Duration and aetiology of extended hospitalization among COVID-19 patients in United Arab Emirates.

Background: A retrospective review of the early stages of the COVID-19 pandemic in 2020 and the challenges faced by hospitals is essential in the post-pandemic era of 2022. Aim: To identify the reasons for prolonged hospitalization after recovery for COVID-19 patients in the United Arab Emirates. Methods: This was a retrospective observational study of 150 (18.75%) patients with prolonged hospitalization in a tertiary hospital in Dubai from 1 April to 1 July 2020. Data was obtained from the electronic medical records of the hospital. Continuous variables are reported as mean and standard deviation, and categorical variables are reported as numbers and percentages. Results: The mean duration of hospitalization was 48.5 (9-272) days, with an interquartile range (IQR) of 22 days. The mean duration of extended stay was 27.5 (2-231) days, with an IQR of 17 days. The common reasons for prolonged hospitalization were mandatory isolation 28% (n = 62), hospital-acquired infections 17% (n = 37), acute respiratory distress syndrome 15% (n = 32), myopathy/neuropathy 14% (n = 31), pulmonary fibrosis requiring oxygen supplementation 14% (n = 31), and completion of COVID-19 treatment 12% (n = 25). Conclusion: To make optimal use of available hospital resources, reasons that directly or indirectly contributed to the prolonged hospitalization of patients should be considered and addressed during future pandemics or disease outbreaks.

An extraordinary case of recurrent stroke, disseminated thrombosis and endocarditis.

A 43-year-old woman with no known cardiovascular risk factors was admitted with a second episode of ischaemic stroke. She was not a known case of connective tissue disease like systemic lupus erythematosus or antiphospholipid syndrome (APS). During the current episode, she was found to have markedly deranged coagulation parameters and laboratory evidence of microangiopathic haemolysis, but no evidence of sepsis or active bleeding. Further investigation revealed multiple organ infarcts. A diagnosis of probable catastrophic APS was made and she improved dramatically with a combination of plasmapheresis, corticosteroids and therapeutic anticoagulation. Serological markers of APS were negative. Her hospital course was complicated by Libman Sacks endocarditis with significant aortic regurgitation that improved markedly with anticoagulation obviating the need for high-risk cardiac surgery. At discharge, she was stable and well and was advised long-term anticoagulation and rheumatology follow-up.