Background COVID-19 pandemic is a major strain on health and economic systems, with rapidly increasing demand for in patients’ facilities. Disease diagnosis and estimating patients at higher risk is important for the optimal management during the pandemic. This study aimed to identify the predictors of mortality and length of hospital stay in COVID-19 patients. Methods A retrospective cross-sectional study was conducted between March 2020 and August 2020 at Al-Noor Specialist Hospital in Mecca, Saudi Arabia. All patients who were admitted and had a confirmed COVID-19 diagnosis by a real-time polymerase chain reaction (PCR) were included in the study. Descriptive statistics were used to describe patients’ demographic characteristics, laboratory findings, and clinical outcomes. Multiple logistic/linear regression analysis was used to identify predictors of death and length of stay at the hospital. Results A total of 706 patients were hospitalised for COVID-19. The mean age was 48.0 years (SD: 15.6 years). More than half of the patients (68.5%; n= 292) were males. The median duration of stay at the hospital was 6.0 days (IQR: 300–10:00). The prevalence rate of venous thromboembolism (VTE) among the patients was 3.0% (n= 21). In the multivariate logistic regression analysis, age (AOR: 1.05; 1.02–1.09), patients with end-stage renal disease (AOR: 6.44; 2.20–18.87), low Oxygen saturation SPO2 (AOR: 9.92; 4.19–23.50), D.dimer >0.5 (AOR: 13.31; 5.45–32.49), ESR>10 mm/h (AOR: 4.08; 1.72–9.68), Ferritin>400mcg/L (AOR: 18.55; 6.89–49.96), and Procalcitonin>0.5ug/L (AOR: 8.23; 1.81– 37.40) were associated with a higher risk of death among patients with COVID-19. Patients with VTE (AOR: 12.86; 3.07– 53.92) were at higher risk of death due to COVID-19. Conclusion Hospitalised COVID-19 patients have multiple negative consequences in terms of their laboratory findings, signs and symptoms. Age and end-stage renal diseases have a significant impact on the mortality rate and the length of hospital stay among COVID-19 patients.

Aims. The prevalence of CKD in patients with diabetes mellitus in the Middle East region is unknown. Therefore, we aimed to understand the pooled prevalence of CKD in patients with diabetes mellitus in the Middle East region. Methods. PubMed, Embase, and Cochrane databases were searched for relevant studies up to October 2020. The search strategy was conducted using both keywords and MeSH terms. Randomised controlled trials (RCTs) and observational studies that included patients from all age groups and any study design that reported on the prevalence of CKD in patients with diabetes mellitus were included. The pooled estimate for the prevalence of CKD in patients with diabetes was calculated using random-effect models with 95% confidence intervals (CIs). Results. A total of 489 citations were identified, of which only nine studies matched our inclusion criteria and were included in the meta-analysis. All of the studies used an observational study design covering a total of 59,395 patients with type 2 diabetes mellitus. The pooled estimate of the prevalence of CKD in patients with diabetes mellitus was 28.96% (95% CI: 19.80–38.11). Conclusions. A high prevalence of CKD in patients with diabetes mellitus in the Middle East region was found. Further epidemiological studies are warranted in this area to have a better estimate of the prevalence of CKD among DM in the Middle East region.

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Background: Acute lymphoblastic leukemia (ALL) is the most common type of childhood malignancy. Despite all the improvements in ALL treatment, cancer relapse remains a major dilemma. Immune checkpoint inhibitors are promising agents that are being evaluated in ALL clinical trials. The overall aim of our study is to evaluate the expression status of immune checkpoint genes in pediatric ALL patients as prognostic factors for the time of relapse and identify possible targets for immunotherapy. Methods: The expression of 21 regulatory immune checkpoint genes was extracted from two microarray datasets of precursor-B-ALL patients (Hogan et al. dataset (GSE28460) included 49 patients and Staal et al. dataset (GSE18497) contained 27 patients). The microarray data were run using the robust multichip average normalization method in RStudio (1.3.959). A 36 month-cutoff was determined to stratify patients into two groups, early relapse (< 36 months) and late relapse (≥ 36 months). The two datasets were normalized to a reference group (late relapse), then combined. The significant differentially expressed genes between the two groups were detected using Student's t-test. An expression score was generated for each patient based on the expression of the significant differentially expressed genes. Survival analysis and Pearson's correlation were performed to assess the impact of significant genes on the time of relapse. Results: 19 out of the 21 genes were downregulated in early relapsing patients compared to the late relapsing group, seven of which were statistically significant; BTLA4, KIR3DS, PDCD1, TIGIT, HAVCR, CTLA4, TNFRSF9. The expression of those seven genes was significantly associated with the time of relapse ( r = 0.381, P = 0.0007). Patients with a low expression profile of the significant differentially expressed genes were 2.3 times more likely to relapse early (CI 1.434-3.713, P = < 0.0001). Conclusion: The expression of immune checkpoint genes is significantly associated with the prognosis of ALL patients. BTLA4, KIR3DS, PDCD1, TIGIT, HAVCR, CTLA4, and TNFRSF9 might be prognostic factors for the time of relapse. Immunotherapy might be beneficial to the late relapsing patients where immune checkpoint genes were upregulated. The study was funded by the deputyship for Research and Innovation, Ministry of Education, Saudi Arabia (DRI-KSU-1273). Citation Format: Basil Jamal Alotaibi, Razan Saad Alshahrani, Munirah Abdulaziz Alkathiri, Ali Mohammed Alqasem, Basil Nasser Alamri, Ali Rashed Alhoshani, Moureq Rashed Alotaibi, Khalid Ahmed Alhazzani, Homood Moqbel As Sobeai. Low expression of immune checkpoint genes is significantly associated with early relapse in pediatric acute lymphoblastic leukemia [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 3031.