SARS-CoV-2 Positivity in Early Infancy: A National Cohort From Saudi Arabia.

Background: Data on SARS-CoV-2 in infants ≤ 90 days are limited with conflicting reports regarding its presentation and outcomes. Methods: We conducted an ambispective cohort study using prospectively collected Health Electronic Surveillance Network Database by the Ministry of Health, Saudi Arabia. Infants of ≤ 90 days of age who had a positive RT-PCR test for SARS-CoV-2 virus were included. Patients were divided in Early neonatal (0-6 days), late neonatal (7-27 days), and post- neonatal (28-90 days) groups and were compared for clinical characteristics and outcomes by contacting parents and collecting information retrospectively. Results: Of 1,793 infants, 898 infants were included for analysis. Most infants in the early neonatal group had no features of infection (tested based on maternal positivity), whereas most infants in the late and post- neonatal groups were tested because of clinical features of infection. Fever and respiratory signs were the most common presenting feature in the late and post-neonatal groups. Hospitalization was higher in the early neonatal group (80%), compared to the two other groups. The overall mortality in the cohort was 1.6%. Conclusion: SARS-CoV-2 infection in infants ≤ 90 days might not be as rare as previously reported. The clinical presentation varies based on age at positive RT-PCR result.

Epidemiology of Child Maltreatment during the COVID-19 Pandemic in Saudi Arabia.

Child maltreatment, especially during health crises, is a major public health issue transcending cultural, social, and racial contexts. We assessed the sociodemographic and related risk factors associated with the types and rates of child maltreatment. We also assessed the economic, social, and environmental characteristics of child maltreatment victims and their perpetrators, as they were reported to the Saudi National Family Safety Program (NFSP), with consideration of the COVID-19 pandemic's impact. A secondary data analysis of a retrospective review was conducted to compare types and rates before and during the COVID-19 outbreak, utilizing descriptive and multivariate analyses on anonymized data from the NFSP. According to a predetermined list of relevant risk factors for child maltreatment outlined by the NFSP, these anonymized data were obtained and analyzed with no exclusion criteria (n = 1304). The findings showed that a child's age correlated significantly and positively with their odds of being physically maltreated; as a child's age increased by one year, on average, their corresponding predicted odds of being physically maltreatment tended to rise by a factor equal to 7.6% (p < 0.001). Neglected children, compared to those who had not been previously neglected, were predicted to be almost twice (2.23 times more) as likely to be victims of physical maltreatment on average (p < 0.001). Children were notably more likely to experience sexual abuse during the COVID-19 pandemic than those exposed to abuse during the period before (1.69 times). The COVID-19 pandemic was associated with significantly lower odds of physical child maltreatment (47.7% less). This study found no statistically significant effect of the COVID-19 pandemic on children's odds of being emotionally maltreated (p = 0.169). These findings support the existence of specific risk factors for child maltreatment for both child victims and perpetrators. They also attest to the significant differences between different types of maltreatment. A systematic, proactive system is needed to screen and document child maltreatment with a higher degree of integration with community reporting systems.

Psychosocial Impact of Lockdown on Children due to COVID-19: A Cross-Sectional Study.

Background: Quarantine measures during the COVID-19 lockdown had a negative impact on children's psychology and development. In this study, we aimed to evaluate the psychological impact of quarantine on children due to the COVID-19 pandemic in Saudi Arabia and to assess types of reported child maltreatment before and after the pandemic. Methods: A cross-sectional survey among parents was performed along with a retrospective data review for anonymized data from the National Family Safety Program, Saudi Arabia. 436 children participated in this survey during June-November 2020. Results: The percentage of fathers with an organic or psychological illness in the children with elevated anxiety levels is 18.5% (p-value = 0.019). The anxiety level of the participants was assessed using the Generalized Anxiety Disorder Assessment (GAD-7). Based on the scores, 10.1% had severe anxiety. The depression level of the participants was assessed using Patient Health Questionnaire (PHQ-9). Based on the scores, 4.4% had severe depression. The anxiety level of the children was assessed using Spence Children's Anxiety Scale - Parent (SCAS-Parent). Based on the overall score, 28.1% of the children had elevated anxiety levels. The anxiety level was elevated in a panic attack and agoraphobia for 36.8% of the kids, in separation anxiety for 26.8%, in physical injury fears for 35.1%, in social phobia for 19%, in obsessive-compulsive for 25.1%, and in generalized anxiety disorder/overanxious for 27.3%. Conclusion: Quarantine and lockdown during the period of the COVID-19 pandemic have had a negative impact and many adverse effects on the mental and intellectual development of children. These negative outcomes may be addressed via well-planned multilevel interventions.

Evaluation of the impact of the COVID-19 pandemic on the reporting of maltreatment cases to the National Family Safety Program in Saudi Arabia.

INTRODUCTION: The COVID-19 pandemic represents a global and nationwide public health crisis. Although protective, socially restrictive measures may cause social isolation, which amounts to an increased ecological risk for mental health disturbance in vulnerable populations. Previous reports have suggested a significant association between the occurrence of public health crises and increased rates of multiple risk factors related to child mental health disturbances, domestic violence, and child-maltreatment. METHODOLOGY: We conducted a retrospective data review of reported child maltreatment cases from the National Family Safety Program during the period of September 2019 to September 2020. A descriptive analysis approach was used to compare rates before and during the COVID-19 pandemic. RESULTS: During COVID-19, abuse was significantly more reported by a family member than by the victims themselves or by a healthcare worker. However, before COVID-19, the offender was less often reported to be known to the victim; was both parents or the mother but was more often described as male, older, single, less educated; and currently unemployed with no significant change observed in their health status (p < 0.001). Interestingly, the predicted type of abuse also significantly differed and was more emotional or sexual than other types (p < 0.001). CONCLUSION: The types of abuse and the characteristics of both abused children and offenders saw significant changes during the COVID-19 pandemic. Sexual and emotional abuses were reported more frequently, and the male gender is considered to feature more commonly in reports prior to the pandemic era than during the pandemic.

Awareness, acceptance, and perspective of women for reconstruction post Mastectomy.

OBJECTIVE: To assess the level of awareness and acceptance among women for breast reconstruction surgery after mastectomy. METHODS: The observational cross-sectional study was conducted at King Khalid University Hospital, Riyadh, Saudi Arabia, from November 2014 to April 2015, and comprised women aged 19-65 years with breast masses and women with high risk for breast cancer who were offered therapeutic mastectomy. The subjects were interviewed using a structured and validated questionnaire. Data was analyzed using SPSS 21. RESULTS: Of the 224 individuals approached, 209(93.3%) participated. Of them, 106(50.7%) considered having reconstruction and 97(46.4%) had read or heard about it. The most influencing factor for reconstruction was improving their psychological status 84(40.2%) and the most common reason for refusal was old age 26(12.4%). Patients who were 40 years or younger were more willing to undergo reconstruction (p=0.001). CONCLUSIONS: Patients with knowledge about breast reconstruction were more willing to accept the procedure. Increasing the awareness will increase acceptance of breast reconstruction..

Migraine and Headache Prevalence and Associated Comorbidities in a Large Saudi Sample.

BACKGROUND: We aimed to assess the prevalence of headache and migraine, along with comorbidities, in a large -Saudi sample. METHODS: Self-reported information was collected about headache, migraine and migraine comorbidities including depression, restless legs syndrome (RLS), syncope, bruxism, hypertension and ischaemic disease. The OR was estimated using logistic regression for any associations with headache and migraine. We then analyzed to find a trend of increasing migraine symptoms for each significant comorbidity. RESULTS: Out of 4,943 respondents, 4,158 (84.12%) had recurring headaches. Migraine was present in 1,333 (26.97%), with female predominance (ratio of 1: 2.9). There were statistically significant ORs between migraine and female sex, current smokers, higher income, hypertension, depression, syncope, RLS and bruxism. Non-migraine headaches were significantly associated with female sex, age, RLS and ischaemic disease. Migraine with aura was significantly associated with syncope, ischaemic disease, higher income and BMI. There was an overall significant trend of increasing migraine features in the presence of depression, syncope, RLS, bruxism and hypertension. CONCLUSIONS: Headache in general and migraine in particular are associated with multiple comorbidities in comparison to non-headache participants in our cohort, with an estimated prevalence similar to that of western countries.