Early predictors of intensive care unit admission among COVID-19 patients in Qatar

BackgroundCOVID-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.MethodsThis 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.ResultsA 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).ConclusionHaving cardiovascular disease, diabetes, obesity, lymphopenia, dyspnea, and increased AST, ferritin, and CRP were independent predictors for ICU admission in patients with COVID-19

Endogenous endophthalmitis due to Serratia marcescens secondary to late‐onset empyema Post‐Cardiac surgery in an End‐Stage renal disease patient on peritoneal dialysis

Abstract Endogenous bacterial endophthalmitis results from bacterial seeding of the eye during bacteremia. A diagnosis of endogenous bacterial endophthalmitis requires clinical findings such as vitritis or hypopyon along with positive blood cultures. Serratia marcescens is the second most common pathogen causing hospital‐acquired ocular infections. This report describes a case of endogenous bacterial endophthalmitis caused by S. marcescens in an older adult with end‐stage renal disease (ESRD) on peritoneal dialysis, who had late‐onset pleural empyema secondary to coronary artery bypass grafting (CABG). A 61‐year‐old gentleman presented with a two‐day history of cloudy vision, black floaters, pain, swelling, and gradual vision loss in his right eye. There was no history of trauma, ocular surgeries, or previous similar episodes. He had myocardial infarction treated with CABG 3 months back. Examination showed a 3 mm hypopyon in the anterior chamber. He had classic signs of endophthalmitis with positive blood cultures for S. marcescens. He was treated with high‐dose intravenous meropenem and intravitreal ceftazidime without vitrectomy. Endophthalmitis progressed to complete vision loss in his right eye, requiring evisceration. Endophthalmitis caused by S. marcescens is rare, but long‐term outcomes can be severe, causing complete vision loss in about 60% of the patients. It is usually hospital‐acquired, and the source can be late‐onset empyema several months after cardiac surgery, in an immunocompromised patient. Systemic antibiotics should be supplemented with intravitreal agents with or without pars plana vitrectomy

Perspectives of clinical pharmacists on the provision of pharmaceutical care through telepharmacy services during COVID-19 pandemic in Qatar: A focus group

Background Coronavirus disease 2019 (COVID-19) pandemic created unprecedented pressures on healthcare systems and led to the widespread adoption of telepharmacy services, a practice that was not previously established in the state of Qatar. Objective The -study aimed to explore clinical pharmacists' (CPs) perspectives and experiences in utilizing telepharmacy for the provision of pharmaceutical care during the COVID-19 pandemic. Methods A descriptive, qualitative approach using face-to-face focus group (FG) discussions was used. CPs across Hamad Medical Corporation (HMC) were purposively invited to participate in the study. FG discussions were audio-recorded, transcribed verbatim, and validated. Transcripts were analyzed using inductive thematic analysis. Recruitment continued until a saturation point was achieved. Results We conducted five focus groups that included 23 CPs and led to seven themes. Overall, CPs reported inadequate preparedness for the practice of telepharmacy, which they perceived as challenging. The primary perceived benefits of telepharmacy were decreased infection exposure risk, improved quality of care, improved patients' satisfaction, and enhanced workplace efficiency and productivity. The main highlighted risks of telepharmacy were related to threatened patient confidentiality, missed pharmaceutical care opportunities, and negatively impacted professional rapport with other healthcare providers; and the major perceived challenges were low digital health literacy, complex illnesses and medication regimens, lack of standardized protocols, and inadequacy of resources and cultural resistance for virtual care. Participants recommended standardization and training, resource allocation, and proper service promotion as potential facilitators of telepharmacy practice. Conclusion The current study revealed that despite perceived barriers, pharmacists identified several benefits of telepharmacy and recommended potential facilitators that should be used to integrate and sustain the practice of telepharmacy in the future. Future studies should investigate the impact of telepharmacy on clinical pharmacy interventions and patient outcomes. Copyright: 2022 Alhmoud et al.The funder provided support in the form of salaries for authors [EA, DA, RB, MS, AO, RA, MA], but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the 'author contributions' section.Scopu