RESUMO
SARS-CoV-2 caused the pandemic of the rapidly evolving COVID-19. As of December 6, 2023, there were 765,152,854 COVID-19-recovering cases. Long-term consequences known as "long COVID" and "post-COVID-19 conditions" (PCCs) or "post-acute COVID-19 syndrome" are being reported more frequently in a subset of recovering patients. Systemic, neuropsychiatric, cardio-respiratory, and gastrointestinal symptoms are the most prevalent. The management of PCCs poses unique challenges due to the lack of official guidelines and the complex nature of the illness. This abstract highlights key principles derived from recent reviews and expert recommendations to provide healthcare professionals with a comprehensive approach to manage post-COVID-19 patients. Preventive medicine plays a crucial role in managing PCCs. While no specific medications are available for treatment, preventive measures such as COVID-19 vaccination, adherence to precautionary measures, regular consultations with medical professionals, monitoring symptoms and progress, and seeking information on symptom management are essential to assist patients in their recovery and improve their quality of life. Medical management requires transparent goal-setting and collaborative decision-making based on the patient's symptoms, comorbidities, and treatment objectives. Treatment plans for post-COVID-19 patients should focus on patient education, using registries and calendars to track symptoms and triggers, providing support and reassurance, and offering holistic support through peer networks and supportive psychotherapy techniques. Symptomatic and rehabilitative care, including well-established symptom management techniques, physical rehabilitation programs, and addressing mental health and well-being, are vital components of post-COVID-19 management. Lifestyle factors such as stress reduction, nutrition, and sleep should be incorporated into managing underlying medical conditions in post-COVID-19 patients. Regular follow-up visits and referrals to specialists are recommended to monitor the patient's progress and address specific organ system involvement or additional care needs. In summary, for the effective management of PCCs, a holistic approach should include preventive measures, patient education, supportive psychotherapy, symptomatic and rehabilitative care, medical management, counseling on lifestyle elements, and appropriate follow-up plans. However, it is crucial to stay updated with evolving guidelines and recommendations from healthcare authorities to provide the most effective and evidence-based care to post-COVID-19 patients.
RESUMO
Background: Adequate supply of health workforce with proper skills is essential to deliver appropriate health services in normal times and during disasters. Objective: To describe the role of the Saudi Temporary Contracting and Visiting Doctors Program in the provision of critical care during COVID-19 pandemic, and in the clearance of the surgical backlog thereafter. Methods: We reviewed reports of General Directorate of Health Services and Saudi Ministry of Health annual statistical books to obtain the following data: number of temporary healthcare professionals contracted from 2019 to 2022; number of intensive care unit beds before and during COVID-19 pandemic; volume of elective surgeries before, during and after COVID-19 pandemic. Results: In 2020, intensive care unit beds increased from 6341 to 9306 in governmental hospitals in response to COVID-19 pandemic. A total of 3539 temporary healthcare professionals were recruited from April to August 2020 to contribute towards staffing the added beds. During the recovery period from COVID-19 pandemic, 4322 and 4917 temporary health care professionals were recruited in 2021and 2022 respectively. Elective surgeries volume increased from 5074 in September 2020 to 17533 in September 2021 to 26242 in September 2022, surpassing the volume of surgeries in pre-COVID-19 period. Conclusions: In response to COVID-19 pandemic, and through the existing temporary contracting program, the Saudi Ministry of Health was able to recruit temporary staff of verified credentials in a timely manner, to supplement the existing staff, for activation of the newly added intensive care unit beds, and for clearing the resulting surgical backlog.
RESUMO
Background: The fight against COVID-19 appears to extend beyond screening and treatment of acute diseases to its medium- and long-term health consequences. Little is known about the epidemiology and the determinants of developing post-COVID-19 conditions (PCCs) among children. The aims of this study were to explore and determine the prevalence of PCCs among three age groups (children and adolescents, adults, and the elderly), and study the predictors of participants' return to their pre-COVID-19 health status among COVID-19 patients at least four weeks after they got sick, from February to 15 July 2022. Methods: This comparison survey study targeted 12,121 COVID-19 patients who fulfilled the selection criteria from the national register system and received a virtual assessment from the Medical Consultation Call Center (937), which was conducted by a well-trained family physician using a validated, well-structured assessment tool. The collected data were coded and analyzed using appropriate tests. Results: Out of the 12,121 recovered COVID-19 patients who received the virtual assessment calls, only 5909 (48.8%) agreed and completed the assessment. The majority of participants (4973, or 84.2%) reported no PCCs. The most common PCCs among young people were a cough, dyspnea, fatigue, and loss of appetite or weight loss, while among the elderly they were a cough, dyspnea, fatigue, stomachaches, poor concentration, sleep disturbance, and recurrent fever. Most post-COVID-19 cases require nothing more than reassurance and health education as only 384 (6.5%) required referral to primary health care centers (PHCCs.) The severity of COVID-19 infection, age group, sex, vaccination status, and body mass index were significant predictors for returning to the pre-infection health status and the required referral was significantly related to many factors. Conclusions: The comparison of children, adults, and the elderly with regard to the acute and post-COVID-19 conditions in Saudi Arabia in terms of the clinical health assessment and the required management plans showed significant differences.
RESUMO
Background: Temporary Contracting and Visiting Doctors' Program was initiated by the Saudi Ministry of Health to address issues of sustainable supply of healthcare professionals in the whole country and in remote areas in particular. Objective: This study aimed to describe the experience of the Saudi Temporary Contracting and Visiting Doctors' Program, the undertaken reform steps and the program outputs. Methods: We conducted a case study and reviewed documents of the Temporary Contracting and Visiting Doctors' Program to obtain data about the program's development and steps of reform. We also extracted data about the number of different types of temporary contracts, the program budget and the healthcare professionals registered on the "VISITORs" platform. Results: Scope of the Temporary Contracting and Visiting Doctors' Program had widened from contracting physicians from outside Saudi Arabia to include healthcare professionals from inside the country. The program's reform efforts included: formation of a governing central committee, development of guidelines, adoption of decentralized implementation system and modified budget release system, development of electronic staff bank and e-recruitment system and the introduction of virtual healthcare under the scope of the program. During the program evolution the number of temporary contracts has increased steadily, specifically the more efficient part-time contract variety, the contracts with physicians with rare sub-specialties, and contracts with Saudi healthcare professionals. Conclusion: Reform undertaken in the Saudi Temporary Contracting and Visiting Doctors' Program ensures needs-based recruitment, efficient use of resources, and supply of staff of verified quality.
RESUMO
OBJECTIVES: To evaluate the effect of decision aids (DAs) for metastatic colorectal cancer (mCRC) patients in the Arabic language. METHODS: A multi-centered randomized control trial was used to evaluate the effect of Arabic DA use with usual care for mCRC patients compared to usual care alone. Patients were recruited from 4 main oncology centers in Saudi Arabia: King Fahad Medical City, Riyadh; King Khalid University Hospital, Riyadh; King Saud Medical City, Riyadh; and King Fahd Specialist Hospital, Dammam, Saudi Arabia, between March 2016 and October 2018. The final follow up was in April 2019. The study measured patient understanding of prognosis, treatment options, and the level of the patient's anxiety. RESULTS: Ninety-two patients were included in the analysis; 51 in the intervention group. A small proportion of both (DA with usual care and usual care) understood that mCRC was incurable (8% and 5%) of the 2 groups, respectively. There was no significant difference between groups in anxiety level; however, a time effect both initially and after one month was significantly higher than at 6 month. CONCLUSION: The study shows that a higher level of patient's baseline understanding lowered anxiety levels over time. Decision aids group presented low levels of anxiety over time than those provided the usual care. We recommend using Arabic DA in the oncology centers dealing with mCRC patients, aiming to empower patients in decision making.
