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Objectives: This study sought to assess the prevalence of persistent COVID-19-related symptoms in patients with mild, severe, and critical disease. Methods: We conducted a bidirectional cohort observational study that included all adult patients ≥ 18 years, admitted to Armed Forces Hospital, Muscat between July 2020 and June 2022, with COVID-19 infection and discharged alive. Patients were requested to attend outpatient clinic at weeks six and 12 post-discharge, where they filled out a questionnaire and underwent a chest X-ray. Additionally, blood tests were performed if necessary. Healthcare workers with mild infections were also requested to fill out a questionnaire about their initial symptoms, persistent symptoms, and comorbidities. Results: The study included 468 patients, comprising 261 hospitalized patients and 207 healthcare workers. On follow-up, 39.7% of patients presented with residual symptoms, such as cough, breathlessness, and joint pain. These symptoms were more common in patients with medical comorbidities, particularly hypertension, diabetes, and dyslipidemia. Notably, these symptoms were also observed in patients with mild disease. Post-COVID-19 pulmonary fibrosis was observed in 21 patients, mainly among those admitted to the intensive care unit or requiring prolonged hospitalization. Conclusions: This study highlights the persistence of symptoms and the prevalence of post-COVID-19 syndrome at two months post-discharge, especially among patients with severe and critical disease during the acute phase. Various predictors of post-COVID-19 syndrome were identified, including female gender, older age, presence of comorbidities, disease severity, and hypertension. Therefore, patients in these categories require thorough evaluation and long-term follow-up to manage residual symptoms.
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Lung cancer is the leading cause of cancer-related death worldwide among both men and women. Although advances in therapy have been made, the 5-year survival rates for lung cancer remain poor, ranging from 10% to 20%. One of the main reasons is late presentation, as only 25% of patients are amenable to cure at the time of presentation. Therefore, the emphasis on lung cancer screening (LCS) is growing with the current evidence that has shown benefits with low-dose computed tomography scan of the chest in high-risk populations. LCS remains a debated topic in Gulf Cooperation Council (GCC) countries, possibly due to a lack of local experience. In this article, we explore the rationale and give recommendations on the best approach for LCS in GCC.
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COVID-19 pandemic has been associated with high short-term morbidity and mortality. Lungs are the main organs affected by SARS-CoV-2 infection. In the long-term, the pulmonary sequelae related to COVID-19 are expected to rise significantly leading to an extended impact on community health and health care facilities. A wide variety of long-term respiratory complications secondary to COVID-19 have been described ranging from persistent symptoms and radiologically observable changes to impaired respiratory physiology, vascular complications, and pulmonary fibrosis. Even after two-years, respiratory sequalae related to post-acute SARS-CoV-2 infection have not been fully explored and understood. The main treatment for most COVID-19 respiratory complications is still symptomatic and supportive-care oriented. In this review article, we shed light on current knowledge of the post-COVID-19 complications, focusing on pulmonary fibrosis, treatment directions, and recommendations to physicians.
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OBJECTIVES: The primary objective is to determine the prevalence of SARS-CoV-2 antibodies persistence among HCWs and specifically among asymptomatic HCWs. A secondary objective is to determine the duration of persistent SARS-CoV-2 antibodies post infection and factors affecting this duration. The findings are expected to open the door for further research into the role of SARS-CoV-2 antibodies during the current COVID-19 pandemic. METHODOLOGY: HCWs were divided into high, intermediate, and low risk based on their type and location of work. All participants filled a questionnaire. Blood samples were obtained for SARS-CoV-2 IgG/total antibodies. A documented SARS-CoV-2 PCR or Anti-SARS-CoV-2 IgG/total antibodies defined the primary outcome. The probability of persistence of antibody was calculated using the Kaplan-Meier estimator. Logistic and Cox regression were used where appropriate. RESULTS: A total of 1111 HCWs were included. The median age 37 years (IQR: 31-43). More than half (67.2%) were females. The primary outcome was seen in 373 (33.6%) participants with a median age of 36 years (IQR: 29-41). Only 37.2% of those with documented positive SARS-CoV-2 PCR had reactive serology, while only 16.2% of those with reactive serology had documented positive SARS-CoV-2 PCR. Male gender (OR 0.44, P < 0.001) and older age (OR 0.98, P < 0.019) were associated with a lower risk of acquiring SARS-CoV-2 infection. The probability of persistent SARS-CoV-2 antibodies at six months was 60.2% (95% CI: 49.5%-73.1%). Omanis had a higher probability of losing the antibody than others (HR 2.63, P = 0.021). CONCLUSION: We report a high prevalence of anti-SARS-CoV-2 antibodies among HCWs in Oman, specifically among asymptomatic HCWs. Community was the most likely source of infection. Therefore, the society must adhere to the roles and regulations set to reduce the risk of transmission. We demonstrate a high percentage of seroconversion post initial infection, and the persistence of SARS-CoV-2 antibodies at six months in more than half of those previously infected. We demonstrated a new interesting finding of fast decline of SARS-CoV2 antibody levels over time among different nationalities and this requires further research.