1
|
Nur AM, Aljunid SM, Almari M. The Economic Burden of the COVID-19 Pandemic in State of Kuwait. CLINICOECONOMICS AND OUTCOMES RESEARCH 2024; 16:111-122. [PMID: 38463550 PMCID: PMC10921943 DOI: 10.2147/ceor.s442913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/28/2024] [Indexed: 03/12/2024] Open
Abstract
Purpose The main aim of this study is to estimate the provider's cost, patients' cost (home and institutional quarantine cost) and the total economic burden of COVID-19 for patients with PCR positive in Kuwait. Patients and Methods This cross-sectional and retrospective study identified the cost incurred for treating COVID-19 inpatients admitted to a General Hospital in Kuwait, a designated COVID-19 treatment center by the Kuwait Government during pandemic. A total of 485 COVID-19 patients were randomly selected from May 1st to September 31st, 2021. Data on sociodemographic information, length of stay (LOS), discharge status, and comorbidities were obtained from the patients' medical records. A step-down approach was done to estimate the healthcare provider cost per patient per admission. Patient cost (loss of productivity due to hospitalization, institutional and home quarantine) was calculated using human capital approach. The national economic burden of COVID-19 was estimated using costing data from a general hospital for the entire nation. The data were analyzed using the statistical software package SPSS version 25. Results In all, 485 COVID-19 patients were involved in the research. KD 2216 (USD 7,344) was the average cost per patient per admission. The ICU accounted for 20.6% of the total cost, the physician and nursing staff for 42.1%, and the laboratory services for 10.2%. The estimated annual cost of care for COVID-19 patients in Kuwait was KD 147.4 (USD 488.5) million, or 5.5% of the MOH budget for 2021, given that 9.03% (383,731) of the population had positive COVID-19 PCR results in 2021. The range of the estimated national economic burden, considering both the best and worst-case scenarios, is KD 73.6 (USD 244.2) million to KD 221.0 (USD 732.7) million. Conclusion COVID-19 poses a substantial financial strain on the healthcare system, estimated at 5.9% to 8.8% of the MOH's annual budget and 0.2% to 0.7% of Kuwait's GDP in 2021. To mitigate costs, prioritizing prevention and health education is crucial. Targeted strategies, such as workforce optimization, are needed to address high expenses. Policymakers and administrators should leverage these insights for enhanced efficiency and sustainability in future epidemic responses.
Collapse
Affiliation(s)
- Amrizal Muhammad Nur
- Department of Health Policy and Management, College of Public Health, Health Sciences Center, Kuwait University, Shadadiya, Kuwait
| | - Syed Mohamed Aljunid
- Department of Public Health and Community Medicine, International Medical University, Kuala Lumpur, Malaysia
| | - Mohammad Almari
- Department of Health Policy and Management, College of Public Health, Health Sciences Center, Kuwait University, Shadadiya, Kuwait
| |
Collapse
|
2
|
Nur AM, Aljunid SM, Almari M. Cost of in-patient management of COVID-19 patients in a general hospital in Kuwait. BMC Health Serv Res 2023; 23:1314. [PMID: 38017444 PMCID: PMC10685622 DOI: 10.1186/s12913-023-10287-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 11/06/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Among the GCC countries affected by COVID-19 infections, Kuwait has been significantly impacted, with 658,520 cases and 2,563 deaths reported by the WHO on September 30, 2022. However, the impact of the COVID-19 epidemic on Kuwait's economy, especially in the healthcare sector, remains unknown. OBJECTIVE This study aims to determine the total cost of managing COVID-19 in-patients in Kuwait. METHOD A cross-sectional design was employed for this study. A total of 485 COVID-19 patients admitted to a general hospital responsible for COVID-19 cases management were randomly selected for this study from May 1st to September 31st, 2021. Data on sociodemographic information, length of stay (LOS), discharge status, and comorbidities were obtained from the patients' medical records. The data on costs in this study cover administration, utility, pharmacy, radiology, laboratory, nursing, and ICU costs. The unit cost per admission was calculated using a step-down costing method with three levels of cost centers. The unit cost was then multiplied by the individual patient's length of stay to determine the cost of care per patient per admission. FINDINGS The mean cost of COVID-19 in-patient care per admission was KD 2,216 (SD = 2,018), which is equivalent to USD 7,344 (SD = 6,688), with an average length of stay of 9.4 (SD = 8.5) days per admission. The total treatment costs for COVID-19 in-patients (n = 485) were estimated to be KD 1,074,644 (USD 3,561,585), with physician and nursing care costs constituting the largest share at 42.1%, amounting to KD 452,154 (USD 1,498,529). The second and third-largest costs were intensive care (20.6%) at KD 221,439 (USD 733,893) and laboratory costs (10.2%) at KD 109,264 (USD 362,123). The average cost for severe COVID-19 patients was KD 4,626 (USD 15,332), which is almost three times higher than non-severe patients of KD 1,544 (USD 5,117). CONCLUSION Managing COVID-19 cases comes with substantial costs. This cost information can assist hospital managers and policymakers in designing more efficient interventions, especially for managing high-risk groups.
Collapse
Affiliation(s)
- Amrizal Muhammad Nur
- Department of Health Policy and Management, College of Public Health, Kuwait University, Shadadiya, Kuwait.
| | - Syed Mohamed Aljunid
- Department of Health Policy and Management, College of Public Health, Kuwait University, Shadadiya, Kuwait
- Department of Public Health and Community Medicine, International Medical University, Kuala Lumpur, Malaysia
| | - Mohammad Almari
- Department of Health Policy and Management, College of Public Health, Kuwait University, Shadadiya, Kuwait
| |
Collapse
|
3
|
Rocha JLL, Riediger I, Gasparetto J, Tuon FF. COVID-19 in real world: Survival and medical costs of hospitalized patients in Brazil´s first wave. Braz J Infect Dis 2023; 27:102778. [PMID: 37209711 PMCID: PMC10183623 DOI: 10.1016/j.bjid.2023.102778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 04/01/2023] [Accepted: 05/04/2023] [Indexed: 05/22/2023] Open
Abstract
OBJECTIVE To evaluate survival and direct medical costs of patients admitted in private hospitals with COVID-19 during the first wave. METHODS A retrospective, observational study analyzing survival and the economic data retrieved on hospitalized patients with COVID-19. Data from March 2020 to December 2020. The direct cost of hospitalization was estimated using the microcosting method with each individual hospitalization. RESULTS 342 cases were evaluated. Median age of 61.0 (95% CI 57.0‒65.0). 194 (56.7%) were men. The mortality rate was higher in the female sex (p = 0.0037), ICU (p < 0.001), mechanical ventilation (p<0.001) and elderly groups. 143 (41.8%) patients were admitted to the ICU (95% CI 36.6%-47.1%), of which 60 (41.9%) required MV (95% CI 34.0%-50.0%). Global LOS presented median of 6.7 days (95% CI 6.0-7.2). Mean costs were US$ 7,060,00 (95% CI 5,300.94-8,819,00) for each patient. Mean cost for patients discharged alive and patients deceased was US$ 5,475.53 (95% CI 3,692.91-7,258.14) and US$ 12,955.19 (95% CI 8,106.61-17,803.76), respectively (p < 0.001). CONCLUSIONS Patients admitted with COVID-19 in these private hospitals point to great economic impact, mainly in the elderly and high-risk patients. It is key to better understand such costs in order to be prepared to make wise decisions during the current and future global health emergencies.
Collapse
Affiliation(s)
- Jaime Luís Lopes Rocha
- Pontifícia Universidade Católica do Paraná, Faculdade de Medicina, Laboratório de Doenças Infecciosas Emergentes, Curitiba, PR, Brazil
| | - Irina Riediger
- Laboratório Central do Estado do Paraná, São José dos Pinhais, PR, Brazil
| | - Juliano Gasparetto
- Pontifícia Universidade Católica do Paraná, Faculdade de Medicina, Laboratório de Doenças Infecciosas Emergentes, Curitiba, PR, Brazil
| | - Felipe Francisco Tuon
- Pontifícia Universidade Católica do Paraná, Faculdade de Medicina, Laboratório de Doenças Infecciosas Emergentes, Curitiba, PR, Brazil.
| |
Collapse
|
4
|
Changes in a Hospital’s Costs and Revenues Before and After COVID-19: A Case Study of an Iranian Hospital. HEALTH SCOPE 2021. [DOI: 10.5812/jhealthscope.111620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: The Coronavirus Disease 2019 (COVID-19) pandemic has caused a severe shock to the world economy and, consequently, healthcare systems. Objectives: The current study aimed to investigate changes in costs and revenues of an Iranian hospital before and after the COVID-19 pandemic to answer the following question: "How can hospital costs and revenues change during the COVID-19 pandemic?" Methods: This descriptive cross-sectional study was conducted retrospectively at the Masih Daneshvari Hospital in 2020. Accounting software available at the hospital (Azarakhsh for salary costs and PMQ for medical equipment costs) was used to collect cost information. Also, the hospital information system software was used to collect revenue information. The 2019 financial year was considered the base year, and the period February-August 2020 was considered the COVID-19 outbreak period. The data were entered into Excel software and analyzed using descrip¬tive statistics methods. Results: Before the COVID-19 outbreak, the Masih Daneshvari Hospital was facing many cost problems, and the new crisis added to the severity of the problems. In total, the hospital's revenue declined by 9%, and its costs increased by 70%. Therefore, in the fiscal year ending in March 2020, the hospital balance was reported to be $-607,143 (-68,000 million Iranian Rial). Conclusions: The soaring healthcare expenditures revealed that the hospital was not ready to deal with the disease. As the COVID-19 outbreak grows rapidly in Iran, there is a pressing need to increase medical capacities and inpatient beds to treat infected patients. Hospitals in the country face financial problems and should be supported by the Ministry of Health and Medical Education.
Collapse
|
5
|
Mathematical model of the feedback between global supply chain disruption and COVID-19 dynamics. Sci Rep 2021; 11:15450. [PMID: 34326384 PMCID: PMC8322052 DOI: 10.1038/s41598-021-94619-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 06/29/2021] [Indexed: 02/07/2023] Open
Abstract
The pandemic of COVID-19 has become one of the greatest threats to human health, causing severe disruptions in the global supply chain, and compromising health care delivery worldwide. Although government authorities sought to contain the spread of SARS-CoV-2, by restricting travel and in-person activities, failure to deploy time-sensitive strategies in ramping-up of critical resource production exacerbated the outbreak. Here, we developed a mathematical model to analyze the effects of the interaction between supply chain disruption and infectious disease dynamics using coupled production and disease networks built on global data. Analysis of the supply chain model suggests that time-sensitive containment strategies could be created to balance objectives in pandemic control and economic losses, leading to a spatiotemporal separation of infection peaks that alleviates the societal impact of the disease. A lean resource allocation strategy can reduce the impact of supply chain shortages from 11.91 to 1.11% in North America. Our model highlights the importance of cross-sectoral coordination and region-wise collaboration to optimally contain a pandemic and provides a framework that could advance the containment and model-based decision making for future pandemics.
Collapse
|
6
|
Jang SY, Seon JY, Yoon SJ, Park SY, Lee SH, Oh IH. Comorbidities and Factors Determining Medical Expenses and Length of Stay for Admitted COVID-19 Patients in Korea. Risk Manag Healthc Policy 2021; 14:2021-2033. [PMID: 34040465 PMCID: PMC8140929 DOI: 10.2147/rmhp.s292538] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 03/20/2021] [Indexed: 01/22/2023] Open
Abstract
Purpose No previous investigations of coronavirus disease 2019 (COVID-19) have estimated medical expenses, length of stay, or factors influencing them using administrative datasets. This study aims to fill this research gap for the Republic of Korea, which has over 10,000 confirmed COVID-19 cases. Patients and Methods Using the nationwide health insurance claims data of 7590 confirmed COVID-19 patients, we estimated average medical expenses and inpatient days per patient, and performed multivariate negative binomial, and gamma regressions to determine influencing factors for higher outcomes. Results According to the results, COVID-19 patients with history of ICU admission, chest CT imaging, lopinavir/ritonavir and hydroxychloroquine use stayed longer in the hospital and spent more on medical expenses, and anti-hypertensive drugs were insignificantly associated with the outcomes. Female patients stayed longer in the hospital in the over 65 age group but spent less in medical expenses that the 20-39 group. In the 40-69 age group, patients with health insurance stayed longer in the hospital and spent more on medical expenses than those aged over 65 years. Comorbidities did not affect outcomes in most age groups. Conclusion In summary, contrary to popular beliefs, medical expenses and length of hospitalization were mostly influenced by age, and not by comorbidities, anti-viral, or anti-hypertensive drugs. Thus, responses should focus on infection prevention and control rather than clinical countermeasures.
Collapse
Affiliation(s)
- Su Yeon Jang
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - Jeong-Yeon Seon
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - Seok-Jun Yoon
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
| | - So-Youn Park
- Department of Medical Education and Humanities, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - Seung Heon Lee
- Division of Pulmonary, Sleep, and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea
| | - In-Hwan Oh
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, South Korea
| |
Collapse
|
7
|
Bagepally BS, Haridoss M, Natarajan M, Jeyashree K, Ponnaiah M. Cost-effectiveness of surgical mask, N-95 respirator, hand-hygiene and surgical mask with hand hygiene in the prevention of COVID-19: Cost effectiveness analysis from Indian context. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021; 10:100702. [PMID: 33558852 PMCID: PMC7859732 DOI: 10.1016/j.cegh.2021.100702] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/29/2020] [Accepted: 01/18/2021] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION In the absence of specific treatment, preventive strategies are of paramount importance in management of coronavirus disease 2019(COVID-19) pandemic. We estimated cost-effectiveness of non-pharmacological interventions such as hand-hygiene, surgical-mask N-95 respirators and surgical mask in general population. METHODS We performed a decision tree and markov-model based economic evaluation. We estimated total costs and outcomes from public payer's perspective, based on information available through systematic literature search on relative intervention effect during early pandemic phase. We estimated outcomes as number COVID-19 prevented and Quality Adjusted life year (QALY) over one-year time-horizon with one-day cycle-length. Incremental cost effectiveness ratios (ICER) was calculated multiple sensitivity analyses were applied to assess parameter uncertainty. RESULTS Use of surgical mask with hand hygiene, fit tested N-95 respirator, surgical-mask, non-fit tested N-95 and hand-hygiene interventions prevented additional 1139, 1124, 1121, 1043 and 975 COVID-19 cases per-million as compared to using none. Additional costs incurred (in billion) were ₹29.78 ($0.40), ₹148.09 ($1.99), ₹72.51 ($0.98), ₹26.84 ($0.36) and ₹2.48 ($0.03) as well as additional QALYs gained were 357.4, 353.01, 327.95, 351.52 and 307.04 for surgical mask with hand hygiene, fit-tested N-95, non-fit-tested N-95, surgical mask and hand-hygiene respectively. ICERs with surgical with hand hygiene, hand-hygiene alone, surgical-mask alone, N-95 respirator fit and non-fit test were 83.32($1.12), 8.07($0.11), 76.36($1.03), 419.51($5.65) and 221.10 ($2.98) million ₹ ($)/QALY respectively. Results were robust on uncertainty analysis. DISCUSSION Among the non-pharmacological interventions to be considered for preventing spread of COVID-19, hand hygiene was cost-effective and avoidance of use of surgical masks and respirators by the general public could save resources.
Collapse
Affiliation(s)
| | - Madhumitha Haridoss
- Health Technology Assessment Resource Centre, ICMR- National Institute of Epidemiology, Chennai, India
| | - Meenakumari Natarajan
- Health Technology Assessment Resource Centre, ICMR- National Institute of Epidemiology, Chennai, India
| | - Kathiresan Jeyashree
- Health Technology Assessment Resource Centre, ICMR- National Institute of Epidemiology, Chennai, India
| | - Manickam Ponnaiah
- Health Technology Assessment Resource Centre, ICMR- National Institute of Epidemiology, Chennai, India
| |
Collapse
|
8
|
Zhu G, Zhu Y, Wang Z, Meng W, Wang X, Feng J, Li J, Xiao Y, Shi F, Wang S. The association between ambient temperature and mortality of the coronavirus disease 2019 (COVID-19) in Wuhan, China: a time-series analysis. BMC Public Health 2021; 21:117. [PMID: 33430851 PMCID: PMC7797893 DOI: 10.1186/s12889-020-10131-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 12/25/2020] [Indexed: 01/08/2023] Open
Abstract
Background The COVID-19 has caused a sizeable global outbreak and has been declared as a public health emergency of international concern. Sufficient evidence shows that temperature has an essential link with respiratory infectious diseases. The objectives of this study were to describe the exposure-response relationship between ambient temperature, including extreme temperatures, and mortality of COVID-19. Methods The Poisson distributed lag non-linear model (DLNM) was constructed to evaluate the non-linear delayed effects of ambient temperature on death, by using the daily new death of COVID-19 and ambient temperature data from January 10 to March 31, 2020, in Wuhan, China. Results During the period mentioned above, the average daily number of COVID-19 deaths was approximately 45.2. Poisson distributed lag non-linear model showed that there was a non-linear relationship (U-shape) between the effect of ambient temperature and mortality. With confounding factors controlled, the daily cumulative relative death risk decreased by 12.3% (95% CI [3.4, 20.4%]) for every 1.0 °C increase in temperature. Moreover, the delayed effects of the low temperature are acute and short-term, with the most considerable risk occurring in 5–7 days of exposure. The delayed effects of the high temperature appeared quickly, then decrease rapidly, and increased sharply 15 days of exposure, mainly manifested as acute and long-term effects. Sensitivity analysis results demonstrated that the results were robust. Conclusions The relationship between ambient temperature and COVID-19 mortality was non-linear. There was a negative correlation between the cumulative relative risk of death and temperature. Additionally, exposure to high and low temperatures had divergent impacts on mortality.
Collapse
Affiliation(s)
- Gaopei Zhu
- Department of Health Statistics, School of Public Health, Weifang Medical University, No. 7166 Baotong West Street, Weifang, 261053, People's Republic of China
| | - Yuhang Zhu
- Department of Health Statistics, School of Public Health, Weifang Medical University, No. 7166 Baotong West Street, Weifang, 261053, People's Republic of China.,Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, W 29, 20246, Hamburg, Germany
| | - Zhongli Wang
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, People's Republic of China
| | - Weijing Meng
- School of Life Sciences and Technology, Weifang Medical University, No. 7166 Baotong West Street, Weifang, 261053, People's Republic of China
| | - Xiaoxuan Wang
- Department of Health Statistics, School of Public Health, Weifang Medical University, No. 7166 Baotong West Street, Weifang, 261053, People's Republic of China
| | - Jianing Feng
- Department of Health Statistics, School of Public Health, Weifang Medical University, No. 7166 Baotong West Street, Weifang, 261053, People's Republic of China
| | - Juan Li
- Department of Health Statistics, School of Public Health, Weifang Medical University, No. 7166 Baotong West Street, Weifang, 261053, People's Republic of China
| | - Yufei Xiao
- Department of Health Statistics, School of Public Health, Weifang Medical University, No. 7166 Baotong West Street, Weifang, 261053, People's Republic of China
| | - Fuyan Shi
- Department of Health Statistics, School of Public Health, Weifang Medical University, No. 7166 Baotong West Street, Weifang, 261053, People's Republic of China.
| | - Suzhen Wang
- Department of Health Statistics, School of Public Health, Weifang Medical University, No. 7166 Baotong West Street, Weifang, 261053, People's Republic of China.
| |
Collapse
|
9
|
Sajini AA, Alkayyal AA, Mubaraki FA. The Recombination Potential between SARS-CoV-2 and MERS-CoV from Cross-Species Spill-over Infections. J Epidemiol Glob Health 2020; 11:155-159. [PMID: 33605109 PMCID: PMC8242116 DOI: 10.2991/jegh.k.201105.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 10/16/2020] [Indexed: 12/13/2022] Open
Abstract
Countries in the Middle-East (ME) are tackling two corona virus outbreaks simultaneously, Middle-Eastern Respiratory Syndrome Coronavirus (MERS-CoV) and the current Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Both viruses infect the same host (humans) and the same cell (type-II alveolar cells) causing lower respiratory illnesses such as pneumonia. Molecularly, MERS-CoV and SARS-CoV-2 enter alveolar cells via spike proteins recognizing dipeptidyl peptidase-4 and angiotensin converting enzyme-II, respectively. Intracellularly, both viruses hide in organelles to generate negative RNA strands and initiate replication using very similar mechanisms. At the transcription level, both viruses utilise identical Transcription Regulatory Sequences (TRSs), which are known recombination cross-over points during replication, to transcribe genes. Using whole genome alignments of both viruses, we identify clusters of high sequence homology at ORF1a and ORF1b. Given the high recombination rates detected in SARS-CoV-2, we speculate that in co-infections recombination is feasible via TRS and/or clusters of homologies. Accordingly, here we recommend mitigation measure and testing for both MERS-CoV and SARS-CoV-2 in ME countries.
Collapse
Affiliation(s)
- Abdulrahim A Sajini
- Department of Biomedical Engineering, Khalifa University of Science and Technology, P.O. Box 127788, Abu Dhabi, United Arab Emirates.,Department of Medical Laboratory Technology, University of Tabuk, Tabuk, P.O. Box 71491, Saudi Arabia
| | - Almohanad A Alkayyal
- Department of Medical Laboratory Technology, University of Tabuk, Tabuk, P.O. Box 71491, Saudi Arabia
| | - Fathi A Mubaraki
- College of Computer and Information Technology, University of Tabuk, Tabuk, P.O. Box 71491, Saudi Arabia.,Department of Computer Science, Iowa State University, Ames, IA 50011, USA
| |
Collapse
|
10
|
Khan AA, AlRuthia Y, Balkhi B, Alghadeer SM, Temsah MH, Althunayyan SM, Alsofayan YM. Survival and Estimation of Direct Medical Costs of Hospitalized COVID-19 Patients in the Kingdom of Saudi Arabia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7458. [PMID: 33066327 PMCID: PMC7602112 DOI: 10.3390/ijerph17207458] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/10/2020] [Accepted: 10/12/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Assess the survival of hospitalized coronavirus disease 2019 (COVID-19) patients across age groups, sex, use of mechanical ventilators (MVs), nationality, and intensive care unit (ICU) admission in the Kingdom of Saudi Arabia. METHODS Data were retrieved from the Saudi Ministry of Health (MoH) between 1 March and 29 May 2020. Kaplan-Meier (KM) analyses and multiple Cox proportional-hazards regression were conducted to assess the survival of hospitalized COVID-19 patients from hospital admission to discharge (censored) or death. Micro-costing was used to estimate the direct medical costs associated with hospitalization per patient. RESULTS The number of included patients with complete status (discharge or death) was 1422. The overall 14-day survival was 0.699 (95%CI: 0.652-0.741). Older adults (>70 years) (HR = 5.00, 95%CI = 2.83-8.91), patients on MVs (5.39, 3.83-7.64), non-Saudi patients (1.37, 1.01-1.89), and ICU admission (2.09, 1.49-2.93) were associated with a high risk of mortality. The mean cost per patient (in SAR) for those admitted to the general Medical Ward (GMW) and ICU was 42,704.49 ± 29,811.25 and 79,418.30 ± 55,647.69, respectively. CONCLUSION The high hospitalization costs for COVID-19 patients represents a significant public health challenge. Efficient allocation of healthcare resources cannot be emphasized enough.
Collapse
Affiliation(s)
- Anas A. Khan
- Department of Emergency Medicine, College of Medicine, King Saud University, Global Center for Mass Gatherings Medicine, Ministry of Health, Riyadh 11451, Saudi Arabia;
| | - Yazed AlRuthia
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box 2454, Riyadh 11451, Saudi Arabia; (B.B.); (S.M.A.)
- Pharmacoeconomics Research Unit, College of Pharmacy, King Saud University, P.O. Box 2454, Riyadh 11451, Saudi Arabia
| | - Bander Balkhi
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box 2454, Riyadh 11451, Saudi Arabia; (B.B.); (S.M.A.)
- Pharmacoeconomics Research Unit, College of Pharmacy, King Saud University, P.O. Box 2454, Riyadh 11451, Saudi Arabia
| | - Sultan M. Alghadeer
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box 2454, Riyadh 11451, Saudi Arabia; (B.B.); (S.M.A.)
| | - Mohamad-Hani Temsah
- College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia;
- Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh 11451, Saudi Arabia
| | - Saqer M. Althunayyan
- Department of Accident and Trauma, Prince Sultan Bin Abdulaziz College for Emergency Medical Services, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Yousef M. Alsofayan
- Global Center for Mass Gatherings Medicine, Ministry of Health, Riyadh 11451, Saudi Arabia;
| |
Collapse
|
11
|
Facchiano A, Facchiano F, Facchiano A. An investigation into the molecular basis of cancer comorbidities in coronavirus infection. FEBS Open Bio 2020; 10:2363-2374. [PMID: 32970391 PMCID: PMC7537529 DOI: 10.1002/2211-5463.12984] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/31/2020] [Accepted: 09/15/2020] [Indexed: 12/20/2022] Open
Abstract
Comorbidities in COVID‐19 patients often worsen clinical conditions and may represent death predictors. Here, the expression of five genes, known to encode coronavirus receptors/interactors (ACE2, TMPRSS2, CLEC4M, DPP4 and TMPRSS11D), was investigated in normal and cancer tissues, and their molecular relationships with clinical comorbidities were investigated. Using expression data from GENT2 databases, we evaluated gene expression in all anatomical districts from 32 normal tissues in 3902 individuals. Functional relationships with body districts were analyzed by chilibot. We performed DisGeNet, genemania and DAVID analyses to identify human diseases associated with these genes. Transcriptomic expression levels were then analyzed in 31 cancer types and healthy controls from approximately 43 000 individuals, using GEPIA2 and GENT2 databases. By performing receiver operating characteristic analysis, the area under the curve (AUC) was used to discriminate healthy from cancer patients. Coronavirus receptors were found to be expressed in several body districts. Moreover, the five genes were found to associate with acute respiratory syndrome, diabetes, cardiovascular diseases and cancer (i.e. the most frequent COVID‐19 comorbidities). Their expression levels were found to be significantly altered in cancer types, including colon, kidney, liver, testis, thyroid and skin cancers (P < 0.0001); AUC > 0.80 suggests that TMPRSS2, CLEC4M and DPP4 are relevant markers of kidney, liver, and thyroid cancer, respectively. The five coronavirus receptors are related to all main COVID‐19 comorbidities and three show significantly different expression in cancer versus control tissues. Further investigation into their role may help in monitoring other comorbidities, as well as for follow‐up of patients who have recovered from SARS‐CoV‐2 infection.
Collapse
Affiliation(s)
| | - Francesco Facchiano
- Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - Angelo Facchiano
- Institute of Food Science, National Research Council, Avellino, Italy
| |
Collapse
|
12
|
Tayal M, Mukherjee A, Chauhan U, Uniyal M, Garg S, Singh A, Bhadoria AS, Kant R. Evaluation of Remote Monitoring Device for Monitoring Vital Parameters against Reference Standard: A Diagnostic Validation Study for COVID-19 Preparedness. Indian J Community Med 2020; 45:235-239. [PMID: 32905265 PMCID: PMC7467188 DOI: 10.4103/ijcm.ijcm_317_20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 05/19/2020] [Indexed: 12/25/2022] Open
Abstract
CONTEXT Vital parameters including blood oxygen level, respiratory rate, pulse rate, and body temperature are crucial for triaging patients to appropriate medical care. Advances in remote health monitoring system and wearable health devices have created a new horizon for delivery of efficient health care from a distance. MATERIALS AND METHODS This diagnostic validation study included patients attending the outpatient department of the institute. The accuracy of device under study was compared against the gold standard patient monitoring systems used in intensive care units. STATISTICAL ANALYSIS The statistical analysis involved computation of intraclass correlation coefficient. Bland-Altman graphs with limits of agreement were plotted to assess agreement between methods. P <0.05 was considered statistically significant. RESULTS A total of 200 patients, including 152 males and 48 females in the age range of 2-80 years, formed the study group. A strong correlation (intraclass correlation coefficient; r > 0.9) was noted between the two devices for all the investigated parameters with significant P value (<0.01). Bland-Altman plot drawn for each vital parameter revealed observations in agreement from both the devices. CONCLUSION The wearable device can be reliably used for remote health monitoring. Its regulated use can help mitigate the scarcity of hospital beds and reduce exposure to health-care workers and demand of personal protection equipment.
Collapse
Affiliation(s)
- Mohit Tayal
- Division of Interventional Radiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Anirudh Mukherjee
- Department of General Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Udit Chauhan
- Division of Interventional Radiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Madhur Uniyal
- Department of Trauma Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sakshi Garg
- Department of Pathology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Anjana Singh
- All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ajeet Singh Bhadoria
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ravi Kant
- Director and CEO, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| |
Collapse
|