Clinico-Epidemiological Characteristics and Survival Outcomes of COVID-19 Infection in Kassala, Eastern Sudan

Introduction: Severe acute respiratory syndrome coronavirus2 (SARS-CoV-2) represents a major health problem worldwide. Thus, early detection and appropriate management of the virus will influence the outcome of the disease. This study aimed to investigate the epidemiological characteristics and survival outcomes of patients with COVID-19 infection in Kassala, Eastern Sudan. Methods: A cross-sectional hospital-study was conducted among patients visiting Kassala teaching hospital with suspicion of COVID-19 infection. A structured questionnaire was used to gather clinical and socio-demo- graphic information from COVID-19 patients. Nasopharyngeal specimens and blood samples were collected and tested to confirm the diagnosis of COVID-19 infection using RT-PCR. Results: A total of 371 patients were enrolled in the study from September 2020 to January 2021, with mean age ± SD was 42.9 ± 19.9. The prevalence of COVID-19 infection was estimated at 61.7%. The majority were males 159 (69.4%), of university-level education, 96 (49.7%), and urban residents, 175 (9.7%). The most common symptoms were fever 215 (93.9%), cough 188 (82.1%), headache 179 (78.2%), and shortness of breath 154 (67.2%). Overall all mortality was reported as 16%. Older age group with the age ≥ 70, P P = 0.020, diabetes mellitus P = 0.029 were significantly associated with high case fatality. Conclusion: This study demonstrated that older age, male gender, laboratory tests (leukocytosis, lymphopenia, low Hemoglobin and high CRP) and various comorbid conditions significantly increase the disease severity and mortality. Therefore, attention should be paid to preventive measures to reduce the considerable impacts of the disease.

Frequency of diabetic retinopathy and associated risk factors in Khartoum,Sudan:population based study

AIM： To assess the frequency and associated risk fac- tors of diabetic retinopathy among Sudanese individuals with diabetes attending Makka Eye complex in Khartoum, Sudan. METHODS： The cross sectional hospital based study recruited 316 individuals with diabetes from Makkah Eye Complex Retina Clinic. Standard questionnaire was used to collect demographic data, medical history and life style characteristics. Blood samples were taken to measure HbAlc and lipid profile. Fundus and slit lamp examination were performed for screening of diabetic retinopathy. RESULTS： Among 316 participants, 187 （59.2%） were males and 129 （40.8%） were females. The mean age of participants was 58.7＋_10.5y. The overall frequency of retinopathy was 261 （82.6%）. The percentages of the total participants with proliferative diabetic retinopathy （PDR） were 126 （39.9%） and non-proliferative diabetic retinopathy （NPDR） were 135 （42.7%）. importantly, duration of diabetes mellitus （DM） （72.2% of more than 10y）, being on oral hypoglycaemic drugs （versus insulin）, and hypertension were all significant risk factors for diabetic retinopathy （P=0.00, 0.01 and 0.00 respectively）. Complications ofdiabetes like diabetic foot （17.7%）, history of amputation （6.7%） and clinically significant macular edema （CSME） （47.4%） of the eyes were all significant risk factors （P〈0.05）. Logistic regression analysis showed that duration of diabetes, hypertension and CSME were found to be absolute risk factors （P=-0.007, 0.003 and 0,000 respectively）. Duration of DM of more than 10y have more than double risk （OR--2.8）, while having hypertension triples the risk of retinopathy （OR=3.1）. CONCLUSION： High rates of diabetic retinopathy are noted among individuals with diabetes attending Makkah Eye hospital in capital Khartoum. Urgent strategies are needed to monitor and treat hypertension and optimize diabetes control in individuals with diabetes. More investment in diabetes services is urgently needed.

The Pattern of Neurological Disorders;Revisited Prevalence Data of a Dedicated Neurology Clinic in Sudan

Background: The diverse modes in geographical locations, environmental factors, genetic and racial characteristics play a complex role in determining the pattern of neurological disorders worldwide. Determining the pattern of neurological disorders enables health policymakers to plan evidently for service, training, and research priorities. Few prevalence studies in neurology were conducted in Sudan. Methods: This is a retrospective hospital-based study that reviewed the medical records of patients who attended a Dedicated Neurology Clinic (DNC) in Omdurman, the national Capital of Sudan, for 24 months, from January 2016 to January 2018. This study aimed to determine the DNC pattern of neurological disorders as a representative subset prevalence in Sudan. Neurologists conducted the medical workup for diagnosis after at least two visits. All patients have ethically consented. Results: The total number of patients was 1050. Only 749 patients (71.3%) fulfilled the inclusion criteria. The mean age was 46.5 ± 1.9, and males were 45.3%. 72% were from the Capital. The presenting symptoms were headache (16.6%), seizures (11.5%), limbs weakness (11.2%), and lower percentages for other neurological symptoms. The commonest diagnoses were Stroke 12.4%, Epilepsy 9.3%, Primary Headache 8.8%, Movement Disorders 7.3%, Peripheral Neuropathy 6%, Dementia 4% Neuroinfections 1.4%, Demyelinating Disorders 2.6%, Spinal Spondylotic Radiculopathy 2.6% and 1.7% for Cerebral Venous Thrombosis. Conclusion: The data from Sudan-DNC showed that the most common neurological disorders descendingly were Stroke, Epilepsy, Headache, Movement Disorders, Peripheral Neuropathy, Dementia, Infections, Demyelinating Disorders, Spinal Spondylotic Radiculopathy, and Cerebral Venous Thrombosis. The demyelinating disorders and peripheral neuropathy showed a higher percentage than our previous preliminary prevalence study in 2012 compared to the other conditions, which showed similar rates in that study.

Nonalcoholic fatty liver disease and COVID-19:An epidemic that begets pandemic

Coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has become a global pandemic,affecting all the individuals across the planet.COVID-19 has gained significant attention due to its high prevalence among individuals with diabetes,nonalcoholic fatty liver disease(NAFLD),and metabolic syndrome.NAFLD is the hepatic manifestation of metabolic syndrome and can be associated with a high risk of developing type 2 diabetes.The association of COVID-19 and NAFLD has also gained more attention because NAFLD is highly associated with the epidemic of obesity.NAFLD is a potential risk factor for SARS-CoV-2 infection and severe COVID-19,independent of metabolic syndrome.Importantly,it is not yet clear whether the epidemics of obesity and NAFLD have perpetuated the current pandemic of COVID-19.Further research is urgently needed to assess the following:(1)Whether NAFLD is a high risk factor for SARS-CoV-2 infection;(2)Whether NAFLD is associated with the severe form of COVID-19;and(3)Whether the presence of NAFLD can explain the racial variation in the morbidity and mortality associated with COVID-19.This review summarizes the interactions between COVID-19 and NAFLD,mechanism of liver injury by COVID-19,and effect of lockdown due to COVID-19 on patients with NAFLD.