Predictors of Illness Severity in COVID-19 Cases in Saudi Arabia

Abstract

Purpose: Multiple studies worldwide have reported the clinical and epidemiological features of coronavirus disease 2019 , with limited reports from the Middle East. This study describes the clinical and epidemiological features of COVID-19 cases in the Eastern Province of Saudi Arabia and identified factors associated with the severity of illness. Patients and Methods: This was an observational study of 341 COVID-19 cases. These cases were reported in the first three months after the first case in the country was identified. Clinical and demographic data were analyzed and described to identify the effects of age, sex, and ethnicity on illness severity. In addition, the duration of viral shedding and cycle threshold (Ct) values of real-time PCR were evaluated as predictors of severity. Results: The median age was 45 years. Males were twice as likely to be infected than females (p <0.0001). The duration of viral shedding ranged from 9 to 36 days. The most common clinical presentations include fever, shortness of breath, cough, myalgia, sore throat, vomiting, and headache. Critical cases were significantly higher in men (23% vs 8.7%), senior adults (>65 years), individuals of Bengali ethnicity, and in patients with comorbidities including diabetes, hypertension, and dyslipidemia (p =0.001). The case fatality rate was found to be 10%. The fatality was significantly higher in males than females (13.8% vs 2.6%), and in Asians (17.9%) than Arabs (6%) and Africans (0) (p =0.002). No association was found between viral load, represented by the RT-PCR cycle threshold (Ct) values, and severity of illness. Conclusion: Age, sex, and ethnicity are important predictors of COVID-19 severity. The cycle threshold (Ct) of the SARS-CoV-2 RT-PCR test cannot be used as a predictor of the criticality of illness.

Vaccine Coverage against Influenza and SARS-CoV-2 in Health Sciences Students during COVID-19 Pandemic in Spain

“…This may have been due to the fact that the questionnaire did not ask whether they had had the disease before or after vaccination against SARS-CoV-2. Similar results were found in a study done in Saudi Arabia [41], and another in Helsinki [42].…”

Utility of the Xpert Xpress CoV-2/Flu/RSV Plus Kit: A Glance at RSV Infection in Adults and Coinfection Rate

“…Except for SARS-CoV-2 infection rates, no significant difference was noted between males and females for any of the other viruses; however, with both kits, males were found more likely to get infected with SARS-CoV-2 than females using either kit, which is in line with previous findings. [ 8 9 10 11 ] Similarly, SARS-CoV-2 infection was more prevalent in patients >10 years, which has also been previously reported from the same region and others. [ 8 12 ]…”

Cycle Threshold Value as a Predictor of Severity and Intensive Care Unit Admission for Children Presenting to the Emergency Department With COVID-19: A Single-Center Experience From Saudi Arabia

“…Similar findings were demonstrated in a community-based study of 555 children and adults where symptomatic subjects had significantly lower Ct values (with higher SARS-CoV-2 RNA levels) compared with asymptomatic individuals [20]. On the other hand, a study done in Saudi Arabia on adults and children failed to demonstrate any association between the Ct value and the criticality of illness [21].…”