Browsing by Author "Alhumaid, Saad"

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    2022 World AIDS day: Past achievements and future optimism
    (Elsevier, 2022-12-17) Al-Tawfiq, Jaffar A.; Alhumaid, Saad; Altawfiq, Kauthar J.; Bearman, Gonzalo; Medicine, School of Medicine
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    A 20-year retrospective clinical analysis of Candida infections in tertiary centre: Single-center experience
    (Elsevier, 2022) Muzaheed; Alshehri, Bashayer A.; Rabaan, Ali A.; El-Masry, Omar S.; Acharya, Sadananda; Alzahrani, Faisal M.; Al Mutair, Abbas; Alhumaid, Saad; Al-Tawfiq, Jaffar A.; Muhammad, Javed; Khan, Amjad; Dhama, Kuldeep; Al-Omari, Awad; Medicine, School of Medicine
    Introduction: Fungal infections have risen exponentially in the last decade. In fact, candidiasis has become the most frequent type of hospital acquired infection especially in patients receiving treatment for chronic and terminal illnesses in a hospital. A retrospective analysis for a period of twenty year was undertaken to analyze the incidence rate of candidiasis, especially of Candida species, patients treated in a tertiary care center. Materials and methods: Clinical data was collected from samples of patients who were receiving tertiary care were presenting with clinically suspected fungal infections. Direct microscopy with 10% potassium hydroxide was done to visualize the presence of fungal elements, and Gram staining was done for any suspected yeast infection. The samples were inoculated on Sabouraud's Dextrose Agar and kept at 22 °C. Results: A total of 1256 samples with presumed fungal etiology were included in the study. The maximum number of fungal infections were present in elderly (70-79 years age). Females (53.8%) were more affected (45.5%). 21% isolates were identified as yeast but belonged to non-Candida fungi. Among Candida species, Candida albicans was the most dominant species (58.3%) followed by Candida glabrata (6.4%). The year-round data of fungal cases showed that the highest incident of Candida albicans infection were in January with a mean value of 3.80, while the lowest infections were reported in June, with prevalence of 2.32 of C. albicans. The twenty-year data analysis showed that the years 2001 and 2000 showed the highest incidents of C. albicans, with a mean prevalence of 7.50 and 6.83, respectively. Specimen vs fungal prevalence data showed that 38% of the C. albicans were isolated from body aspirate specimens, followed by 26% from swab specimens. Conclusion: The high prevalence of Candida spp. in the present study suggests increased susceptibility of patients with critical or chronic illnesses to fungal infections.
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    Anaphylactic and nonanaphylactic reactions to SARS-CoV-2 vaccines: a systematic review and meta-analysis
    (BMC, 2021-10) Alhumaid, Saad; Al Mutair, Abbas; Al Alawi, Zainab; Rabaan, Ali A.; Tirupathi, Raghavendra; Alomari, Mohammed A.; Alshakhes, Aqeel S.; Alshawi, Abeer M.; Ahmed, Gasmelseed Y.; Almusabeh, Hassan M.; Alghareeb, Tariq T.; Alghuwainem, Abdulaziz A.; Alsulaiman, Zainab A.; Alabdulmuhsin, Mohammed A.; AlBuwaidi, Emad A.; Dukhi, Amjad K. Bu; Mufti, Hani N.; Al-Qahtani, Manaf; Dhama, Kuldeep; Al-Tawfiq, Jaffar A.; Al-Omari, Awad; Medicine, School of Medicine
    Background Currently there is no systematic review and meta-analysis of the global incidence rates of anaphylactic and nonanaphylactic reactions to SARS-CoV-2 vaccines in the general adult population. Objectives To estimate the incidence rates of anaphylactic and nonanaphylactic reactions after COVID-19 vaccines and describe the demographic and clinical characteristics, triggers, presenting signs and symptoms, treatment and clinical course of confirmed cases. Design A systematic review and meta-analysis. Preferred Reporting Items for Systematic Reviews and Meta-Analyses [PRISMA] statement was followed. Methods Electronic databases (Proquest, Medline, Embase, Pubmed, CINAHL, Wiley online library, and Nature) were searched from 1 December 2020 to 31 May 2021 in the English language using the following keywords alone or in combination: anaphylaxis, non-anaphylaxis, anaphylactic reaction, nonanaphylactic reaction, anaphylactic/anaphylactoid shock, hypersensitivity, allergy reaction, allergic reaction, immunology reaction, immunologic reaction, angioedema, loss of consciousness, generalized erythema, urticaria, urticarial rash, cyanosis, grunting, stridor, tachypnoea, wheezing, tachycardia, abdominal pain, diarrhea, nausea, vomiting and tryptase. We included studies in adults of all ages in all healthcare settings. Effect sizes of prevalence were pooled with 95% confidence intervals (CIs). To minimize heterogeneity, we performed sub-group analyses. Results Of the 1,734 papers that were identified, 26 articles were included in the systematic review (8 case report, 5 cohort, 4 case series, 2 randomized controlled trial and 1 randomized cross-sectional studies) and 14 articles (1 cohort, 2 case series, 1 randomized controlled trial and 1 randomized cross-sectional studies) were included in meta-analysis. Studies involving 26,337,421 vaccine recipients [Pfizer-BioNTech (n = 14,505,399) and Moderna (n = 11,831,488)] were analyzed. The overall pooled prevalence estimate of anaphylaxis to both vaccines was 5.0 (95% CI 2.9 to 7.2, I2 = 81%, p =  < 0.0001), while the overall pooled prevalence estimate of nonanaphylactic reactions to both vaccines was 53.9 (95% CI 0.0 to 116.1, I2 = 99%, p =  < 0.0001). Vaccination with Pfizer-BioNTech resulted in higher anaphylactic reactions compared to Moderna (8.0, 95% CI 0.0 to 11.3, I2 = 85% versus 2.8, 95% CI 0.0 to 5.7, I2 = 59%). However, lower incidence of nonanaphylactic reactions was associated with Pfizer-BioNTech compared to Moderna (43.9, 95% CI 0.0 to 131.9, I2 = 99% versus 63.8, 95% CI 0.0 to 151.8, I2 = 98%). The funnel plots for possible publication bias for the pooled effect sizes to determine the incidence of anaphylaxis and nonanaphylactic reactions associated with mRNA COVID-19 immunization based on mRNA vaccine type appeared asymmetrical on visual inspection, and Egger’s tests confirmed asymmetry by producing p values < 0.05. Across the included studies, the most commonly identified risk factors for anaphylactic and nonanaphylactic reactions to SARS-CoV-2 vaccines were female sex and personal history of atopy. The key triggers to anaphylactic and nonanaphylactic reactions identified in these studies included foods, medications, stinging insects or jellyfish, contrast media, cosmetics and detergents, household products, and latex. Previous history of anaphylaxis; and comorbidities such as asthma, allergic rhinitis, atopic and contact eczema/dermatitis and psoriasis and cholinergic urticaria were also found to be important. Conclusion The prevalence of COVID-19 mRNA vaccine-associated anaphylaxis is very low; and nonanaphylactic reactions occur at higher rate, however, cutaneous reactions are largely self-limited. Both anaphylactic and nonanaphylactic reactions should not discourage vaccination.
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    Antibiotics in the pipeline: a literature review (2017–2020)
    (Springer, 2021-10-04) Al-Tawfiq, Jaffar A.; Momattin, Hisham; Al-Ali, Anfal Y.; Eljaaly, Khalid; Tirupathi, Raghavendra; Haradwala, Mohamed Bilal; Areti, Swetha; Alhumaid, Saad; Rabaan, Ali A.; Al Mutair, Abbas; Schlagenhauf, Patricia; Medicine, School of Medicine
    Introduction Antimicrobial resistance (AMR) is an emerging global threat. It increases mortality and morbidity and strains healthcare systems. Health care professionals can counter the rising AMR by promoting antibiotic stewardship and facilitating new drug development. Even with the economic and scientific challenges, it is reassuring that new agents continue to be developed. Methods This review addresses new antibiotics in the pipeline. We conducted a review of the literature including Medline, Clinicaltrials.org, and relevant pharmaceutical companies for approved and in pipeline antibiotics in phase 3 or new drug application (NDA). Results We found a number of new antibiotics and reviewed their current development status, mode of action, spectra of activity, and indications for which they have been approved. The included studies from phase 3 clinical trials were mainly utilized for the treatment of acute bacterial skin and skin structure infections, community-acquired bacterial pneumonia, and pneumonia acquired in the healthcare settings. The number of these agents is limited against high priority organisms. The identified antibiotics were based mainly on previously known molecules or pre-existing antimicrobial agents. Conclusion There are a limited number of antibiotics against high priority organisms such as multi-drug-resistant Pseudomonas aeruginosa, and carbapenem-resistant Enterobacteriaceae. New antimicrobial agents directed against the top priority organisms as classified by the World Health Organization are urgently needed.
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    Clinical Characteristics of Non-Intensive Care Unit COVID-19 Patients in Saudi Arabia: A Descriptive Cross-sectional Study
    (Elsevier, 2020-11-13) Al-Omari, Awad; Alhuqbani, Waad N.; Zaidi, Abdul Rehman Z.; Al-Subaie, Maha F.; AlHindi, Alanoud M.; Abogosh, Ahmed K.; Alrasheed, Aljwhara K.; Alsharafi, Aya A.; Alhuqbani, Mohammed N.; Salih, Samer; Alhedaithy, Mogbil Abdullah; Abdulqawi, Rayid; Ismail, Alaa Fariz; Alhumaid, Saad; Hamdan, Noura; Saad, Fares; Olhaye, Fahad Abdullah; Eltahir, Tarig Ali; Alomari, Mohammed; Alshehery, Maied; Yassiri, Aziz; Al-Tawfiq, Jaffar A.; Al Mutair, Abbas; Medicine, School of Medicine
    Introduction: The ongoing pandemic of the coronavirus disease 2019 (COVID-19) is a global health concern. It has affected more than 5 million patients worldwide and resulted in an alarming number of deaths globally. While clinical characteristics have been reported elsewhere, data from our region is scarce. We investigated the clinical characteristics of mild to moderate cases of COVID-19 in Saudi Arabia. Methods: This is a descriptive, cross-sectional study. Data of 401 confirmed COVID-19 patients were collected from 22 April 2020 to 21 May 2020 at five tertiary care hospitals in Riyadh, Saudi Arabia. The patients were divided into four groups according to age, Group 1: 0-<18 years, Group 2: 18-<50 years, Group 3: 50-60 years, and Group 4: >60 years; and their clinical symptoms were compared. Results: The median (IQR) age in years was 10.5 (1.5-16) in group I, 34 (29-41) in group II, 53 (51-56) in group III, and 66 (61-76) in group IV. Most patients were male (80%, n = 322) and of Arabian or Asian descent. The median length of stay in the hospital was 10 (8-17) days (range 3-42 days). The most common symptoms were cough (53.6%), fever (36.2%), fatigue (26.4%), dyspnea (21.9%), and sore throat (21.9%). Hypertension was the most common underlying comorbidity (14.7%), followed by obesity (11.5%), and diabetes (10%). Hypertensive patients were less likely to present with shortness of breath, cough, sputum, diarrhea, and fever. Conclusion: There was no significant difference in the symptoms among different age groups and comorbidities were mostly seen in the older age group. Interestingly, hypertensive patients were found to have milder symptoms and a shorter length of stay. Further larger collaborative national studies are required to effectively understand clinical characteristics in our part of the world to efficiently manage and control the spread of SARS-CoV-2.
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    Clinical features and prognostic factors of intensive and non-intensive 1014 COVID-19 patients: an experience cohort from Alahsa, Saudi Arabia
    (BioMed Central, 2021-05-24) Alhumaid, Saad; Al Mutair, Abbas; Al Alawi, Zainab; Al Salman, Khulud; Al Dossary, Nourah; Omar, Ahmed; Alismail, Mossa; Al Ghazal, Ali M.; Jubarah, Mahdi Bu; Al Shaikh, Hanan; Al Mahdi, Maher M.; Alsabati, Sarah Y.; Philip, Dayas K.; Alyousef, Mohammed Y.; Al Brahim, Abdulsatar H.; Al Athan, Maitham S.; Alomran, Salamah A.; Ahmed, Hatim S.; Al-Shammari, Haifa; Elhazmi, Alyaa; Rabaan, Ali A.; Al-Tawfiq, Jaffar A.; Al-Omari, Awad; Medicine, School of Medicine
    COVID-19 is a worldwide pandemic and has placed significant demand for acute and critical care services on hospitals in many countries.
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    Clinical Outcomes and Severity of Acute Respiratory Distress Syndrome in 1154 COVID-19 Patients: An Experience Multicenter Retrospective Cohort Study
    (MDPI, 2022) Al Mutair, Abbas; Alhumaid, Saad; Layqah, Laila; Shamou, Jinan; Ahmed, Gasmelseed Y.; Chagla, Hiba; Alsalman, Khulud; Alnasser, Fadhah Mohammed; Thoyaja, Koritala; Alhuqbani, Waad N.; Alghadeer, Mohammed; Al Mohaini, Mohammed; Almahmoud, Sana; Al-Tawfiq, Jaffar A.; Muhammad, Javed; Al-Jamea, Lamiaa H.; Woodman, Alexander; Alsaleh, Ahmed; Alsedrah, Abdulaziz M.; Alharbi, Hanan F.; Saha, Chandni; Rabaan, Ali A.; Medicine, School of Medicine
    Background: Acute Respiratory Distress Syndrome (ARDS) is caused by non-cardiogenic pulmonary edema and occurs in critically ill patients. It is one of the fatal complications observed among severe COVID-19 cases managed in intensive care units (ICU). Supportive lung-protective ventilation and prone positioning remain the mainstay interventions. Purpose: We describe the severity of ARDS, clinical outcomes, and management of ICU patients with laboratory-confirmed COVID-19 infection in multiple Saudi hospitals. Methods: A multicenter retrospective cohort study was conducted of critically ill patients who were admitted to the ICU with COVID-19 and developed ARDS. Results: During our study, 1154 patients experienced ARDS: 591 (51.2%) with severe, 415 (36.0%) with moderate, and 148 (12.8%) with mild ARDS. The mean sequential organ failure assessment (SOFA) score was significantly higher in severe ARDS with COVID-19 (6 ± 5, p = 0.006). Kaplan–Meier survival analysis showed COVID-19 patients with mild ARDS had a significantly higher survival rate compared to COVID-19 patients who experienced severe ARDS (p = 0.023). Conclusion: ARDS is a challenging condition complicating COVID-19 infection. It carries significant morbidity and results in elevated mortality. ARDS requires protective mechanical ventilation and other critical care supportive measures. The severity of ARDS is associated significantly with the rate of death among the patients.
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    Clinical, epidemiological, and laboratory characteristics of mild-to-moderate COVID-19 patients in Saudi Arabia: an observational cohort study
    (BMC, 2020) Al Mutair, Abbas; Alhumaid, Saad; Alhuqbani, Waad N.; Zaidi, Abdul Rehman Z.; Alkoraisi, Safug; Al-Subaie, Maha F.; AlHindi, Alanoud M.; Abogosh, Ahmed K.; Alrasheed, Aljwhara K.; Alsharafi, Aya A.; Alhuqbani, Mohammed N.; Alhowar, Njoud A.; Salih, Samer; Alhedaithy, Mogbil A.; Al-Tawfiq, Jaffar A.; Al-Shammari, Haifa; Abdulqawi, Rayid; Ismail, Alaa F.; Hamdan, Noura; Saad, Fares; Olhaye, Fahad A.; Eltahir, Tarig A.; Rabaan, Ali A.; Al-Omari, Awad; Medicine, School of Medicine
    Background Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) emerged from China in December 2019 and has presented as a substantial and serious threat to global health. We aimed to describe the clinical, epidemiological, and laboratory findings of patients in Saudi Arabia infected with SARS-CoV-2 to direct us in helping prevent and treat coronavirus disease 2019 (COVID-19) across Saudi Arabia and around the world. Materials and methods Clinical, epidemiological, laboratory, and radiological characteristics, treatment, and outcomes of pediatric and adult patients in five hospitals in Riyadh, Saudi Arabia, were surveyed in this study. Results 401 patients (mean age 38.16 ± 13.43 years) were identified to be SARS-CoV-2 positive and 80% of cases were male. 160 patients had moderate severity and 241 were mild in severity. The most common signs and symptoms at presentation were cough, fever, fatigue, and shortness of breath. Neutrophil and lymphocyte counts, aspartate aminotransferase, C-reactive protein, and ferritin were higher in the COVID-19 moderate severity patient group. Mild severity patients spent a shorter duration hospitalized and had slightly higher percentages of abnormal CT scans and X-ray imaging. Conclusions This study provides an understanding of the features of non-ICU COVID-19 patients in Saudi Arabia. Further national collaborative studies are needed to streamline screening and treatment procedures for COVID-19.
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    Coinfections with Bacteria, Fungi, and Respiratory Viruses in Patients with SARS-CoV-2: A Systematic Review and Meta-Analysis
    (MDPI, 2021-06) Alhumaid, Saad; Al Mutair, Abbas; Al Alawi, Zainab; Alshawi, Abeer M.; Alomran, Salamah A.; Almuhanna, Mohammed S.; Almuslim, Anwar A.; Bu Shafia, Ahmed H.; Alotaibi, Abdullah M.; Ahmed, Gasmelseed Y.; Rabaan, Ali A.; Al-Tawfiq, Jaffar A.; Al-Omari, Awad; Medicine, School of Medicine
    Background: Coinfection with bacteria, fungi, and respiratory viruses in SARS-CoV-2 is of particular importance due to the possibility of increased morbidity and mortality. In this meta-analysis, we calculated the prevalence of such coinfections. Methods: Electronic databases were searched from 1 December 2019 to 31 March 2021. Effect sizes of prevalence were pooled with 95% confidence intervals (CIs). To minimize heterogeneity, we performed sub-group analyses. Results: Of the 6189 papers that were identified, 72 articles were included in the systematic review (40 case series and 32 cohort studies) and 68 articles (38 case series and 30 cohort studies) were included in the meta-analysis. Of the 31,953 SARS-CoV-2 patients included in the meta-analysis, the overall pooled proportion who had a laboratory-confirmed bacterial infection was 15.9% (95% CI 13.6–18.2, n = 1940, 49 studies, I2 = 99%, p < 0.00001), while 3.7% (95% CI 2.6–4.8, n = 177, 16 studies, I2 = 93%, p < 0.00001) had fungal infections and 6.6% (95% CI 5.5–7.6, n = 737, 44 studies, I2 = 96%, p < 0.00001) had other respiratory viruses. SARS-CoV-2 patients in the ICU had higher co-infections compared to ICU and non-ICU patients as follows: bacterial (22.2%, 95% CI 16.1–28.4, I2 = 88% versus 14.8%, 95% CI 12.4–17.3, I2 = 99%), and fungal (9.6%, 95% CI 6.8–12.4, I2 = 74% versus 2.7%, 95% CI 0.0–3.8, I2 = 95%); however, there was an identical other respiratory viral co-infection proportion between all SARS-CoV-2 patients [(ICU and non-ICU) and the ICU only] (6.6%, 95% CI 0.0–11.3, I2 = 58% versus 6.6%, 95% CI 5.5–7.7, I2 = 96%). Funnel plots for possible publication bias for the pooled effect sizes of the prevalence of coinfections was asymmetrical on visual inspection, and Egger’s tests confirmed asymmetry (p values < 0.05). Conclusion: Bacterial co-infection is relatively high in hospitalized patients with SARS-CoV-2, with little evidence of S. aureus playing a major role. Knowledge of the prevalence and type of co-infections in SARS-CoV-2 patients may have diagnostic and management implications.
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    Colorectal cancer in patients with SARS-CoV-2: a systematic review and meta-analysis
    (BMC, 2022-09-12) Alhumaid, Saad; Al Mutair, Abbas; Busubaih, Jawad S.; Al Dossary, Nourah; Alsuliman, Murtadha; Baltyour, Sarah A.; Alissa, Ibrahim; Al Hassar, Hassan I.; Al Aithan, Noor A.; Albassri, Hani A.; AlOmran, Suliman A.; ALGhazal, Raed M.; Busbaih, Ahmed; Alsalem, Nasser A.; Alagnam, Waseem; Alyousef, Mohammed Y.; Alseffay, Abdulaziz U.; Al Aish, Hussain A.; Aldiaram, Ali; Al Eissa, Hisham A.; Alhumaid, Murtadha A.; Bukhamseen, Ali N.; Al Mutared, Koblan M.; Aljwisim, Abdullah H.; Twibah, Abdullah M.; AlSaeed, Meteab M.; Alkhalaf, Hussien A.; ALShakhs, Fatemah M.; Koritala, Thoyaja; Al-Tawfiq, Jaffar A.; Dhama, Kuldeep; Rabaan, Ali A.; Al-Omari, Awad; Medicine, School of Medicine
    Background: Patients with colorectal cancer (CRC) are more likely to develop severe course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and experience increased risk of mortality compared to SARS-CoV-2 patients without CRC. Objectives: To estimate the prevalence of SARS-CoV-2 infection in CRC patients and analyse the demographic parameters, clinical characteristics and treatment outcomes in CRC patients with COVID-19 illness. Methods: For this systematic review and meta-analysis, we searched Proquest, Medline, Embase, Pubmed, CINAHL, Wiley online library, Scopus and Nature for studies on the incidence of SARS-CoV-2 infection in CRC patients, published from December 1, 2019 to December 31, 2021, with English language restriction. Effect sizes of prevalence were pooled with 95% confidence intervals (CIs). Sub-group analyses were performed to minimize heterogeneity. Binary logistic regression model was used to explore the effect of various demographic and clinical characteristics on patient's final treatment outcome (survival or death). Results: Of the 472 papers that were identified, 69 articles were included in the systematic review and meta-analysis (41 cohort, 16 case-report, 9 case-series, 2 cross-sectional, and 1 case-control studies). Studies involving 3362 CRC patients with confirmed SARS-CoV-2 (all patients were adults) were analyzed. The overall pooled proportions of CRC patients who had laboratory-confirmed community-acquired and hospital-acquired SARS-CoV-2 infections were 8.1% (95% CI 6.1 to 10.1, n = 1308, 24 studies, I2 98%, p = 0.66), and 1.5% (95% CI 1.1 to 1.9, n = 472, 27 studies, I2 94%, p < 0.01). The median patient age ranged from 51.6 years to 80 years across studies. The majority of the patients were male (n = 2243, 66.7%) and belonged to White (Caucasian) (n = 262, 7.8%), Hispanic (n = 156, 4.6%) and Asian (n = 153, 4.4%) ethnicity. The main source of SARS-CoV-2 infection in CRC patients was community-acquired (n = 2882, 85.7%; p = 0.014). Most of those SARS-CoV-2 patients had stage III CRC (n = 725, 21.6%; p = 0.036) and were treated mainly with surgical resections (n = 304, 9%) and chemotherapies (n = 187, 5.6%), p = 0.008. The odd ratios of death were significantly high in patients with old age (≥ 60 years) (OR 1.96, 95% CI 0.94-0.96; p < 0.001), male gender (OR 1.44, 95% CI 0.41-0.47; p < 0.001) CRC stage III (OR 1.54, 95% CI 0.02-1.05; p = 0.041), CRC stage IV (OR 1.69, 95% CI 0.17-1.2; p = 0.009), recent active treatment with chemotherapies (OR 1.35, 95% CI 0.5-0.66; p = 0.023) or surgical resections (OR 1.4, 95% CI 0.8-0.73; p = 0.016) and admission to ICU (OR 1.88, 95% CI 0.85-1.12; p < 0.001) compared to those who survived. Conclusion: SARS-CoV-2 infection in CRC patient is not uncommon and results in a mortality rate of 26.2%. Key determinants that lead to increased mortality in CRC patients infected with COVID-19 include older age (≥ 60 years old); male gender; Asian and Hispanic ethnicity; if SARS-CoV-2 was acquired from hospital source; advanced CRC (stage III and IV); if patient received chemotherapies or surgical treatment; and if patient was admitted to ICU, ventilated or experienced ARDS.