Non-A, non-B is a major form of hepatitis in haemodialysis (HD) patients. Hepatitis C virus (HCV) has been recently identified as the leading cause of non-A, non-B hepatitis in HD. A variable prevalence of hepatitis in HD has appeared in the literature, ranging between 1% and 29% in the Western world, and between 30% and 54% in Saudi Arabia, but all these reports used first-generation ELISA. Using second-generation enzyme immunoassay, we conducted a multi-centre study involving 22 HD centres all over Saudi Arabia in order to establish the prevalence and risk factors for HCV in HD patients in Saudi Arabia. A total of 1147 patients were studied, with a mean age of 43.4 +/- 15.3 years. Five hundred and eighty were males and 567 were females. The overall prevalence rate of positive anti-HCV was 68%, with a range from as low as 14.5%, to 94.7%. To our knowledge, this is the highest value reported among dialysis patients world-wide. A positive correlation was found between anti-HCV positivity and male sex (P = 0.005), longer duration on dialysis (P = 0.002) and blood transfusion (P = 0.003). However, interestingly 62.6% of the patients who had not had blood transfusion had anti-HCV antibodies. HCV antibodies were also found more frequently in Egyptians, Pakistanis and Yemenis than in Saudis. A comparison between those centres with low prevalence of positive HCV and those with high prevalence regarding risk factors was carried out, and it was found that the major difference between them was the adherence of the staff to universal infection precautions.(ABSTRACT TRUNCATED AT 250 WORDS)

The epidemiological characteristics of Crohn's disease among Saudi patients are comparable to those reported from other parts of the world. However the incidence of Crohn's disease in our hospital increased over the last 10 years. The anatomic distribution of the disease is different from other world institutions with less isolated colonic affection.

OBJECTIVEInfection with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), which causes coronavirus disease 2019 (COVID‐19), manifests with a wide spectrum of presentations. Most reports of COVID‐19 highlight fever and upper respiratory symptoms as the dominant initial presentations, consistent with the World Health Organization guidelines regarding suspected SARS‐CoV‐2 infection. However, atypical presentations of this disease have been evolving since the initial outbreak of the pandemic in December 2019. We report a case of an older male patient who presented at our hospital with an unusual manifestation of COVID‐19.DESIGNBrief report.SETTINGA university hospital in Saudi Arabia.PARTICIPANTA 73‐year‐old man who presented with confusion in the absence of any respiratory symptoms or fever.INTERVENTIONThe patient was initially admitted with delirium and underwent a further work‐up.MEASUREMENTSGiven his recent history of domestic travel and the declaration of a global COVID‐19 pandemic status, the patient was administered a swab test for SARS‐CoV‐2.RESULTSThe patient's positive test led to a diagnosis of COVID‐19. Although he began to experience a spiking fever and mild upper respiratory symptoms, he recovered rapidly with no residual sequela.CONCLUSIONThe recognition of atypical presentations of COVID‐19 infection, such as delirium, is critical to the timely diagnosis, provision of appropriate care, and avoidance of outbreaks within healthcare facilities during this pandemic. J Am Geriatr Soc 68:1382‐1384, 2020.

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The genotypes of hepatitis C virus (HCV) were investigated in 28 Saudi patients (21 males, seven females; age range 23-68 years; mean 45.0 years) with histologically proven chronic hepatitis (13 chronic active hepatitis and 15 liver cirrhosis) and in 32 Saudi patients with chronic renal failure maintained on haemodialysis (22 males, 10 females; age range 18-60 years; mean 40.0 years) who also had liver disease due to HCV. Among the 28 patients with chronic liver disease genotype 4 was the predominant one (60.7%), followed by types 1b (21.4%), 1a (14.3%) and 2a (3.6%). The distribution of genotypes was similar in patients with chronic active hepatitis to those with liver cirrhosis. Among the 32 patients with chronic renal failure and maintained on haemodialysis, genotype 4 was also the dominant type (55.0%), followed by 1a (25.0%), 1b (21.9%) and 2a (3.1%). In all categories studied the prevalence of genotypes between males and females was the same. As our patients were selected from various regions of Saudi Arabia, we believe that genotype 4 is the predominant one throughout the whole kingdom.