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Objectives In this study, we aimed to determine the frequency of neurological signs, symptoms, and complications in coronavirus disease 2019 (COVID-19) patients. We also sought to explore the general characteristics of stroke patients in particular. Methods A retrospective cohort study was conducted among COVID-19 patients who were hospitalized between April-September 2020 at the Al-Noor Specialist Hospital in Makkah city, Saudi Arabia. The study included patients who were aged ≥18 years and presented with or were reported to have any neurological manifestations and/or complications secondary to COVID-19 infection. Results A total of 79 patients were included. The mean age of the cohort was 63.6 years, with a significant male predominance (67.1%). The most commonly reported neurological signs and symptoms were altered level of consciousness (45.9%), dizziness (11.5%), and focal neurological deficit (10.4%). Acute ischemic stroke was seen in 18 patients. Most of them were males (66.7%). Most strokes were in the right middle cerebral artery territory (MCA) (50.0%). Diabetic patients were four times more at risk to develop stroke [odds ratio (OR)=3.76; 95% confidence interval (CI): 1.1-29.9]. Patients with respiratory failure were 21 times more likely to have a stroke (OR=21.3; 95% CI: 2.2-54.6). Patients with acute respiratory distress syndrome recorded a three-fold increased risk for developing stroke (OR=2.96; 95% CI: 1.25-37.3). Critically ill patients had double the risk of stroke (OR=1.8; 95% CI: 1.1-6.9). Other neurological complications were hemorrhagic stroke (3.3%), subacute/chronic infarction (23.3%), meningitis (10%), and brain mass lesion (3.3%). Conclusions Neurological symptoms and complications are not uncommon among COVID-19 patients. Most of these patients had poor outcomes. Acute ischemic stroke was the most common finding on neuroimaging.
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Objectives Coronavirus disease 2019 (COVID-19) is associated with several known signs and symptoms, including olfactory disturbances leading to anosmia and parosmia. This study aimed to evaluate the clinical features of the emerging symptoms of post-COVID-19 parosmia and to report the outcome of commonly used intervention methods. Methods The study's sample included post-COVID-19 patients who complained of parosmia, presented to otorhinolaryngology clinics at private tertiary care hospitals from December 2020 to April 2021. Patients' data were collected from the hospital system and through direct phone interviews. The Modified Arabic 20-Items Sino-Nasal Outcome Test (MA-SNOT-20) was used to measure the severity of rhinosinusitis symptoms. Results Twenty-one patients were included in the study, and their ages mainly ranged between 20 and 39 years (76.2%), predominantly females 19 (90.5%). Post the COVID-19 illness course, nearly half of the patients (9; 42.9%) reported full recovery of olfaction and taste senses. Nine cases (42.9%) received treatment with intranasal and oral steroids, of which only three cases (14.3%) noticed improvement. The remaining 12 cases (57.1%) did not receive any treatment, two of which improved (9.5%). The maximum MA-SNOT score was 37 while the minimum was 3, and eight patients (38.1%) scores were between one and 10 points. Conclusion Olfactory and taste dysfunctions are common symptoms of COVID-19. The emerging symptom of parosmia is worth reporting in the literature to increase the awareness of this particular symptom in this pandemic era. Many management strategies have been introduced that might be effective. However, further studies are needed to establish evidence-based management protocols.
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OBJECTIVE: Due to introduction of a new curriculum and the related stressors that medical students might encounter, we aimed to assess the quality of the students' learning environment across academic years at Umm Al-Qura University (UQU), by evaluating stress levels, their sources, and impacts on students, to help improve the quality of learning environment and protect students from personal and academic burnout. METHODS: We conducted a descriptive cross-sectional study in August and September of 2020 on 572 students enrolled in the new Bachelor of Medicine and Bachelor of Surgery (MBBS) curriculum at UQU. All statistical analyses were performed using SPSS software and two-tailed tests. RESULTS: In total, 46.5% of participants encountered severe stress levels during their studies at UQU. In term of stressor sources, the highest prevalence of severe stress was found among students who lacked learning resources (68.8%), followed by those who complained of ambiguity in teaching, learning, and assessment strategies (64.1%). Self-study strategy issues (58.4%) and difficulty in reading textbooks (58.2%) also ranked high. Anxiety was often reported by the students as an impact of stress (62.9%), followed by mood swings (60%). Severe stress levels showed a statistically significant relationship to gender, being highest among females (P = 0.001). For a solution to manage the stress, 79% of the students suggested a supportive learning environment and identification of students' struggles at early stages. CONCLUSION: Almost half the medical students were severely stressed after the new curriculum was introduced. Therefore, professors and universities should look out for potential stressors and help students overcome them. Universities can also help by offering counseling services to students, improving the student tutoring system, providing appropriate learning environment and resources, and including stress management courses as a part of the overall curriculum.
