Factors Affecting Hospitalization Length and in-Hospital Death Due to COVID-19 Infection in Saudi Arabia: A Single-Center Retrospective Analysis

Background

The emerging COVID-19 coronavirus disease has widely spread, causing a serious worldwide pandemic. Disease severity and mortality risk can be predicted using an analysis of COVID-19 clinical characteristics. Finding out what influences patients' hospitalization length and in-hospital mortality is crucial for decision-making and planning for emergencies. The goal of this study is to identify the factors that influence hospital stay length and in-hospital death due to COVID-19 infection.

Methods

This cross-sectional study was conducted from August to October 2020 and included 630 patients with a confirmed diagnosis of COVID-19 infection. Using odds ratios (OR) and 95% confidence intervals (CI), a multivariable logistic regression model was used to assess the variables that are linked to longer hospital stays and in-hospital deaths.

Results

Most patients were male (64.3%), and most were older than 40 years (81.4%). The mean length of hospital stay (LoHS) was 10.4±11.6 days. The overall death rate among these COVID-19 cases was 14.3%. Non-survivors were older, had more comorbidities, had prolonged LoHS with increased ICU admission rates and mechanical ventilation usage, and had a more severe condition than survivors. ICU admission, low serum albumin, and elevated LDH levels were associated with longer LoHS, while ICU admission, DM, and respiratory diseases as comorbidities, total leukocytic count, and serum albumin were predictors of mortality.

Conclusion

Longer LoHS due to COVID-19 infection was linked to ICU admission, low serum albumin, and elevated LDH levels, while the independent predictors of in-hospital death were ICU admission, DM, and respiratory diseases as comorbidities, total leukocytic count, and serum albumin.

Splenectomy perspective for hematological disorders: a cross-sectional study in the Eastern Province of KSA

Objectives

Splenectomy is considered a therapeutic modality for several hematological diseases, although complications are possible. This study assessed the effects of splenectomy on various hematological disorders and the roles of prophylactic measures on postoperative outcomes.

Methods

This was a cross-sectional study performed in KSA on adult patients with underlying non-malignant hematological disorders who had undergone splenectomy.

Results

This study examined 179 patients with various hematological disorders, 38 (21.1%) of whom had undergone a splenectomy. Of those 38 patients, more than two-thirds (73.7%) had an open splenectomy. The average hospital stay was 2–7 days, and no significant difference was observed between the open and laparoscopic approaches. Approximately 95% of the patients showed overall improvements in their condition after splenectomy. However, 26.3% of patients reported a recurrence or need for further treatment 1 year or more after splenectomy. Approximately 16% of patients had an increased incidence of postoperative infectious complications, particularly patients with sickle cell disease and beta thalassemia. More than half the patients who developed complications had not received vaccination preoperatively, whereas 44.4% of vaccinated patients experienced complications (p = 0.04).

Conclusion

Splenectomy is considered a universal line of treatment for most non-malignant hematological diseases. Although splenectomy is an effective treatment, the reasons why patients with the same disease can have different responses remains unclear. Infection is a common postoperative complication, and vaccinations are underused. This study emphasizes the roles of patient education, scheduled vaccinations and proper selection of patients in the use of splenectomy for the treatment of non-malignant hematological diseases.

Paediatric Crohn's disease: a radiological review

Paediatric Crohn's disease can be a serious and complex condition which is not always easy to diagnose if it presents in an atypical manner. Although the pathological processes are the same in adults and children, the clinical presentation and disease distribution can be different in children. The impact of the disease can also be much more significant in a growing and developing child than in an adult. Numerous investigations are available to establish the diagnosis, define the complications and to demonstrate the extra-intestinal manifestations. Close cooperation is required between the clinician and radiologist when investigating a child suspected of having Crohn's disease or its symptoms to minimise the radiation dose and the psychological and physical trauma. We review the clinical and radiological aspects of Crohn's disease and discuss the imaging modalities available in diagnosing Crohn's disease and its complications and suggest an investigation pathway as used in our institution.

Pyridinium Hydrobromide Perbromide: A Versatile Catalyst for Aziridination of Olefins Using Chloramine-T

[reaction: see text] Pyridinium hydrobromide perbromide (Py x HBr3) catalyzes effectively the aziridination of electron-deficient as well as electron-rich olefins using Chloramine-T (N-chloro-N-sodio-p-toluenesulfonamide) as a nitrogen source to afford the corresponding aziridines in moderate to good yields.

Fabric softeners and softness perception

In order to evaluate the efficiency of various commercial chemical fabric softeners, a technique of obtaining subjective assessment known as 'magnitude estimation' was used to estimate the fabric softness. Particular emphasis was given to subjective scaling and limits of human perception. Comparison between softness and compression (a physical measure) was demonstrated.

Prevalence of intestinal parasites among food handlers in Al-Medinah

Fecal specimens from 13.216 food handlers (male) adults, representing 21 different nationalities, were analyzed for the presence of intestinal parasites at King Abdul Azeez Hospital, Al-Medinah. Approximately 14% of these individuals harbored potentially pathogenic parasites, the most common organism being Giardia lamblia (33%), followed by Entamoeba histolytica (23%), Trichuris trichiura (12.3%), Ascaris lumbricoides (11.8%) and others. The highest incidence of parasite load was found in Sri Lankans (40.7%). Although G. lamblia and E. histolytica were found in almost all the nationalities, preponderance of metazoan parasites with complicated life cycles occurred in individuals from tropical countries where optimal conditions of temperature and humidity are favorable for the survival and development of these organisms.

A comparison of bacterial resistance to antimicrobials in Riyadh, Medina, and Oklahoma City

Many bacteria are known to develop resistance to anti-microbial agents following their clinical use. The resistance pattern varies from one geographic location to another depending upon the patient population and local history of antibiotic use. The bacterial resistance to commonly used antimicrobial agents in Oklahoma City was found to be different from two cities in Saudi Arabia, especially amongst Gram-negative bacilli. A total of 13,575 fresh clinical isolates from the Veterans Administration Medical Center (VAMC), Oklahoma City, Oklahoma; the King Faisal Specialist Hospital and Research Centre (KFSH), Riyadh; and the King Fahad Hospital (KFH), Medina, Saudi Arabia; were used. There were 6,270 isolates of Enterobacteriaceae, 2,799 pseudomonads and Acinetobacter, and 4,506 Gram positive strains of staphylococcus bacteria. Gram-negative bacteria from KFH were considerably more resistant to ampicillin, gentamicin, and trimethoprim-sulfamethoxazole than at KFSH and VAMC. On the other hand, Staphylococcus aureus isolated from VAMC exhibited a significantly higher degree of resistance to oxacillin and trimethoprim-sulfamethoxazole than those at KFSH and KFH.

Postsynaptic supersensitivity in schizophrenia

In the context of the dopamine hypothesis of schizophrenia, the authors examined postsynaptic dopamine (DA) receptor sensitivity in schizophrenic patients by means of a neuroendocrine strategy using the DA receptor agonist apomorphine and growth hormone (GH) release as the measurable postsynaptic event. The activity of platelet adenylate cyclase, an enzyme intimately associated with catecholamine receptor activity, was also studied following stimulation by prostaglandin E1 (PGE1). Patients diagnosed as having acute schizophrenia had significantly higher GH responses and adenylate cyclase activity than normal control subjects and patients diagnosed as having chronic schizophrenia. Chronic schizophrenic patients with and without tardive dyskinesia showed GH responses slightly lower than but not significantly different from those of control groups.