Clinical characteristics of COVID-19 in Saudi Arabia: A national retrospective study

Alsofayan, Yousef M.; Althunayyan, Saqer M; Khan, Anas; Hakawi, Ahmed; Assiri, Abdullah M.

doi:10.1016/j.jiph.2020.05.026

Cited by 218 publications

(258 citation statements)

References 21 publications

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“…In addition, the LOS varied significantly between countries even before the pandemic [ 11 ]. In Saudi Arabia, the rate of hospitalization among all confirmed COVID-19 cases during March 2020 was 71.6% according to Alsofayan and colleagues, but the mortality rate was as low as 0.65% [ 12 ]. This high reported rate of hospitalization among COVID-19 cases may exacerbate the cost burden of viral respiratory infections in a country that was deeply affected by the Middle East Respiratory Syndrome (MERS) in 2012, and resulted in a huge financial burden with an estimated direct medical cost per patient of SAR 48,551.36 (United States dollars (USD) 12,947.03) [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Survival and Estimation of Direct Medical Costs of Hospitalized COVID-19 Patients in the Kingdom of Saudi Arabia

Khan

AlRuthia

Balkhi

et al. 2020

IJERPH

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Objectives: Assess the survival of hospitalized coronavirus disease 2019 (COVID-19) patients across age groups, sex, use of mechanical ventilators (MVs), nationality, and intensive care unit (ICU) admission in the Kingdom of Saudi Arabia. Methods: Data were retrieved from the Saudi Ministry of Health (MoH) between 1 March and 29 May 2020. Kaplan–Meier (KM) analyses and multiple Cox proportional-hazards regression were conducted to assess the survival of hospitalized COVID-19 patients from hospital admission to discharge (censored) or death. Micro-costing was used to estimate the direct medical costs associated with hospitalization per patient. Results: The number of included patients with complete status (discharge or death) was 1422. The overall 14-day survival was 0.699 (95%CI: 0.652–0.741). Older adults (>70 years) (HR = 5.00, 95%CI = 2.83–8.91), patients on MVs (5.39, 3.83–7.64), non-Saudi patients (1.37, 1.01–1.89), and ICU admission (2.09, 1.49–2.93) were associated with a high risk of mortality. The mean cost per patient (in SAR) for those admitted to the general Medical Ward (GMW) and ICU was 42,704.49 ± 29,811.25 and 79,418.30 ± 55,647.69, respectively. Conclusion: The high hospitalization costs for COVID-19 patients represents is a significant public health challenge. Efficient allocation of healthcare resources cannot be emphasized enough.

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Section: Introductionmentioning

confidence: 99%

Survival and Estimation of Direct Medical Costs of Hospitalized COVID-19 Patients in the Kingdom of Saudi Arabia

Khan

AlRuthia

Balkhi

et al. 2020

IJERPH

Self Cite

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“…Similar to SARS [ 14 ] and MERS [ 15 ], patient’s age, comorbid conditions and certain laboratory abnormalities were associated with poor in-hospital outcomes in COVID-19 patients [ 16 ]. Underlying chronic medical conditions are commonly reported in hospitalized COVID-19 patients with variable proportions between studies probably due to variable hospitalization criteria (94% in USA, 77% in UK, 23% in China, 20% in KSA) [ 17 – 19 ]. COVID-19 fatality rate among the hospitalized cases in this cohort is within the reported 12–15% range [ 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Outcome of Hospitalized COVID-19 Patients in a MERS-CoV Endemic Area

Barry¹,

Almohaya²,

Alhijji³

et al. 2020

JEGH

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Background: The Kingdom of Saudi Arabia (KSA) reported 170,639 cases and 1430 deaths from COVID-19 since the first case emerged in the country on March 2 through June 25, 2020. The objective of this report is to describe the characteristics and outcome observed among 99 hospitalized COVID-19 patients in the largest academic hospital in KSA, and assess co-infection with the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). Methods: This single-center case series data included select epidemiological, clinical, radiological features and laboratory findings of all confirmed hospitalized cases of COVID-19 in King Saud University Medical City (KSUMC), Riyadh, KSA, from March 22 until May 31, 2020, followed through June 6, 2020. We conducted retrospective analysis of listed data from 99 hospitalized patients and present characteristics and factors associated with severity in percentages and univariate odds ratios. Cases were confirmed using nasopharyngeal or throat swab by real-time Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and MERS-CoV by RT-PCR. Results: The 99 hospitalized COVID-19 patients included in this analysis constitute 16% of 632 positive SARS-CoV-2 among 6633 persons who were tested at the KSUMC (positivity rate, 9.4%). MERS-CoV PCR was negative in all 99 patients tested. The majority of these 99 hospitalized patients were males (66%), had a mean age of 44 years (range, 19–87), and a quarter (25.3%) were health care workers. Patients with comorbid conditions accounted for 52.5% of patients including the 8.1% who were asymptomatic; diabetes mellitus being the most frequent (31.3%), followed by hypertension (22.2%). The most common presenting symptoms were fever (67.7%), cough (60.6%), dyspnea (43.4%), upper respiratory symptoms (27.3%), fatigue (26.3%), diarrhea (19.2%) and loss of smell (9.1%). The clinical conditions among these 99 patients included upper respiratory tract infection (47.5%), abnormal chest X-ray, lymphopenia, high inflammatory markers a fifth (21%) of patients had moderate pneumonia, while 7% had severe pneumonia with 22.2% requiring admission to the intensive care unit and 12.1% died. Late presentation with severe disease, an abnormal chest X-ray, lymphopenia, high inflammatory markers (C-reactive protein, ferritin, and procalcitonin), and end organ damage (high creatinine or high aspartate aminotransferase) were predictors for admission to critical care unit or died. Conclusion: We observed no MERS-CoV co-infection in this early cohort of hospitalized COVID-19 patients who were relatively young, more than half had comorbid conditions, presented with fever and/or cough, an abnormal chest X-ray, lymphopenia, and high inflammatory markers. Given MERS-CoV endemicity in the country, co-monitoring of MERS-CoV and SARS-CoV-2 coinfection is critical.

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“…The incubation period ranges between two and 14 days [15]. Generally, the mid-value of 7 days of the incubation period is considered but in the case of Saudi Arabia, the median incubation period is identified as six days [16]. The inverse of the incubation period is known as the incubation rate.…”

Section: Model Parameters and Valuesmentioning

confidence: 99%

COVID-19 Modeling in Saudi Arabia Using the Modified Susceptible-Exposed-Infectious-Recovered (SEIR) Model

Ahmad¹

2020

Cureus

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The coronavirus disease 2019 (COVID-19) pandemic has created unprecedented healthcare emergencies across the globe. The World Health Organization (WHO) has proposed social distancing (SD) as a prudent measure to contain the pandemic and, hence, governments have been enacting lockdowns of varied nature. These lockdowns, causing economic and social strain, warrant the development of quantitative models to optimally manage the pandemic. Similarly, extensive testing aids in early detection and isolation, hence containing the spread of the pandemic. Compartment epidemiology models have been used extensively in modeling such infectious diseases. This paper attempts to utilize the modified Susceptible-Exposed-Infectious-Recovered (SEIR) model incorporating the SD, testing, and infectiousness of exposed and infectious compartments to study the COVID-19 pandemic in Saudi Arabia. Saudi Arabia has put restrictions on the movement of people in different phases to ascertain SD. Timedependent parameters based on the timeline of restrictions and testing in Saudi Arabia have been introduced to capture SD and testing. The arrived model has been validated through statistical tests. The (R naught), basic reproduction number, value has ranged between 0.6014 and 2.7860 with an average of 1.4904 and currently holds at 0.8952. In the absence of SD and testing measures, the model predicts the threshold herd immunity to be 69.31% and value as 3.26. Further, scenario analysis has been conducted for alleviating the SD measure. The results show that early lifting of all restrictions may undo all efforts in the containment of the COVID-19 pandemic. The outcome of results will help policymakers and medical practitioners prepare better to manage the pandemic and lockdown.

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Clinical characteristics of COVID-19 in Saudi Arabia: A national retrospective study

Cited by 218 publications

References 21 publications

Survival and Estimation of Direct Medical Costs of Hospitalized COVID-19 Patients in the Kingdom of Saudi Arabia

Survival and Estimation of Direct Medical Costs of Hospitalized COVID-19 Patients in the Kingdom of Saudi Arabia

Clinical Characteristics and Outcome of Hospitalized COVID-19 Patients in a MERS-CoV Endemic Area

COVID-19 Modeling in Saudi Arabia Using the Modified Susceptible-Exposed-Infectious-Recovered (SEIR) Model

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