Background:
COVID-19 disease is one of the most destructive events that humanity has witnessed in the 21st century. It has impacted all aspects of life and all segments of populations, including ...already vulnerable health care providers.
Aims:
This study sought to detect the prevalence of mental health issues in sample of physicians and nurses working in several health facilities in Oman.
Method:
We gauged the mental health conditions of 509 physicians (38.1%) and nurses (61.9 %) using the Perceived Stress Scale, Generalized Anxiety Disorder Scale and World Health Organization Well-Being Index.
Results:
The study revealed a high prevalence of stress, anxiety and poor psychological well-being, especially among females, young health care workers and those who interacted with known or suspected COVID-19 patients.
Conclusion:
The outcomes of this study support the handful of studies published during this global health crisis that have found that the mental health of health care workers has been harshly affected and predicted that it will continue, to various degrees, to be affected in the foreseeable future. The results of this study highlight the urgency of providing administrative and psychological support as well as current and accurate information on COVID-19 to health care workers.
Thyroid dysfunction is diagnosed and managed based on guidelines that focus primarily on the measurement of thyroid stimulating hormone (TSH), as the most sensitive and specific marker of systemic ...thyroid status, with test results interpreted according to defined reference ranges. Understanding the results of a biomarker test of thyroid function hangs on the ability to distinguish normal from abnormal results. As such, the population reference range for normal TSH is classified as comprising 95% of a normal population who are assumed to be free of conditions that could influence TSH levels, with 2.5% of people over and under the actual range. Thyroid function tests may differ with age and sex, and between race and ethnicity. This is possibly influenced by genetic factors and hence populationspecific thyroid hormones normative data should be employed to provide clinicians the accurate evaluation of thyroid disease disorders. Presently, we utilize international reference ranges for almost all our laboratory tests. Among chronic kidney disease (CKD), we found that thyroid dysfunction had a prevalence of 11.7%, whereas Rhee et al, found that among hemodialysis patients, 1928 (22%) had hypothyroid and 6912 (78%) had euthyroid.
To identify the clinical characteristics and outcomes of hospitalized patients with COVID-19 in Oman.
A case series of hospitalized COVID-19 laboratory-confirmed patients between February 24th ...through April 24th, 2020, from two hospitals in Oman. Analyses were performed using univariate statistics.
The cohort included 63 patients with an overall mean age of 48±16 years and 84% (n=53) were males. A total of 38% (n=24) of the hospitalized patients were admitted to intensive care unit (ICU). Fifty one percent (n=32) of patients had at least one co-morbidity with diabetes mellitus (DM) (32%; n=20) and hypertension (32%; n=20) as the most common co-morbidities followed by chronic heart and renal diseases (12.8%; n=8). The most common presenting symptoms at onset of illness were fever (84%; n=53), cough (75%; n=47) and shortness of breaths (59%; n=37). All except two patients (97%; n=61) were treated with either chloroquine or hydroxychloroquine, while the three most prescribed antibiotics were ceftriaxone (79%; n=50), azithromycin (71%; n=45), and the piperacillin/tazobactam combination (49%; n=31). A total of 59% (n=37), 49% (n=31) and 24% (n=15) of the patients were on lopinavir/ritonavir, interferons, or steroids, respectively. Mortality was documented in (8%; n=5) of the patients while 68% (n=43) of the study cohort recovered. Mortality was associated with those that were admitted to ICU (19% vs 0; p=0.009), mechanically ventilated (31% vs 0; p=0.001), had DM (20% vs 2.3%; p=0.032), older (62 vs 47 years; p=0.045), had high total bilirubin (43% vs 2.3%; p=0.007) and those with high C-reactive protein (186 vs 90mg/dL; p=0.009) and low corrected calcium (15% vs 0%; p=0.047).
ICU admission, those on mechanical ventilation, the elderly, those with high total bilirubin and low corrected calcium were associated with high mortality in hospitalized COVID-19 patients.
Since the first cases were reported in Wuhan, China, COVID-19 has spread swiftly worldwide and is caused by SARS-CoV-2. The development of myocardial injury is associated with significantly worse ...clinical course and increased mortality. However, currently, it is unclear whether cardiac injury occurred in COVID-19 patients. Histological results obtained directly from the viral infection of the myocardium (i.e., SARS-CoV-2 viral myocarditis) or indirectly from the complications of COVID-19, showed that only a portion of patients infected with the virus developed viral myocarditis. Therefore, it is possible that with more autopsy evidence of SARS-CoV-2 and more correlation with the severity of the viral infection, viral myocarditis will emerge. Although COVID-19 manifests primarily as respiratory disease, few cases of cardiac injury without respiratory involvement or febrile illness have been reported. The pathogenesis of cancer and viral infections is due to the inability of the immune system to distinguish between self and non-self. Several oncogenic (hepatitis B virus, hepatitis C virus, human papilloma virus, Epstein-Barr virus, and HIV) and oncolytic viruses (coxsackievirus, reovirus, vaccinia virus, and adenovirus) are known to cause and regress various cancer types. We report a case of atypical manifestation of COVID-19-induced acute myocarditis and thyroid gland follicular neoplasm in a hemodialysis patient with no respiratory symptoms. This case illustrates that COVID-19 can present atypically and affect non-respiratory organ systems.
The severity and mortality from COVID-19 infection vary among populations. The aim of this study was to determine the prevalence and predictors of mortality among patients hospitalized with COVID-19 ...infection in a tertiary care hospital in Oman.
We conducted a retrospective study using database that included: demographic, clinical characteristics, laboratory parameters, medications and clinical outcomes of all patients hospitalized in Royal Hospital, Muscat, Oman, between March 12, 2020 and December 1st 2020. Univariate and multivariate logistic regression was performed to investigate the relationship between each variable and the risk of death of COVID-19 infected patients.
In total,1002 patients with COVID-19 infection with mean age of the cohort was 54±16 years (65% (n=650) male) were included, with an overall and intensive care unit (ICU) mortalities of 26% (n=257) and 42% (n=199/473), respectively. The prevalence of ICU admission was 47% (n=473) and the need for mechanical ventilation was 41% (n=413). The overall length of stay in the ICU was 13 (9–21) days. Adjusting for other factors in the model, the multivariable logistic regression demonstrated that in-hospital mortality in admitted COVID-19 patients was associated with old age (p<0.001), heart diseases (adjusted odds ratio (aOR), 1.84; 95% confidence interval (CI): 1.11–3.03; p=0.018), liver diseases (aOR, 4.48; 95% CI: 1.04–19.3; p=0.044), those with higher ferritin levels (aOR, 1.00; 95% CI: 1.00–1.00; p=0.006), acute respiratory distress syndrome (ARDS) (aOR, 3.20; 95% CI: 1.65–6.18; p=0.001), sepsis (aOR, 1.77; 95% CI: 1.12–2.80; p=0.022), and those that had ICU admission (aOR, 2.22; 95% CI: 1.12–4.38; p=0.022).
In this cohort, mortality in hospitalized COVID-19 patients was high and was associated with advanced age, heart diseases, liver disease, high ferritin, ARDS, sepsis and ICU admission. These high-risk groups should be prioritized for COVID-19 vaccinations.
Background : We investigated the association between changes in physical activity and the risk of a major adverse cardiovascular event (MACE) in people with newly diagnosed diabetes. Methods : Using ...a nationwide database, we identified 8,596 people with newly diagnosed diabetes who underwent national health examinations within a year before and after a diabetes diagnosis. Cox proportional hazards models, hazard ratios (HRs) and 95% confidence intervals (CIs) for MACE risks were calculated according to changes in physical activity before and after a diagnosis of diabetes. Results : During a median follow-up of 2.3 years, study participants who engaged in sustained physical activity after a diagnosis of diabetes had a 34% lower MACE risk compared to those with sustained inactivity (HR, 0.66; 95% CI, 0.44-0.98). An advantage was observed in those with a history of cardiovascular disease, although this was of borderline statistical significance (HR, 0.63; 95% CI, 0.40-1.01; P=0.054). In people considered obese, physical activity was significantly associated with a decreased risk of a MACE, regardless of the period preceding and following the diabetes diagnosis. Those who became inactive to active had the lowest risk of a MACE (HR, 0.38; 95% CI, 0.18-0.79). Conclusion : Maintaining active physical activity before and after a diagnosis of diabetes is essential to preventing cardiovascular disease. Early intervention strategies are necessary to promote physical activity and exercise routines after a diagnosis of diabetes in people with obesity and those with pre-existing cardiovascular disease.
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