Exploring the reported adverse effects of COVID-19 vaccines among vaccinated Arab populations: a multi-national survey study.

The coronavirus disease 2019 (COVID-19) pandemic has been a major challenge worldwide for the past years with high morbidity and mortality rates. While vaccination was the cornerstone to control the pandemic and disease spread, concerns regarding safety and adverse events (AEs) have been raised lately. A cross-sectional study was conducted between January 1st and January 22nd, 2022, in six Arabic countries namely Saudi Arabia, Egypt, Syria, Libya, Iraq, and Algeria. We utilized a self-administered questionnaire validated in Arabic which encompassed two main parts. The first was regarding sociodemographic data while the second was about COVID-19 vaccination history, types, doses, and experienced AEs. A multistage sampling was employed in each country, involving the random selection of three governorates from each country, followed by the selection of one urban area and one rural area from each governorate. We included the responses of 1564 participants. The most common AEs after the first and second doses were local AEs (67.9% and 46.6%, respectively) followed by bone pain and myalgia (37.6% and 31.8%, respectively). After the third dose, the most common AEs were local AEs (45.7%) and fever (32.4%). Johnson and Johnson, Sputnik Light, and Moderna vaccines showed the highest frequency of AEs. Factors associated with AEs after the first dose included an increase in age (aOR of 61-75 years compared to the 12-18 years group: 2.60, 95% CI: 1.59-4.25, p = 0.001) and male gender (OR: 0.72, 95% CI: 0.63-0.82, p < 0.001). The cumulative post-vaccination COVID-19 disease was reported with Sinovac (16.1%), Sinopharm (15.8%), and Johnson and Johnson (14.9) vaccines. History of pre-vaccination SARS-CoV-2 infection significantly increases the risk of post-vaccination COVID-19 after the first, second, and booster doses (OR: 3.09, CI: 1.9-5.07, p < 0.0001; OR: 2.56, CI: 1.89-3.47, p < 0.0001; and OR: 2.94, CI: 1.6-5.39, p = 0.0005 respectively). In conclusion, AEs were common among our participants, especially local AEs. Further extensive studies are needed to generate more generalizable data regarding the safety of different vaccines.

Role of neutrophil to lymphocyte ratio as a prognostic indicator for COVID-19.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a new pandemic disease, associated with substantial morbidity and mortality. Its diagnosis requires centralized facilities and time. AIMS: To describe the exposure history and clinical picture of the COVID-19 patients, to study the SARS-CoV-2 Virus load and some determinants that may correlate with its prognosis, and to evaluate the role of inflammatory index NLR as an early predictor of COVID-19 prognosis. METHODOLOGY: A prospective follow-up study included laboratory-confirmed 179 COVID-19 cases out of 660 suspected COVID-19 cases, at El-Madinah El-Monawarah General Hospital in April 2020. Confirmed cases were managed by the Saudi Protocol and followed up every 2 weeks by PCR, neutrophil to lymphocyte ratio (NLR) for 1 month. Data were collected through a validated questionnaire and by qualified infection control staff. RESULTS: The majority of the COVID-19 cases were 67 (37.4%) aged 30 to <45 years, 157 (87.7%) males, 76.0% working outside the medical field. 38.0% were asymptomatic and 26.3% had severe symptoms, while the main presenting symptoms were fever and dry cough (49.7% and 43.6%), respectively. The case fatality was 7.8%. The male, nonmedical occupation, and low level of education had a statistically significant relationship with the baseline PCR. There was an inverse significant correlation between baseline PCR readings and the recovery duration and health status outcomes. NLR was noted to be significantly higher among old age, illiterate nonmedical occupation, case with severe symptoms, MICU admission, and worst health status outcomes, but it was paradoxically higher among nonadmitted positive cases. CONCLUSION: Admitted COVID-19 cases outcomes (disease severity, ICU admission, and mortality) significantly correlated to NLR and not to the baseline PCR viral load. NLR could be a beneficial prognostic and triaging parameter especially old nonmedical COVID-19 patients.

Effect of glycemic gap on short term outcome in critically ill patient: In zagazig university hospitals.

Both admission Blood glucose and previous glycemic state may affect critically ill patients; So Glycemic gap may be a good indicator of ICU outcomes. This study investigated the effect of glycemic gap on short term outcome in critically ill patient and the value of incorporation of the Glycemic Gap into the APACHE-II on its discriminative performance. SUBJECTS AND METHODS: This cross sectional study was conducted in medical ICU of Zagazig University Hospitals, March 2018 to September 2018; total numbers of 240 critically ill patients admitted to ICU were enrolled in. All of them were subjected to: full history taking, clinical examination, routine investigations, random blood sugar, hemoglobin A1c. ADAG, Glycemic Gap and APACHE II were calculated. RESULTS: Elevated glycemic gap was associated with an increased ICU mortality and APACHE-II score was a good predictor of ICU mortality in critically ill patients. CONCLUSIONS: Elevated glycemic gap was significantly associated with an increased ICU mortality that the glycemic gap can be used to assess the severity and prognosis of critically ill patients and their incorporation into the APACHE II score has increased its performance as a predictor of mortality.

Effect of Ramadan fasting on incidence of cerebrovascular stroke in Egyptian patients with Type 2 Diabetes Mellitus.

Diabetes is an independent risk factor for stroke disease. Fasting during Ramadan, Muslims must abstain from eating, drinking, taking oral medications, and smoking from the exact time of dawn until time of sunset; in this study we investigated if there is impact of Ramadan Fasting on incidence of Cerebrovascular stroke among Patients with Type 2 Diabetes Mellitus. This cross sectional study was conducted in medical ICU of Zagazig University Hospitals, in months of Sha'ban, Ramadan and Shawwal, in 1436; total numbers of 220 patients diagnosed as cerebrovascular stroke were enrolled in. All of them were subjected to: full history taking and clinical examination, routine investigations and special investigations (CT brain & MRI brain). RESULTS: There was no significant difference in total frequency of Cerebrovascular stroke (ischemic, hemorrhagic) between patients with diabetes admitted during the month of Ramadan and other months before or after. However, during Ramadan, there was numerical but statistically not significant increase in number of patients with ischemic stroke than hemorrhagic stroke. CONCLUSION: Fasting during Ramadan does not increase the frequency of hospitalization for stroke as whole. Although; there is numerical increase in frequency of ischemic stroke than hemorrhagic stroke.

Complement c1q tumor necrosis factor-related protein 3 a novel adipokine, protect against diabetes mellitus in young adult Egyptians.

C1q/TNF-related protein-3 (CTRP3) is a novel adipokine with anti-inflammatory and a multitude of biological effects on glucose and lipid metabolism however, the influence of CTRP3 on incidence of diabetes mellitus remain unclear. This study investigated the effects of CTRP3 levels in obese and normal body weight young adults on insulin resistance and occurrence of diabetes mellitus. SUBJECTS AND METHODS: In this case control study, Serum levels of CTRP3, HbA1c, Lipid profile, glucose and insulin levels were determined in 75 obese and 68 normal body weight individuals. RESULTS: In obese young adults CTRP3 concentrations were decreased compared to normal body weight young adults (NBW). The association between reduction of CTRP3 concentrations and the presence of diabetes is statistically significant. CTRP3 showed significant negative correlation with BMI, HOMA-IR and triglycerides as well as positive correlations with HDL - cholesterol while there is no association between CTRP3 and BMI within the NBW group. Higher HbA1C, HOMA-IR, and risk of diabetes development within obese subjects were related to lower CTRP3 concentration. CONCLUSIONS: This study shows that reduction of CTRP3 concentrations is likely to bring a concomitant increase in risk of diabetes in obese and normal body weight young adults. Decrease in CTRP3 concentration may have an essential role in the pathophysiology of metabolic disorders concomitant to obesity.