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Abuyousef S, Alnaimi S, Omar NE, Elajez R, Elmekaty E, Abdelfattah-Arafa E, Barazi R, Ghasoub R, Rahhal A, Hamou F, Al-Amri M, Karawia A, Ajaj F, Alkhawaja R, Kardousha A, Awaisu A, Abou-Ali A, Khatib M, Aboukamar M, Al-Hail M. Early predictors of intensive care unit admission among COVID-19 patients in Qatar. Front Public Health 2024; 12:1278046. [PMID: 38572008 PMCID: PMC10987715 DOI: 10.3389/fpubh.2024.1278046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 02/19/2024] [Indexed: 04/05/2024] Open
Abstract
Background COVID-19 is associated with significant morbidity and mortality. This study aimed to explore the early predictors of intensive care unit (ICU) admission among patients with COVID-19. Methods This was a case-control study of adult patients with confirmed COVID-19. Cases were defined as patients admitted to ICU during the period February 29-May 29, 2020. For each case enrolled, one control was matched by age and gender. Results A total of 1,560 patients with confirmed COVID-19 were included. Each group included 780 patients with a predominant male gender (89.7%) and a median age of 49 years (interquartile range = 18). Predictors independently associated with ICU admission were cardiovascular disease (adjusted odds ratio (aOR) = 1.64, 95% confidence interval (CI): 1.16-2.32, p = 0.005), diabetes (aOR = 1.52, 95% CI: 1.08-2.13, p = 0.016), obesity (aOR = 1.46, 95% CI: 1.03-2.08, p = 0.034), lymphopenia (aOR = 2.69, 95% CI: 1.80-4.02, p < 0.001), high AST (aOR = 2.59, 95% CI: 1.53-4.36, p < 0.001), high ferritin (aOR = 1.96, 95% CI: 1.40-2.74, p < 0.001), high CRP (aOR = 4.09, 95% CI: 2.81-5.96, p < 0.001), and dyspnea (aOR = 2.50, 95% CI: 1.77-3.54, p < 0.001). Conclusion Having cardiovascular disease, diabetes, obesity, lymphopenia, dyspnea, and increased AST, ferritin, and CRP were independent predictors for ICU admission in patients with COVID-19.
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Affiliation(s)
- Safae Abuyousef
- Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Shaikha Alnaimi
- Department of Pharmacy, Hamad Bin Khalifa Medical City, Hamad Medical Corporation, Doha, Qatar
| | - Nabil E. Omar
- Department of Pharmacy, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
- Health Sciences Program, Clinical and Population Health Research, College of Pharmacy, Qatar University, Doha, Qatar
| | - Reem Elajez
- Department of Pharmacy, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Eman Elmekaty
- Department of Pharmacy, Communicable Diseases Center, Hamad Medical Corporation, Doha, Qatar
| | | | - Raja Barazi
- Department of Pharmacy, Al Wakra Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Rola Ghasoub
- Department of Pharmacy, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Ala Rahhal
- Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Fatima Hamou
- Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Maha Al-Amri
- Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Karawia
- Department of Pharmacy, Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Fatima Ajaj
- Department of Pharmacy, Home Health Care, Hamad Medical Corporation, Doha, Qatar
| | - Raja Alkhawaja
- Department of Pharmacy, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Kardousha
- Department of Pharmacy, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Awaisu
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Adel Abou-Ali
- Astellas Pharma Global Development, Inc., Northbrook, IL, United States
| | - Mohamad Khatib
- Department of Critical Care, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Mohammed Aboukamar
- Department of Infectious Disease, Communicable Diseases Center, Hamad Medical Corporation, Doha, Qatar
| | - Moza Al-Hail
- Department of Pharmacy, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
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Abuyousef S, Alnaimi S, Omar N, Elajez R, Elmekaty E, Arafa E, Barazi R, Ghasoub R, Rahhal A, Hamou F, Al-Amri M, Karawia A, Ajaj F, Alkhawaja R, Kardousha A, Awaisu A, Abou-Ali A, Khatib M, Aboukamar M, Al-Hail M. Characteristics and Early Predictors of Intensive Care Unit Admission among COVID-19 Patients in Qatar. Int J Infect Dis 2022. [PMCID: PMC8884751 DOI: 10.1016/j.ijid.2021.12.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Purpose This study aimed to explore the early predictors of intensive care unit (ICU) admission and in-hospital mortality among patients diagnosed with Coronavirus disease (COVID-19). Methods & Materials This was a case-control study of adult patients with confirmed COVID-19. Cases were defined as patients admitted to ICU during the period February 29 - May 29, 2020. For each case enrolled, one control was matched by age and gender. Univariate and multivariate logistic regression models were used to identify the predictors for ICU admission and in-hospital mortality among the COVID‐19 patients. Results A total of 1560 patients with confirmed COVID-19 were included. Each group included 780 patients with a predominant male gender (89.7%) and a median age of 49 years (interquartile range, IQR=18). Predictors independently associated with ICU admission included having cardiovascular disease (CVD) (adjusted odds ratio (aOR)=1.64, 95% confidence interval (CI): 1.16 - 2.32, p= 0.005), diabetes (aOR=1.52, 95% CI: 1.08 - 2.13, p= 0.016), body mass index ≥30 kg/m2 (aOR=1.46, 95% CI: 1.03-2.08, p= 0.034), lymphocytes ≤0.8 × 103/μL (aOR=2.69, 95% CI: 1.80-4.02, p<0.001), aspartate aminotransferase (AST) >120 U/L (aOR= 2.59, 95% CI: 1.53-4.36, p<0.001), ferritin >600 μg/L (aOR=1.96, 95% CI: 1.40-2.74, p<0.001), C-reactive protein (CRP) >100 mg/L (aOR=4.09, 95% CI: 2.81-5.96, p<0.001), and dyspnea (aOR=2.50, 95% CI: 1.77-3.54, p <0.001). Similarly, significant predictors of mortality included CVD (aOR=2.16, 95% CI: 1.32- 3.53, p=0.002), diabetes (aOR=1.77, 95% CI: 1.07-2.90, p=0.025), cancer (aOR=4.65, 95% CI: 1.50-14.42, p= 0.008), lymphocytes ≤0.8 x,103/μL (aOR=2.34, 95% CI: 1.45-3.78, p= 0.001), and AST >120 U/L (aOR= 1.89, 95% CI: 1.04-3.43, p=0.036). Conclusion Having CVD, diabetes, lymphopenia, and increased AST were independent predictors for both ICU admission and in-hospital mortality in patients with COVID-19. In addition, obesity, high ferritin, and CRP levels were also associated with increased risk of ICU admission, while cancer was strongly associated with in-hospital mortality. Early identification and monitoring of patients at risk is essential in planning the level of care needed to prevent delay in medical intervention.
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Al Bishawi A, Abdel Hadi H, Elmekaty E, Al Samawi M, Nair A, Abou Kamar M, Al Maslamani M, Abdelmajid A. Remdesivir for COVID‐19 pneumonia in patients with severe chronic kidney disease: A Case series and review of the literature. Clin Case Rep 2022; 10:e05467. [PMID: 35228879 PMCID: PMC8867201 DOI: 10.1002/ccr3.5467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/26/2022] [Accepted: 02/01/2022] [Indexed: 12/30/2022] Open
Abstract
Remdesivir was the first antiviral agent to receive FDA authorization for severe COVID‐19 management, which restricts its use with severe renal impairment due to concerns that active metabolites might accumulate, causing renal toxicities. With limited treatment options, available evidence on such patient groups is important to assess for future safety. Our report suggests that Remdesivir is well tolerated and potentially safe among hospitalized patients with severe COVID‐19 infection with the background of advanced kidney diseases where benefits outweigh potential risks.
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Affiliation(s)
- Ahmad Al Bishawi
- Division of infectious Diseases Department of Internal Medicine Hamad Medical Corporation Doha Qatar
| | - Hamad Abdel Hadi
- Division of infectious Diseases Department of Internal Medicine Hamad Medical Corporation Doha Qatar
| | - Eman Elmekaty
- Division of infectious Diseases Department of Clinical Pharmacy Hamad Medical Corporation Doha Qatar
| | - Musaed Al Samawi
- Division of infectious Diseases Department of Internal Medicine Hamad Medical Corporation Doha Qatar
| | - Arun Nair
- Division of infectious Diseases Department of Internal Medicine Hamad Medical Corporation Doha Qatar
| | - Mohammed Abou Kamar
- Division of infectious Diseases Department of Internal Medicine Hamad Medical Corporation Doha Qatar
| | - Muna Al Maslamani
- Division of infectious Diseases Department of Internal Medicine Hamad Medical Corporation Doha Qatar
| | - Alaaeldin Abdelmajid
- Division of infectious Diseases Department of Internal Medicine Hamad Medical Corporation Doha Qatar
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Nasr ZG, Jibril F, Elmekaty E, Sonallah H, Chahine EB, AlNajjar A. Assessment of antimicrobial stewardship programs within governmental hospitals in Qatar: a SWOC analysis. Int J Pharm Pract 2020; 29:70-77. [PMID: 33793820 DOI: 10.1093/ijpp/riaa011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 10/08/2020] [Indexed: 01/18/2023]
Abstract
OBJECTIVES Antimicrobial resistance is a worldwide public health issue that requires emergent action. Antimicrobial stewardship programs (ASPs) have been proposed as a strategy to minimise resistance. Although ASPs were implemented in governmental hospitals in Qatar since 2015, a formal evaluation of these programs has not been conducted. We aimed to assess the status of ASPs in Qatar and to identify strengths, weaknesses, opportunities and challenges (SWOC) to further enhance ASPs within Hamad Medical Corporation (HMC). METHODS Lead stakeholders of ASPs in HMC filled a questionnaire adapted from the 2019 Centers for Disease Control Prevention checklist for ASPs. Notes were taken by research team to assist in formulating a SWOC analysis. KEY FINDINGS All hospitals (12/12) had an infectious diseases physician and pharmacist designated as an ASP leader (major strength identified). Almost all hospitals lack a financial statement and information technology resources to support ASPs (major weaknesses identified). Nine hospitals had an antibiotic pre-authorisation policy and adopted a prospective audit with feedback strategy. Among hospitals surveyed, 11 hospitals tracked antibiotic use by measuring the defined daily dose, and only four hospitals tracked rates of Clostridioides difficile infection. Qatar's rich economy supports the allocation of financial resources and budgeting to improve ASPs despite the increased emergence of resistant organisms and the limited resources currently available to expand ASPs across the country's healthcare settings. CONCLUSIONS Although ASPs were implemented in all governmental hospitals in Qatar, national efforts and more resources are needed to further develop and improve these programs.
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Affiliation(s)
- Ziad G Nasr
- College of Pharmacy, Qatar University, Doha, Qatar
| | - Farah Jibril
- National Center for Cancer Care and Research, Doha, Qatar
| | | | | | - Elias B Chahine
- Palm Beach Atlantic University Lloyd L. Gregory School of Pharmacy, West Palm Beach, FL, USA
| | - Afnan AlNajjar
- Palm Beach Atlantic University Lloyd L. Gregory School of Pharmacy, West Palm Beach, FL, USA
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Wilby KJ, Elmekaty E, Abdallah I, Habra M, Al-Siyabi K. Blood glucose control for patients with acute coronary syndromes in Qatar. Saudi Pharm J 2015; 24:35-9. [PMID: 26903766 PMCID: PMC4720025 DOI: 10.1016/j.jsps.2015.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 03/11/2015] [Indexed: 01/27/2023] Open
Abstract
Background: Blood glucose is known to be elevated in patients presenting with acute coronary syndromes. However a gap in knowledge exists regarding effective management strategies once admitted to acute care units. It is also unknown what factors (if any) predict elevated glucose values during initial presentation. Objectives: Objectives of the study were to characterize blood glucose control in patients admitted to the cardiac care unit (CCU) in Qatar and to determine predictive factors associated with high glucose levels (>10 mmol/l) on admission to the CCU. Setting: All data for this study were obtained from the CCU at Heart Hospital in Doha, Qatar. Method: A retrospective chart review was completed for patients admitted to the CCU in Qatar from October 1st, 2012 to March 31st, 2013, of which 283 were included. Baseline characteristics (age, gender, nationality, medical history, smoking status, type of acute coronary syndrome), capillary and lab blood glucose measurements, and use of insulin were extracted. Time spent in glucose ranges of <4, 4 to <8, 8 to <10, and >10 mmol/1 was calculated manually. Univariate and multivariate logistic regression were performed to assess factors associated with high glucose on admission. The primary analysis was completed with capillary data and a sensitivity analysis was completed using laboratory data. Main outcome measure: Blood glucose values measured on admission and throughout length of stay in the CCU. Results: Capillary blood glucose data showed majority of time was spent in the range of >10 mmol/l (41.95%), followed by 4–8 mmol/l (35.44%), then 8–10 mmol/l (21.45%), and finally <4 mmol/l (1.16%). As a sensitivity analysis, laboratory data showed very similar findings. Diabetes, hypertension, and non-smoker status predicted glucose values >10 mmol/l on admission (p < 0.05) in a univariate analysis but only diabetes remained significant in a multivariate model (OR 23.3; 95% CI, 11.5–47.3). Conclusion: Diabetes predicts high glucose values on hospital admission for patients with ACS and patients are not being adequately controlled throughout CCU stay.
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Affiliation(s)
- Kyle John Wilby
- College of Pharmacy, Qatar University, PO Box 2713, Doha, Qatar
| | - Eman Elmekaty
- College of Pharmacy, Qatar University, PO Box 2713, Doha, Qatar
| | | | - Masa Habra
- College of Pharmacy, Qatar University, PO Box 2713, Doha, Qatar
| | - Khalid Al-Siyabi
- Heart Hospital, Hamad Medical Corporation, PO Box 3050, Doha, Qatar
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