Objectives Coronavirus Disease 2019 (COVID-19) is caused by a new strain of betacoronavirus called SARS-CoV-2, which leads to mild to severe symptoms. Micronutrients in blood serum, namely, zinc, iron, copper, and selenium, play essential roles in the human body’s various organs. This study investigates the association between micronutrient levels and the severity of symptoms in SARS-CoV-2 infected patients. Methods A cross-section study was conducted during June–August 2020 in Riyadh city among 80 patients with confirmed SARS-CoV-2 infection. Within 24 hours of hospital admission, patients have been divided into non-severe and severe cases, and blood samples were drawn from each patient to measure the serum levels of copper, iron “in the form of ferritin,” selenium, and zinc. Results In both study groups, the mean copper and selenium serum levels were within the normal range, while the mean zinc and iron serum levels were elevated. A statistically significant difference was recorded between non-severe and severe cases regarding serum levels of iron and selenium (331.24 vs. 1174.95 ng/ml and 134 vs. 162 mcg/L, respectively, P < 0.0001). On the other hand, no significant difference was detected between both studied groups regarding serum level of zinc and copper (124.57 vs. 116.37 mcq/L and 18.35 vs. 18.2 mcmol/L, respectively, P > 0.05). Conclusions There was a significant elevation of selenium and iron serum levels among severe cases compared to non-severe cases of COVID-19. High levels of iron and selenium could be correlated with the disease severity during infection with SARS-CoV-2.

Background Several reports have been published about the impact of coronavirus disease 2019 (COVID-19) vaccines on human health, and each vaccine has a different safety and efficacy profile. The aim of this study was to reveal the nature and classification of reported adverse drug reactions (ADRs) of the two COVID-19 vaccines (tozinameran and ChAdOx1) among citizens and residents living in Saudi Arabia, and show possible differences between the two vaccines and the differences between each batch on the health of populations. Methods A cross-sectional study was conducted in Saudi Arabia between December 2020 and March 2021. Saudi citizens and residents aged ≥ 16 years who had at least one dose of any batch of either of the two approved COVID-19 vaccines (tozinameran and ChAdOx1) and who reported at least one ADR from the vaccines were included. The study excluded people who reported ADRs after receiving tozinameran or ChAdOx1 vaccines but no information was provided about the vaccine’s batch number. Results During the study period, 12,868 vaccinated people, including a high-risk group (i.e., those with chronic illness or pregnant women), reported COVID-19 vaccine ADRs that had been documented in the General Directorate of Medical Consultations, Saudi Ministry of Health. The study reported several ADRs associated with COVID-19 vaccines, with the most common (> 25%) being fever/chills, general pain/weakness, headache, and injection site reactions. Among healthy and high-risk people, the median onset of all reported ADRs for tozinameran and ChAdOx1 vaccine batches were 1.96 and 1.64 days, respectively ( p < 0.01). Furthermore, significant differences ( p < 0.05) were recorded between the two studied vaccines in regard to fever/chills, gastrointestinal symptoms, headache, general pain/weakness, and neurological symptoms, with higher incidence rates of these ADRs observed with the ChAdOx1 vaccine than the tozinameran vaccine. However, the tozinameran vaccine was found to cause significantly ( p < 0.05) more palpitation, blood pressure variations, upper respiratory tract symptoms, lymph node swelling, and other unspecified ADRs than the ChAdOx1 vaccine. Among patients vaccinated with seven different batches of the tozinameran vaccine, people vaccinated with the T4 and T5 batches reported the most ADRs. Conclusion There were significant differences regarding most of the reported ADRs and their onset among tozinameran and ChAdOx1 vaccines on both healthy people and high-risk individuals living in Saudi Arabia. Moreover, the study found that the frequencies of most listed ADRs were statistically different when seven batches of tozinameran vaccine were compared.

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Objectives: The mechanism of action of drugs that depress the central nervous system (CNS) was unknown until molecular pharmacology discovered each drug's exact role. The benefit of knowing the mechanism of action is to design a new drug that could have the same efficacy as the prototype drug but with fewer side effects. Some of the available CNS depressant drugs that were abused or illegally used could be modified to make them used medically. Methods: We reviewed various published articles in PubMed and Google Scholar that focused on CNS depressants' molecular pharmacology.Results: It was clear that at specific plasma concentrations of ethyl alcohol showed almost same mode of action of propofol by targeting the extrasynaptic GABA-A receptors, which causes tonic GABAergic inhibition. Besides, the High affinity of some benzodiazepines (e.g., midazolam) to &alpha;1 subunit of GABA-A receptor causes sedative, hypnotic, amnesic, and some antiepileptic effects; however, some other benzodiazepines (e.g., diazepam) have high affinity to &alpha;3 subunits, which causes anxiolytic, muscle relaxant, and strong antiepileptic effects. The CB1 receptor partial agonism effect of tetrahydrocannabinol has a sedative advantage over full agonism due to desensitization of CB1 receptors. Conclusion: From the molecular pharmacology prospect, it is possible to design new drugs with more specific CNS depressants effect and fewer side effects by targeting particular receptors with a precise reaction.

Objectives: Diabetes mellitus is a chronic metabolic disorder characterized by elevation of blood glucose and a high percentage of glycated hemoglobin A1c. Elevated hemoglobin A1c percentage of more than 7% will result in high production of advanced glycation end-products. Th e elevated level of advanced glycation end-products in diabetic patients means a high risk for diabetic complications. Th e primary endpoint was to evaluate the hemoglobin A1c levels among diabetic patients and its effect on the prognosis of this metabolic disease in all regions inside Saudi Arabia. Methods: Th is was a cross-sectional observational study conducted between March and August 2018. Th e study was done by using a questionnaire containing nine questions which planned to involve at least 390 diabetic patients. Results: Six hundred and ninety-four diabetic patients from Saudi Arabia had answered the nine-question questionnaire about hemoglobin A1c percentage and prognosis of diabetes. Th e mean age of these patients is 43.4 years old and most of those patients (75.5%) were visiting governmental hospitals. Th e number of diabetic patients having hemoglobin A1c less than 7% are 259 patients with hemoglobin A1c mean 6.66% + 3.33%, however, there are 435 patients having hemoglobin A1c more than 7% with mean equals 7.75% + 1.2%, the difference between them is statistically significant (P value < 0.0001). Conclusion: Th e glycated hemoglobin of diabetic patients in all regions of Saudi Arabia was significantly elevated and uncontrolled based on most diabetic guidelines and significantly affects the prognosis by causing diabetic complications especially cardiovascular diseases.

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Background and Objective A limited number of studies have addressed the protective duration of coronavirus disease 2019 (COVID-19) vaccines following primary and booster doses in Saudi Arabia. Therefore, this study aimed to evaluate the protective duration of primary and booster doses of BNT162b2 and ChAdOx1 COVID-19 vaccine batches in Saudi Arabia. Methods A cross-sectional study was conducted from 1 January to 31 December, 2021. The study included 53,354 people infected with severe acute respiratory syndrome coronavirus-2 2 weeks or more after receiving at least a primary vaccination of either the ChAdOx1 or BNT162b2 vaccine. Results The total median protective duration of both primary COVID-19 vaccinations was 134 days. Heterologous primary vaccination (ChAdOx1 followed by BNT162b2) showed a significantly higher median protective duration of 142 days. The results show that the total median protective duration of the first booster doses of COVID-19 vaccines was 57 days. ChAdOx1 batch code C1 was found to have the most extended protective duration of 173 days (range 163–192 days). Conclusions The current study revealed that the median protective duration of ChAdOx1 and BNT162b2 COVID-19 primary vaccination regimens administered in Saudi Arabia in 2021 was 134 days and that heterologous primary vaccination (ChAdOx1→BNT162b2) exhibited a significantly higher protective duration than other vaccination regimens.