Saudi Critical Care Journal

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Clinical presentation of COVID-19 infection can be variable in the current pandemic, even in patients presenting to the clinic with mild history of upper respiratory complaints. Various cutaneous manifestations have been noticed in COVID-19 patients with herpes zoster (HZ) being one among them. HZ is an infection that results when varicella zoster virus reactivates from its latent state in a posterior dorsal root ganglion. Here, we aim to expand our knowledge by reporting three cases of associated zoster infection in COVID-19 patients admitted to our intensive care unit in view of respiratory complaints. All the three patients admitted had revealed lymphocytopenia at the time of HZ diagnosis and were managed conservatively throughout the course. In all the cases, acyclovir/valacyclovir led to the resolution of lesions in 10 days. No postherpetic sequelae were observed. We hereby suggest that the clinical presentation of HZ at the time of current pandemic should be considered as an alarming sign for a latent subclinical SARS-CoV-2 infection and thorough follow-up of such patients should be adopted.

Background: Critical care response team (CCRT) is a proactive department of intensive care unit (ICU) that consists of an intensivist, a staff physician, a critical care nurse, and a respiratory therapist. The purpose of this team is to manage patients in their wards to avoid unnecessary ICU bed occupancies. The aim of the study is to explore factors affecting CCRT service in terms of patient disposition and mortality rate and to analyze interventions provided to the patients by the team. Materials and Methods: This is a retrospective cohort study conducted at a tertiary hospital in Riyadh. All CCRT event data collection forms from the period between February 2018 and April 2019 were reviewed. Patients meeting our criteria were included. Outcome measures were as follows: (1) patient disposition. (2) mortality rate. Factors that were tested for effect on CCRT service were patient age, activation time, and reasons for activation. All statistical analyses were done using SAS software 9.4. Results: A total of 1088 CCRT events were considered during the period of the study. Out of all deaths, the mean age was 70.90 ± 16.67 compared to the mean age of survivors 61.21 ± 20.65 (P < 0.0001). Furthermore, older patients had higher chances for ICU transfer (P = 0.0399). CCRT service was not affected by activation time as patient disposition and mortality rates were almost the same in activations during and out of work hours. The most common reason for CCRT activation was tachypnea (28.49%). Majority of patients within each reason for activation were not transferred to the ICU, except for low oxygen saturation (50.54% transferred to the ICU) (P = 0.0001), decreased level of consciousness (DLOC) (49.40% transferred to ICU) (P = 0.0001). Patients not transferred to the ICU had lower mortality rate (15.18%) than those transferred to the ICU (55.41%) (P < 0.0001). Conclusion: Given these results, increased vigilance and quick responses to CCRT calls for older patients, and those with low oxygen saturation and DLOC, must be considered. Increased vigilance is also needed for those spending more time in ICUs.

Nursing research is a scientific method that provides evidence to support nursing practices. Investigation of the critical care nursing research in Saudi Arabia has not been well established. This review aims to examine the numbers, and the characteristics of PubMed-cited critical care nursing articles contributed from Saudi Arabia over the past decade. We conducted a PubMed search to analyze nursing publications in the field of critical care published or contributed in Saudi Arabia for over 10 years (2010–2019). We investigated the number of publications per year, specialty, study design, journal impact factor, and international collaboration. A total of 94 critical care nursing publications were included in this review. International collaborations were noted in 49 (52.1%) articles. The majority 53 (56.4%) of the critical care nursing publications were related to the nursing field and 66 (70.2%) of these articles were classified as clinical practice topics. Observation cohort study was the most used study design 64 (68.1%). The median impact factor for the journals of these publications was 1.76 (1.48, 2.52). Despite the lower rate of published researches, critical care nursing research in Saudi Arabia is increasing over the years. International collaborations had contributed dramatically in the published articles. Developing local strategy for critical care nursing research and promoting local and international collaboration to conduct and use research according to the critical care nursing priority are also warranted. More interventional nursing researches are needed in critical care settings in Saudi Arabia.

Online since 15^th Dec, 2016