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Objectives: To analyze the clinical characteristics and in-hospital outcomes among coronavirus disease 2019 (COVID-19) positive medical staff compared with those of public. Methods: A total of 108 COVID-19-positive medical staff patients were included in the study from March 23, 2020 to June 15, 2020. Patients were analyzed for demographic data, clinical presentations, and in-hospital outcomes and compared against 661 COVID-19-infected patients of non-medical personel. Results: Mean age of medical staff patients was 44.05±13.9 years, most of whom were women (63.9%). The infected medical staff members consisted of 63 nurses (58.3%), 37 physicians (34.3%), 5 technicians (4.6%), and 3 pharmacists (2.8%). Smoking (60.2%) was the most frequent, followed by diabetes mellitus (37%). Of 108 COVID-19 infected medical staff, 18 (16.6%) were isolated in the intensive care unit (ICU), of which 14 (77.8%) were male, 16 (88.9%) were smokers, and 16 (88.9%) presented with pneumonia. Fatality ratio among medical staff patients was 4.6%. Male gender with odds ratios (OR) of 7.771 and 95% confidence intervals (CI) of 0.837-72.195 and a history of chronic kidney disease of (OR=10.778, 95% CI: 1.503-77.287) were predictors of death among the medical staff group. Conclusion: The incidence of COVID-19 infection among medical staff is quite high, but the occurrence of extreme illness and death is significantly low compared with the general community. Training should be implemented for all hospital staff on infection prevention techniques. Reliable and quick access for testing medical personnel is essential to maintain health, safety, and availability of health care workers during this pandemic. Saudi Med J. 2020 Dec;41(12):1336-1343 doi: 10.15537/smj.2020.12.25514 How to cite this article: Abohamr SI, Aldossari MA, Alaklobi FA, Amer HA, Alzarzour SH, Abdelhamid SW, Aljunaidi O, Badhawi OS, Siddiqui S, Jumaa H, Badwi M, Elsheikh E. Clinical characteristics and in-hospital outcome of medical staff infected with COVID-19 in Saudi Arabia. A retrospective single-center study. Saudi Med J. 2020 Dec;41(12):1336-1343. doi: 10.15537/smj.2020.12.25514. PMID: 33294892.

Objectives : To provide a detailed study of demographic, baseline comorbidities, clinical features, and outcome for Coronavirus disease 2019 (COVID-19) patients. Methods : A record-based case-series study conducted from March 23 to June 15, 2020 in King Saud Medical City, Riyadh, Saudi Arabia. Demographic data, clinical presentation, laboratory investigations, complications, and in-hospital outcome of COVID-19 patients collected with analysis of the clinical characteristics for survivors and deceased. Results : A total of 768 patients were included. The mean age was 46.36±13.7 years and 76.7% were men. Approximately 96.3% reported more than one comorbidity; diabetes mellitus was the most frequent (46.4%). Fever (84.5%), cough (82.3%), and shortness of breath (79.8%) were the main presenting symptoms. During the follow-up, pneumonia reported in 68.6%, acute respiratory distress syndrome in 32.7%, septic shock in 20.7%, respiratory failure in 20.3%, and acute kidney injury in 19.3%. Approximately 45.8% of enrolled patients required intensive care unit admission. Lung disease (odd ratio [OR]=3.862 with 95% confident interval [CI] (2.455-6.074), obesity (OR=3.732, CI=2.511-5.546), smoking (OR=2.991, CI=2.072-4.317), chronic kidney disease (OR=2.296. CI=1.497-3.521), and diabetes mellitus (OR=2.291, CI=1.714-3.063) are predictors of ICU admission. Fatality ratio was 4.27%; therefore, men were more prevalent in dead group. Conclusion : Coronavirus disease 2019 places a huge burden on healthcare facilities, particularly in patients with comorbidity. Coronavirus disease 2019 patients who are obese and smokers with history of diabetes mellitus have a high risk of death. Saudi Med J 2020; Vol. 41 (11): 1217-1226 doi: 10.15537/smj.2020.11.25495 How to cite this article: Abohamr SI, Abazid RM, Aldossari MA, Amer HA, Badhawi OS, Aljunaidi OM, Alzarzour SH, Saadeddin HM, Bhat FA, Elsheikh E. Clinical characteristics and in-hospital mortality of COVID-19 adult patients in Saudi Arabia. Saudi Med J. 2020 Nov;41(11):1217-1226. doi: 10.15537/smj.2020.11.25495.

Objectives: To analyze predictors of death in elderly patients diagnosed with acute coronary syndrome (ACS). Methods: A record-based study carried out between January 2016 and January 2018 at The central province in Saudi Arabia. All elderly patients (greater than 75 years) with definite diagnosis of ACS were retrospectively included. Demographic data, echocardiographic, and angiographic parameters were reported. Results: A total of 179 patients were enrolled, 129 (72%) were male. The mean age was 79±4.7 years. Approximately 102 (57%) patients were diagnosed with ST-segment elevation myocardial infarction (STEMI). Of all 125 (70%) underwent invasive coronary angiography, we found that 43 (24%) had significant single vessel disease (1VD), 29 (16.2%) had 2 vessel disease (2VD), and 41 (22.9%) had 3 vessel disease (3VD) or left main stenosis. During hospitalization 21 (11.7%) patients died, t-test analysis showed patients who died were significantly older (82±6.7 versus [vs.] 79±4.2 years, p =0.003). In addition we found that ejection fraction was lower in death group (30.2%±10.7) vs. (36.5%±1.1) in survivors, p =0.017); STEMI was more common in death group (90.5%) vs. (52.5%) in survivors, p =0.001); similarly, the prevalence of 3VD was higher in death group (38.1%) vs. (20.9%) in survivors, p=0.018). Importantly, PCI was not significantly different between death and survival groups (40% vs. 53.8%, p =0.177). A multivariate regression analysis demonstrated that predictors of death were: age (hazard ratio [HR], 1.214; 95% confidence interval [CI], 1.122-1.384; p less than 0.0001), intubation (HR, 10.106; 95% CI, 9.844-10.792; p less than 0.0001), and raised creatinine kinase-MB (CK-MB) (HR, 1.005; 95% CI, 1.002-1.013; p =0.04) predicted in hospital death. Conclusion: Older age, mechanical ventilation and raised CK-MB can significantly predict death in elderly patients (greater than 75-year-old) diagnosed with ACS; nevertheless, PCI showed no survival benefits. Saudi Med J 2019; Vol. 40 (10): 1003-1007 doi: 10.15537/smj.2019.10.24583 How to cite this article: Ahmed OE, Abohamr SI, Alharbi SA, Aldrewesh DA, Allihimy AS, Alkuraydis SA, Alhammad IM, Elsheikh E, Azazy AS, Mohammed AA, Dar MA, Abazid RM. In-hospital mortality of acute coronary syndrome in elderly patients. Saudi Med J 2019; 40: 1003-1007. DOI: 10.15537/smj.2019.10.24583