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Background: Stigma and discrimination (SAD) can greatly impact the management of Coronavirus Disease-19 (COVID-19) patients. Studies examining SAD in managing COVID-19 patients in Saudi Arabia (SA) are limited. This study examined the discrimination and inequality in treating COVID-19 patients and the associated beliefs among healthcare workers (HCWs) during the pandemic., Methods: This was a cross sectional study using an online self-administrated questionnaire by 414 HCWs from September 2022 to January 2023., Results: Of the 414 participants, 53.4% aged 18-30 years, were males (53.4%), mostly Saudi (82.1%), and residents of western SA (90.8%). Almost one-third of the participants (32.1%) were physicians, and 23.7% were pharmacists. 53.1% of the HCWs had work experience < 5 years, 49.3% either had a current/previous COVID-19 infection and 10.1% (n = 42) reported treating ≥ 2000 COVID-19 patients. Most of the participants had not received training on avoiding discrimination against COVID-19 patients (n = 246; 59.4%) and denied receiving any incentives from their institution (n = 294; 71%) or community (n = 248; 59.9%) during the pandemic. Less than 20% of the HCWs had observed some sort of discrimination in providing care for COVID-19 patients. The responses significantly differed by nationality, educational level, specialty, workplace and COVID-19 infection status (P < 0.05). Approximately, 20% of the participants held negative beliefs about COVID-19 patients and these responses varied significantly by nationality, work experience, workplace, gender, and age (p < 0.05). Cross-tabulation and regression analyses showed some differences by gender, workplace, specialty and COVID-19 infection status., Conclusions: There was a low prevalence of negative beliefs about COVID-19 patients and a low prevalence of discriminatory behaviors in providing care for these patients in SA. Training and governmental regulations could further lower the prevalence of SAD against COVID-19 patients., Competing Interests: Conflicts of interest All authors declare that they do not have any conflict of interest related to this work., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

To control the spread of coronavirus disease (COVID-19), Saudi Arabia's government imposed a strict lockdown during March-July 2020. As a result, the public was confined to indoors, and most of their daily activities were happening in their indoor places, which might have resulted in lower indoor environment quality. Polycyclic aromatic hydrocarbons (PAHs) were analyzed in household dust ( n = 40) collected from different residential districts of Jeddah, Saudi Arabia, during the lockdown period. PAHs' levels were two folds higher than the previously reported PAHs in indoor dust from this region. We detected low molecular weight (LMW) with two to four aromatic ring PAHs in all the samples with a significant contribution from Phenanthrene (Phe), present at an average concentration of 1590 ng/g of dust. Although high molecular weight (HMW) (5-6 aromatic ring) PAHs were detected at lower concentrations than LMW PAHs, however, they contributed >90% in the carcinogenic index of PAHs. The estimated daily intake (EDI) of specific PAHs was above the reference dose (RfD) for young children in high-end exposure and the calculated Incremental Lifetime Cancer Risk (ILCR) was >1.00 × 10 -4 for both Saudi adults and young children. The study highlighted that indoor pollution has increased significantly during lockdown due to the increased indoor activities and inversely affect human health. This study also warrants to conduct more studies involving different chemicals to understand the indoor environment quality during strict lockdown conditions.

The novel coronavirus Severe Acute Respiratory Syndrome (SARS)-Coronavirus-2 (CoV-2) has resulted in an ongoing pandemic and has affected over 200 countries around the world. Mathematical epidemic models can be used to predict the course of an epidemic and develop methods for controlling it. As social contact is a key factor in disease spreading, modeling epidemics on contact networks has been increasingly used. In this work, we propose a simulation model for the spread of Coronavirus Disease 2019 (COVID-19) in Saudi Arabia using a network-based epidemic model. We generated a contact network that captures realistic social behaviors and dynamics of individuals in Saudi Arabia. The proposed model was used to evaluate the effectiveness of the control measures employed by the Saudi government, to predict the future dynamics of the disease in Saudi Arabia according to different scenarios, and to investigate multiple vaccination strategies. Our results suggest that Saudi Arabia would have faced a nationwide peak of the outbreak on 21 April 2020 with a total of approximately 26 million infections had it not imposed strict control measures. The results also indicate that social distancing plays a crucial role in determining the future local dynamics of the epidemic. Our results also show that the closure of schools and mosques had the maximum impact on delaying the epidemic peak and slowing down the infection rate. If a vaccine does not become available and no social distancing is practiced from 10 June 2020, our predictions suggest that the epidemic will end in Saudi Arabia at the beginning of November with over 13 million infected individuals, and it may take only 15 days to end the epidemic after 70% of the population receive a vaccine.

This study aimed to estimate the effect of the coronavirus disease 2019 (COVID-19) quarantine on low back pain (LBP) intensity, prevalence, and associated risk factors among adults in Riyadh (Saudi Arabia). A total of 463 adults (259 males and 204 females) aged between 18 and 64 years and residing in Riyadh (Saudi Arabia) participated in this cross-sectional study. A self-administered structured questionnaire composed of 20 questions regarding demographic characteristics, work- and academic-related aspects, physical activity (PA), daily habits and tasks, and pain-related aspects was used. The LBP point prevalence before the quarantine was 38.8%, and 43.8% after the quarantine. The LBP intensity significantly increased during the quarantine. The low back was also the most common musculoskeletal pain area. Furthermore, during the quarantine, a significantly higher LBP intensity was reported by those individuals who (a) were aged between 35 and 49 years old, (b) had a body mass index equal to or exceeding 30, (c) underwent higher levels of stress, (d) did not comply with the ergonomic recommendations, (e) were sitting for long periods, (f) did not practice enough physical activity (PA), and (g) underwent teleworking or distance learning. No significant differences were found between genders. The COVID-19 quarantine resulted in a significant increase in LBP intensity, point prevalence, and most associated risk factors.

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emerging infection causing a widely spread pandemic of Coronavirus disease 2019 (COVID-19). The current COVID-2019 pandemic is prompting fear of falling sick, dying, helplessness and stigma, urgent and timely understanding of mental health status is needed to help the community. Our investigation designed to survey the general population in Saudi Arabia to assess the degree of psychological impact during the pandemic., Methods: During the early stage of the outbreak, we conducted an online-based survey using a snowballing sample technique. The surveys collected data about several aspects of participant sociodemographic, knowledge, concerns, psychological impact, and mental health status. We assessed the psychological impact and mental health status using the Impact of Event Scale-Revised (IES-R), and the Depression, Anxiety, and Stress Scale (DASS-21)., Results: Our survey recruited 1160 respondents of the general public of Saudi Arabia. Of them, 23.6% reported moderate or severe psychological impact of the outbreak, 28.3%,24%, and 22.3% reported moderate to severe depressive, anxiety, and stress symptoms, respectively. Females reported IES-R (B: 5.46, 95% CI: 3.61 to 7.31) and DASS subscales B coefficient ranged from 1.65 to 2.63, along with high-school students, working in the medical field, and poor self-reported health status was significantly associated with a high level of IES-R and DASS scales (p < .05). Experiencing breathing difficulty and dizziness showed a stronger association with higher IES-R and DASS subscales than other somatic symptoms (e.g., headache and fever);(p < .001). Respondents who practiced specific preventative measures (e.g., hand washing, social distancing) demonstrated a protective effect against stress, anxiety, and depression symptoms. Social distancing appeared to be protective on stress and anxiety subscales (B: -1.49, 95% CI: -2.79 to -0.19),(B: -1.53, 95% CI: -2.50 to -0.57),respectively; and hand hygiene on depression subscale (B: -2.43, 95% CI: -4.44 to -0.42)., Conclusion: Throughout the early stage of the COVID-19 outbreak in Saudi Arabia, the results showed that nearly one-fourth of the sampled general population experienced moderate to severe psychological impact. Following specific precautionary measures appeared to have a protective effect on the individual's mental health. Our findings can be used to construct psychological interventions directed toward vulnerable populations and to implement public mental health strategies in the early stages of the outbreak., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2020 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background: Restricted interests and repetitive behavior are characteristics of autism spectrum disorder (ASD). The likelihood that persons with ASD will respond adversely to unfamiliar situations is great. The novel coronavirus outbreak has resulted in disruptions to all aspects of routine and behavior. Hence, this study proposed to investigate the impact of the outbreak on the eating behavior and routines of childrenwith ASD in Saudi Arabia through the perceptions of their parents. Method: A cross-sectional study with a quantitative approach was utilized to obtain data from 150 parents of children with ASD aged =18 years in Saudi Arabia. The data collected included demographic data of the parents, the ASD status of the family, impact of COVID-19 to the family, eating behavior of the children with ASD, and daily routines of the children with ASD. Moreover, parents were able to provide comments regarding their children's eating behavior or daily routines. Results: The study found that changes in the eating behavior of children with ASD were found to differ significantly (p<0.05) based on the number of children with ASD, the age of the children with ASD, the gender of the children with ASD, and the severity of their ASD symptoms. Moreover, changes to dinner-time routines were found to differ significantly (p<0.05) based on the age of the children with ASD. Also, changes to morning routines were found to differ significantly (p<0.05) based on the age of the children with ASD, their gender, and the severity of their ASD symptoms. Additionally, impact of COVID-19 to the family had a significant impact to eating behavior and daily routines of the children with ASD. Conclusion: This study found that the eating behavior and daily routines of children with ASD in Saudi Arabia have been considerably worsened and changed. The study recommends the collaboration of multidisciplinary teams and parents to modify or design interventions that help to change their eating behavior and routine can be implemented in the home. It also recommends the provision of virtual helplines to aid parents of children with ASD in such cases. [ABSTRACT FROM AUTHOR]

Background and Objective: Identification of clinical characteristics and risk factors for mortality in COVID-19 is important for early detection and precise case management. The study aimed to describe the sociodemographic, clinical, and laboratory characteristics of in-hospital COVID-19 deaths in Almadinah Almonawarah city, Saudi Arabia, and to identify risk factors for early mortality among them. Methods: This is an analytical cross-sectional study. The main outcomes were demographic and clinical characteristics of COVID 19 patients who died from March till December 2020, during the hospital stay. We collected 193 records of COVID-19 patients, from two major hospitals in Al Madinah region, Saudi Arabia. Descriptive and inferential analysis were performed to identify and relate the factors of early death. Results: Out of the total deaths, 110 died during the first 14 days of admission (Early death group) and 83 died after 14 days of admission (Late death group). Early death group had a significantly higher percentages of old age patients (p=0.027) and males (72.7%). Comorbidities were found in 166 (86%) of cases. Multimorbidity were significantly higher in early deaths than in late deaths 74.5% (p=<0.001). Women had significantly higher mean values of CHA2SD2 comorbidity scores (3.28 versus 1.89 for men; p <0.001). Moreover, predictors of high comorbidity scores were older age (p=0.005), higher respiratory rate (p=0.035), and raised alanine transaminase (p=0.047). Conclusion: Old age, comorbid illness, and severe respiratory involvement were prevalent among COVID-19 deaths. Comorbidity scores were significantly higher in women. Comorbidity was found to be significantly more associated with early deaths. [ABSTRACT FROM AUTHOR]

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes respiratory disorders, with disease severity ranging from asymptomatic to critical manifestations. The current retrospective study compared the efficacies of different antiviral regimens used in patients suffering from severe COVID-19 disease from 19 January 2020 to December 2021 in a single center in Saudi Arabia. In total, 188 patients were enrolled in the current study, including 158 patients treated with different antiviral regimens, and 30 who did not receive any antiviral treatment. Different antiviral regimens, including favipiravir, remdesivir, oseltamivir, favipiravir/remdesivir, and favipiravir/oseltamivir were adopted. The effects of using different antivirals and antibiotics on the survival rate were evaluated, as well as the presence of comorbidities. Among all severely affected patients, 39/188 (20.7%) survived. Both age and comorbidities, including diabetes and hypertension, were significantly correlated with high case fatality following SARS-CoV-2 infection. Remdesivir alone and the combination of favipiravir and remdesivir increased the survival rate. Surprisingly, both imipenem and linezolid helped in the deterioration of disease outcome in the patients. A negative correlation was detected between increased mortality and the use of favipiravir and the use of either imipenem or linezolid. Among the compared antiviral regimens used in the treatment of severe COVID-19, remdesivir was found to be an effective antiviral that reduces COVID-19 case fatality. Antibiotic treatment using imipenem and/or linezolid should be carefully re-evaluated. [ABSTRACT FROM AUTHOR]

The global pandemic of coronavirus disease 2019 (COVID 19) is reported to have started in Wuhan City, Hebei Province, China. It has spread rapidly all over the world, including Saudi Arabia, having a severe health emergency. This new virus was named as the 2019 novel coronavirus (2019-nCoV), and now severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) based on previous practice and phylogenetic and taxonomic investigations. SARS-CoV-2 belongs to the family of Coronaviridae, Betacoronavirus, Sarbecovirus subgenus, genome β. Throughout the COVID 19 pandemic, several strains of SARS-CoV-2 have been recognized around the world. The SARS-CoV-2 variants have caused significant morbidity and mortality worldwide and in Saudi Arabia as well. The rate at which COVID-19 spread across borders and affected countries has highlighted the significance of health care systems to nations and global operations. This review focuses on the origin, epidemiology, pathophysiology, transmission, and the impact of this disease, while highlighting the knowledge about SARS-CoV-2 variants. [ABSTRACT FROM AUTHOR]

Antibiotic resistance is a global health and development threat, especially during the Severe Acute Respiratory Syndrome Coronavirus 2 (COVID-19) pandemic. Therefore, the current study was conducted to describe antibiotic usage and resistance among patients with COVID-19 in the intensive care unit (ICU) in Makkah, Saudi Arabia. In this cross-sectional study, only patients with positive COVID-19 status (42 patients) admitted to the ICU at the King Faisal Hospital were selected using a census sampling method. The susceptibility test of bacteria was carried out according to the standard protocol. The identified strains were tested in-vitro against several antibiotics drugs. Statistical analysis was performed using SPSS version 24. A total of 42 patients were included, with a mean age of 59.35 ± 18 years. Of them, 38.1% were males, and 61.9% were females. 35.7% have blood group O +. For age and blood groups, statistically significant associations were found between males and females, with p-values = 0.037 and 0.031, respectively. A large percentage (42.7%) of the obtained samples contained Klebsiella Pneumoniae; all bacteria were multidrug-resistance bacteria. Furthermore, 76.2% of bacteria were resistant to Ampicillin, 66.7% were resistant to Ciprofloxacin, 64.3% were resistant to Levofloxacin, 57.1% were resistant to Imipenem, and 57.1% were resistant to Moxifloxacin. On the contrary, among the 40 examined antibiotics, the effective antibiotics were Daptomycin, Linezolid, Mupirocin, Synercid, Teicoplanin, Vancomycin, and Nitrofurantoin. Our study demonstrates that antibiotic resistance is highly prevalent among ICU patients with COVID-19 at the King Faisal Hospital. Additionally, all bacteria were multidrug-resistance bacteria. Therefore, this high prevalence should be seriously discussed and urgently considered. [ABSTRACT FROM AUTHOR]

Copyright of Saudi Medical Journal is the property of Saudi Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Coronavirus disease 2019 (COVID-19) has caused a global public health crisis. The disease is known to be caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, but the detailed characteristics of the immune response to this novel virus have not been fully elucidated yet. In this study, we aimed to determine the level of immunoglobulin G (IgG) antibodies and their correlation with clinical features at three time points postinfection in a group of patients in Saudi Arabia. Method: In this prospective observational study, we collected the demographic and clinical data from 43 polymerase chain reaction (PCR)-confirmed patients and measured the COVID-19 antispike IgG levels at three different visits. Result: The seroconversion rate after COVID-19 infection was 88.4% in the study participants, with no significant changes in the IgG levels through the three visits. The duration of shortness of breath had a significant positive correlation with the IgG level of the patients. Using the logistic regression model, participants having coughs were found to be 12.48 times more likely to develop positive IgG. The IgG levels were less in smokers than nonsmokers [Odds ratio = 6.42 (95% CI 2.11–19.48); P = 0.001]. Conclusion: Positive IgG levels have been developed in most COVID-19 patients and did not significantly change over 3 months following the diagnosis. The level of IgG antibodies was found to be significantly associated with the presence of cough, duration of shortness of breath, and the smoking habit of the patients. These findings have clinical and public health significance and need to be validated in larger studies in different populations. [ABSTRACT FROM AUTHOR]

Since the emergence of the pandemic of the coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the discovery of antiviral phytoconstituents from medicinal plants against SARS-CoV-2 has been comprehensively researched. In this study, thirty-three plants belonging to seventeen different families used traditionally in Saudi Arabia were tested in vitro for their ability to inhibit the SARS-CoV-2 main protease (MPRO). Major constituents of the bio-active extracts were isolated and tested for their inhibition potential against this enzyme; in addition, their antiviral activity against the SARS-CoV-2 Egyptian strain was assessed. Further, the thermodynamic stability of the best active compounds was studied through focused comparative insights for the active metabolites regarding ligand–target binding characteristics at the molecular level. Additionally, the obtained computational findings provided useful directions for future drug optimization and development. The results revealed that Psiadia punctulata, Aframomum melegueta, and Nigella sativa extracts showed a high percentage of inhibition of 66.4, 58.7, and 31.5%, against SARS-CoV-2 MPRO, respectively. The major isolated constituents of these plants were identified as gardenins A and B (from P. punctulata), 6-gingerol and 6-paradol (from A. melegueta), and thymoquinone (from N. sativa). These compounds are the first to be tested invitro against SARS-CoV-2 MPRO. Among the isolated compounds, only thymoquinone (THY), gardenin A (GDA), 6-gingerol (GNG), and 6-paradol (PAD) inhibited the SARS-CoV-2 MPRO enzyme with inhibition percentages of 63.21, 73.80, 65.2, and 71.8%, respectively. In vitro assessment of SARS-CoV-2 (hCoV-19/Egypt/NRC-03/2020 (accession number on GSAID: EPI_ISL_430820) revealed a strong-to-low antiviral activity of the isolated compounds. THY showed relatively high cytotoxicity and was anti-SARS-CoV-2, while PAD demonstrated a cytotoxic effect on the tested VERO cells with a selectivity index of CC50/IC50 = 1.33 and CC50/IC50 = 0.6, respectively. Moreover, GNG had moderate activity at non-cytotoxic concentrations in vitro with a selectivity index of CC50/IC50 = 101.3/43.45 = 2.3. Meanwhile, GDA showed weak activity with a selectivity index of CC50/IC50 = 246.5/83.77 = 2.9. The thermodynamic stability of top-active compounds revealed preferential stability and SARS-CoV-2 MPRO binding affinity for PAD through molecular-docking-coupled molecular dynamics simulation. The obtained results suggest the treating potential of these plants and/or their active metabolites for COVID-19. However, further in-vivo and clinical investigations are required to establish the potential preventive and treatment effectiveness of these plants and/or their bio-active compounds in COVID-19. [ABSTRACT FROM AUTHOR]

Copyright of Saudi Medical Journal is the property of Saudi Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Saudi Medical Journal is the property of Saudi Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Several observational studies have reported the rate of venous and arterial thrombotic events in patients infected with COVID-19, with conflicting results. The aim of this study was to estimate the rate of thrombotic and bleeding events in hospitalized patients diagnosed with Coronavirus disease 2019 (COVID-19). Methods: This was a multicenter study of 636 patients admitted between 20 March 2020 and 31 May 2020 with confirmed COVID-19 in four hospitals. Results: Over a median length of stay in the non-ICU group of 7 days and of 19 days in the ICU group, twelve patients were diagnosed with Venous thromboembolism (VTE) (1.8 %) (95 % CI, 1.1–3). The rate in the non-ICU group was 0.19 % (95 % CI, 0.04–0.84), and that in the ICU group was 10.3 % (95 % CI, 6.4–16.2). The overall rate of arterial event is 2.2 % (95 % CI, 1.4–3.3). The rates in the non-ICU and ICU groups were 0.94 % (95 % CI, 0.46–0.1.9) and 8.4 % (95 % CI, 5.0–14.0). The overall composite event rate was 2.9 % (95 % CI, 2.0–4.3). The composite event rates in the non-ICU and ICU groups were 0.94 % (95 % CI, 0.46–0.1.9) and 13.2 % (95 % CI, 8.7–19.5). The overall rate of bleeding is 1.7 % (95 % CI, 1.0–2.8). The bleeding rate in the non-ICU group was 0.19 % (95 % CI, 0.04–0.84), and that in the ICU group was 9.4 % (95 % CI, 5.7–15.1). The baseline D-dimer level was a significant risk factor for developing VTE (OR 1.31, 95 % CI, 1.08–1.57, p = 0.005) and composite events (OR 1.32, 95 % CI, 1.12–1.55, p = 0.0007). Conclusions: In this study, we found that the VTE rates in hospitalized patients with COVID-19 might not be higher than expected. In contrast to the risk of VTE, we found a high rate of arterial and bleeding complications in patients admitted to the ICU. An elevated D-dimer level at baseline could predict thrombotic complications in COVID-19 patients and may assist in the identification of these patients. Given the high rate of bleeding, the current study suggests that the intensification of anticoagulation therapy in COVID-19 patients beyond the standard of care be pursued with caution and would best be evaluated in a randomized controlled study. [ABSTRACT FROM AUTHOR]

Background: A novel coronavirus was identified at the end of 2019 in Wuhan City, China. Later, it was named as coronavirus disease 2019 (COVID-19) and declared a pandemic in March 2020. Saudi and global health agencies have provided various COVID-19 knowledge tools and facts to the general public. Therefore, this study aims to assess COVID-19 knowledge among the general public in Saudi Arabia at the early stages of the pandemic. Participants and Methods: A cross-sectional study was conducted in March 2020 in Saudi Arabia. The study included 1006 participants who responded to a random online COVID-19 public knowledge questionnaire that included five sections: demographic characteristics, general knowledge, prevention practices, home quarantine measures, and knowledge of governmental restrictions. Three levels of knowledge were established: excellent, intermediate, and poor. Differences in the percentages of participants with different knowledge levels by the demographic variables were analyzed using the chi-square test. Results: Regarding overall general knowledge of COVID-19, 75%, 24%, and 1% of the participants had excellent, intermediate, and poor knowledge levels, respectively. Knowledge levels were significantly different by nationality and age (P=0.027 and 0.008, respectively). Most participants (98.4%) reported excellent knowledge of prevention practices, with no statistically significant differences among groups (P> 0.005). Older age groups reported higher knowledge of home quarantine measures (86.6% and 86.4% of the 51– 60 and older than 60 age groups, respectively, P=0.001). Conclusion and Recommendations: High levels of knowledge about the virus, including prevention practices, are essential. The provision of COVID-19 facts and knowledge tools should be focused on younger generations to enhance compliance with the governmental restrictions required to stop the spread of COVID-19. [ABSTRACT FROM AUTHOR]

In 2019 in Wuhan province, China, an outbreak of atypical pneumonia was reported with similar symptoms to Severe Acute Respiratory Syndrome (SARS), an outbreak reported in 2003, and Middle East Respiratory Syndrome (MERS) reported in Saudi Arabia in 2012. This emerging disease was caused by a novel coronavirus "Severe Acute Respiratory Syndrome Coronavirus 2" (SARS-CoV-2) or also called COVID-19. Which causes severe respiratory problems and various extrapulmonary manifestations. At the moment, the high mortality of COVID-19 has been related to the male sex, older adults (>60 years), and preexisting comorbidities of diabetes, obesity, hypertension, and heart problems. Diabetes is a disease characterized by insulin resistance and loss of ß cell function in the pancreas, with an impaired immune system due to chronic inflammation. In patients with severe COVID-19 infection, altered secretion of pro-inflammatory cytokines has been observed, if this infection occurs in a diabetic patient who already has an inflammatory state per se, an exacerbated inflammation and multiorgan failure with fatal consequences can be triggered. Several authors hypothesis suggest that hyperglycemia increases the viral replication in patients "diabetic with COVID-19 infection" is necessary to keep adequate glycemic control. Treatments for COVID-19 had focused on decreasing symptoms, the use of antivirals, anti-inflammatory drugs, monoclonal antibodies and COVID-19 convalescent plasma has shown variable results. A vaccine is needed to control this viral infection, at the moment more than 150 candidates have been developed with efficiency ranges from 70 to 95%, however, the long-term immunity in vaccinated people is still unknown. This review focus on the characteristics of SARS-CoV-2 infection and the immune response in diabetic patients facing COVID-19. [ABSTRACT FROM AUTHOR]

In humans, coronaviruses can cause infections of the respiratory system, with damage of varying severity depending on the virus examined: ranging from mild-to-moderate upper respiratory tract diseases, such as the common cold, pneumonia, severe acute respiratory syndrome, kidney failure, and even death. Human coronaviruses known to date, common throughout the world, are seven. The most common—and least harmful—ones were discovered in the 1960s and cause a common cold. Others, more dangerous, identified in the early 2000s and cause more severe respiratory tract infections. Among these the SARS-CoV, isolated in 2003 and responsible for the severe acute respiratory syndrome (the so-called SARS), which appeared in China in November 2002, the coronavirus 2012 (2012-nCoV) cause of the Middle Eastern respiratory syndrome (MERS) from coronavirus, which exploded in June 2012 in Saudi Arabia, and actually SARS-CoV-2. On December 31, 2019, a new coronavirus strain was reported in Wuhan, China, identified as a new coronavirus beta strain ß-CoV from group 2B, with a genetic similarity of approximately 70% to SARS-CoV, the virus responsible of SARS. In the first half of February, the International Committee on Taxonomy of Viruses (ICTV), in charge of the designation and naming of the viruses (i.e., species, genus, family, etc.), thus definitively named the new coronavirus as SARS-CoV-2. This article highlights the main knowledge we have about the biomolecular and pathophysiologic mechanisms of SARS-CoV-2. [ABSTRACT FROM AUTHOR]

Introduction: Efforts have been made to contain COVID-19. Human behavior, affected by knowledge and perceptions, may influence the course of disease. Methodology: A structured questionnaire was used to collect data from 422 participants. It consisted of 28 questions in four sections; seven questions about sociodemographic characteristics of participants, 12 questions to estimate level of knowledge about COVID-19, six questions to evaluate attitudes toward disease, and three questions to assess practices to prevent disease transmission. Results: Their overall understanding of COVID-19 was satisfactory. 69% of the participants had satisfactory levels of knowledge, and the main sources of information were social media platforms (79.70%) and television (70.90%). There was a significant difference in knowledge as a function of gender (p = 0.50), occupation (p = 0.012), and smoking (p = 0.041). The participants held optimistic attitudes and adopted appropriate protective measures. Most participants agreed that COVID-19 can cause death (64.7%), poses greater risks to elderly (93.4%) and those with chronic diseases (96.7%), it is mandatory to quarantine infected individuals (98.1%), preventive health measures are important (97.6%), and health authorities will succeed in controlling the pandemic (67.5%). There was a statistically significant association between satisfactory levels of knowledge and the practice of wearing masks and the adoption of protective measures (avoiding crowded places, frequent hand washing). Conclusions: Residents of Al-Jouf region in Saudi Arabia have satisfactory levels of knowledge, optimistic attitudes, and good practice during the rapid rise period of the pandemic. Awareness campaigns will improve any misbeliefs and risky behaviors. [ABSTRACT FROM AUTHOR]

Coronavirus, a pandemic threat to human beings, has awakened huge concern worldwide, but no bibliometric studies have been conducted on Coronavirus research during 2011-Feb.2020. The aim of this study is to map research productivity on the Coronavirus based on the articles indexed in the Scopus database. The articles related to Coronavirus dated from 2011 to Feb. 2020 were retrieved from the Scopus database. A total of 7558 papers were retrieved for this study which indexed by the Scopus database during 2010-Feb. 2020. The most productive year is recognized 2015with 1012 (13.38 %) articles while Maximum AGR 40.38 percent was recorded in the year. The USA ranked first with 2373 publications, followed by China with1378 publications while The Journal of Virology published the highest 330 articles followed by PLoS One with 224 articles. Dusten, C. is ranked topmost productive corresponding author (first position) with 108 articles followed by Memish, Z.A. with 107 articles. Medicine subject identified as the top subject for publishing paper on Coronavirus followed by Immunology and Microbiology. The title Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia received the highest 1346 citations, followed by Immune Signaling by RIG-I-like Receptors with 818 citations. [ABSTRACT FROM AUTHOR]

Lately, there was an outbreak of Coronavirus disease (COVID-19) in Wuhan, a city of province Hubei, China. The infectious and transferrable virus originated in bats, seafood and animals. COVID-19 belongs to Coronviradae family. Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) also belong to this family and their outbreak occurred in China and Saudi Arabia back in 2003 and 2012. The mortality rate of COVID-19 is much greater than that of SARS and MERS. The clinical symptoms of infected individuals from virus are almost the same but diagnostically they are different from one another. Reverse transcription polymerase chain reaction (RT-PCR) laboratory technique is a standard test for evaluation and confirmation of COVID-19 disease. In early stages, imaging modalities can be used for screening purposes. X-Ray is used to identify the gross changes within the chest region while Computed Tomography scan chest is used for detailed modification which occurs due to coronavirus. CT scan evaluates the different characteristics in the individuals infected from COVID-19 such as presence of bilateral ground glass opacities, presence of diffuse consolidation, presence of nodules with halo sign, enlarge thoracic lymph nodes, presence of thicken inter-lobar septa, presence of bronchiectasis and pleural effusion. Each lung lobe was assigned different score on the basis of lobe area involvement. A lobe having no involvement is of score 0, minimal involvement lobe score is 1, mild involvement lobe score is 2, moderate involvement lobe score is 3, and severe involvement lobe score is 4. The lobes are assessed for different degree of involvement and then are divided as none (0%), minimal (1% to 25%), mild (26% to 50%), moderate (51% to 75%) and severe 76% to above level. These all techniques are very effective and responsible for the exact location of the area involved and also show the extension of pathology that can only be possible on CT scan. CT scan not only evaluates the disease but it also provides the assessment of the disease severity. [ABSTRACT FROM AUTHOR]

Vaccination has a major role in the control of the COVID-19 pandemic. The behavior toward accepting the COVID-19 vaccine is complex and multifactorial, while the level of acceptance and hesitancy depends on many factors. This study aims to measure the level of vaccine acceptance among Jazan University students and identify its predictors. In this cross-sectional study, an online questionnaire based on the health belief model (HBM) was sent through social media "WhatsApp" to two strata of students selected by convenient sampling. The overall desire to get vaccinated was noted in 83.6% of participants, and 16.4% reported no desire to be vaccinated. The constructs of the HBM were shown to significantly predict vaccine acceptance with the exception of "perceived susceptibility". In conclusion, the level of acceptance of the COVID-19 vaccine among Jazan University students was relatively high. The HBM constructs are important predictors of the vaccination behavior with the exception of the construct "perceived susceptibility". [ABSTRACT FROM AUTHOR]

The unusual cases of pneumonia outbreak were reported from Wuhan city in late December 2019. Serological testing provides a powerful tool for the identification of prior infection and for epidemiological studies. Pseudotype virus neutralization assays are widely used for many viruses and applications in the fields of serology. The accuracy of pseudotype neutralizing assay allows for its use in low biosafety lab and provides a safe and effective alternative to the use of wild-type viruses. In this study, we evaluated the performance of this assay compared to the standard microneutralization assay as a reference. The lentiviral pseudotype particles were generated harboring the Spike gene of SARS-CoV-2. The generated pseudotype particles assay was used to evaluate the activity of neutralizing antibodies in 300 human serum samples from a COVID-19 sero-epidemiological study. Testing of these samples resulted in 55 positive samples and 245 negative samples by pseudotype viral particles assay while microneutralization assay resulted in 64 positive and 236 negative by MN assay. Compared to the MN, the pseudotyped viral particles assay showed a sensitivity of 85.94% and a specificity of 100%. Based on the data generated from this study, the pseudotype-based neutralization assay showed a reliable performance for the detection of neutralizing antibodies against SARS-CoV-2 and can be used safely and efficiently as a diagnostic tool in a biosafety level 2 laboratory. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic is impacting national and international public health. Routine childhood immunization may be adversely affected by COVID-19 mitigation measures. We aimed to identify the prevalence of delayed immunization and explore the reasons and barriers for delayed immunization during the COVID-19 pandemic in the Qassim region, Saudi Arabia. We conducted a cross-sectional study using an online self-administered questionnaire for parents of children under two years of age during the period from 1 May to 30 June 2020. Most of the 749 participants (82.6%) were mothers, with 31 to 40 years being the most common age group (49.8%). Nearly three-quarters (73.2%) of the parents had appointments scheduled for their child's vaccination during the pandemic, and approximately 23.4% of the parents reported a delay of more than one month in the immunization of their child. The most common reason for the delay was the fear of being infected by COVID-19 (60.9%). Large household size and lack of insurance were risk factors for immunization delay. The COVID-19 pandemic has affected the timeliness of routine childhood immunization in Saudi Arabia. Childhood immunization should be prioritized, as well as the implementation of focused strategies to achieve significant and sustainable vaccination rates during pandemics. [ABSTRACT FROM AUTHOR]