, medication use, and clinical outcomes were extracted from patients' records. Data was entered and analyzed with SPSS software. RESULTS: A total of 30 patients admitted with COVID-19 were included. The mean age 52.53 years (SD=16.31) with a range from 22-98 years; 73.3% were males. About two-thirds of the patients at least had comorbidities; most common were diabetes (46.7%) and hypertension (46.7%), and chronic heart disease (16.7%). About 57% patients had fever, cough, and shortness of breath. The median C-reactive protein (CRP) level was 87.5 mg/dL (IQR 45.0 - 165.65); 46.7% had CRP levels >120 mg/dL. The median white blood cell, lymphocytes, and platelet counts were 4.39, 1.05, and 212 K/µL, respectively. All the patients received corticosteroids; 17 (56.7%) patients were given IV methylprednisolone and 13 (43.3%) received dexamethasone tablets. Of the total patients, 13 (43.3%) patients developed acute respiratory distress syndrome (ARDS); 17 (56.7%) required oxygen, 10 (33.3%) were admitted to Intensive Care Unit (ICU), and 7 (23.3%) required mechanical ventilation. All the patients improved and were discharged home well. CONCLUSION: Early use of oral corticosteroids in patients with higher CRP levels may lead to better outcomes and may lower risk of transfer to ICU and use of mechanical ventilation.
ABSTRACT
INTRODUCTION: The Kingdom of Saudi Arabia was one of the first countries to implement a COVID-19 vaccination program. This study estimated the safety and reactogenicity of the ChAdOx1-S vaccine after the first dose administered to adults. METHODS: This cross-sectional study included 1592 randomly selected vaccinees from April to May 2021. A questionnaire was delivered to the vaccinees via phone calls 7 and 21 days after the first vaccine dose. RESULTS: Of the 1592 vaccinees who had the first dose, the mean age was 37.4 (± 9.6) years and 81% were males. Of all the vaccinees, 553 (34.7%) reported an adverse reaction on the first telephone call. The most common symptoms were: pain at the site of injection (485, 30.5%), musculoskeletal symptoms (438, 27.5%), skin rash (307, 19.2%), gastrointestinal symptoms (379, 23.8%) and fever (498, 31.3%). Men were more likely to report fever (76.9% vs. 23.1%; P = 0.005), skin rash (81.1% vs. 18.9%, P = 0.005) and pain at the injection site (77.3% vs. 22.7%, P < 0.0001). Post-vaccine COVID-19 infection was 0.5% and there were no hospitalizations. CONCLUSION: This study observed no major side effects of the ChAdOx1-S vaccine and no reported breakthrough infection during the observation period.
