Risk Assessment and Travelers Characteristics: 6-Month Travel Clinic Experience From Qatar

Introduction: The number of international travelers is increasing, yet currently, there is no data on risk assessment and travelers’ characteristics from Qatar. To identify and minimize the risks associated with travel, a detailed knowledge of travelers’ characteristics is needed. Methods: This retrospective descriptive study was conducted in a travel clinic in the Communicable Disease Center, Qatar. All patients seen in the clinic from February 2017 to August 2017 were included. Data was analyzed using SPSS version 22 software. Results: A total of 279 travelers were included in this study. The top 2 most visited countries were Tanzania and Kenya. Tourism (57.3%) was the number one purpose for travel, while travelers visiting friends and relatives (VFRs) accounted for 10.7% of travel. Among the study population, 21% of participants had pre-existing medical conditions with hypertension and diabetes as the most common comorbidities. Mean travel duration was 46.5 days (range = 3 to 90 days). Vaccinations were required by 97% of the study population with the most commonly prescribed vaccines being the typhoid (69%), Tdap (62%), hepatitis A (55%), flu (49.3%), and yellow fever (39%) vaccines. Conclusion: Travelers from Qatar tend to visit high-risk destinations; the lack of proper travel medicine services and awareness among travelers may increase the risk of illness, especially in Qatar where a large number of expatriates reside and travel frequently to and from their home countries (VFRs)

Effectiveness of the neutralizing antibody sotrovimab among high-risk patients with mild-to-moderate SARS-CoV-2 in Qatar

ObjectivesTo estimate the real-world effectiveness of sotrovimab against severe, critical, or fatal COVID-19 in Qatar at a time in which most SARS-CoV-2 incidences occurred due to the BA.2 Omicron subvariant. MethodsWe conducted a matched case-control study among all individuals eligible for sotrovimab treatment per United States Food and Drug Administration guidelines in the resident population of Qatar. The odds of progression to severe forms of COVID-19 were compared in cases (treatment group) versus controls (eligible patients who opted not to receive the treatment). Subgroup analyses were conducted. ResultsA total of 3364 individuals were eligible for sotrovimab treatment during the study period, of whom 519 individuals received the treatment, whereas the remaining 2845 constituted the controls. The adjusted odds ratio of disease progression to severe, critical, or fatal COVID-19 comparing the treatment group to the control group was 2.67 (95% confidence interval 0.60-11.91). In the analysis including only the subgroup of patients at higher risk of severe forms of COVID-19, the adjusted odds ratio was 0.65 (95% confidence interval 0.17-2.48). ConclusionThere was no evidence for a protective effect of sotrovimab in reducing COVID-19 severity in a setting dominated by the BA.2 subvariant

Longitudinal cellular and humoral immune responses following COVID-19 BNT162b2-mRNA-based booster vaccination of craft and manual workers in Qatar

BackgroundIn March 2020, the rapid spread of SARS-CoV-2 prompted global vaccination campaigns to mitigate COVID-19 disease severity and mortality. The 2-dose BNT162b2-mRNA vaccine effectively reduced infection and mortality rates, however, waning vaccine effectiveness necessitated the introduction of a third vaccine dose or booster.AimTo assess the magnitude and longevity of booster-induced immunity, we conducted a longitudinal study of SARS-CoV-2 specific cellular and humoral immune responses among Qatar’s vulnerable craft and manual worker community. We also investigated the impact of prior naturally acquired immunity on booster vaccination efficacy.MethodsSeventy healthy participants were enrolled in the study, of whom half had prior SARS-CoV-2 infection. Blood samples were collected before and after booster vaccination to evaluate immune responses through SARS-CoV-2 specific ELISpots, IgG ELISA, neutralization assays, and flow cytometric immunophenotyping.ResultsT cell analysis revealed increased Th1 cytokine responses, marked by enhanced IFN-γ release, in recently infected participants, which was further enhanced by booster vaccination for up to 6-months. Furthermore, booster vaccination stimulated cytotoxic responses in infection-naïve participants, characterized by granzyme B production. Both natural SARS-CoV-2 infection and booster vaccination induced robust and durable SARS-CoV-2 specific humoral immune responses, with high neutralizing antibody levels. Prior natural infection was also linked to an increased number of class-switched B cells prior to booster vaccination.ConclusionsThese findings underscore the importance of booster vaccination in enhancing anti-viral immunity across both infection-naïve and previously infected individuals, enhancing distinct arms of the anti-viral immune response and prolonging naturally acquired immunity

Adult K lebsiella pneumoniae meningitis in Qatar: clinical pattern of ten cases

ABSTRACTObjectiveTo describe the clinical presentation, underlying diseases, antimicrobial susceptibility, treatment and outcome of Klebsiella pneumoniae meningitis patients.MethodsThis retrospective study involved all patients with 15 years of age or older who admitted to Hamad General Hospital with culture proven Klebsiella pneumoniae meningitis from January 1, 2007 to December 31, 2012.ResultsA total of ten cases were identified (nine males and one female). Their mean age was (43.3±12.8) years. Eight patients (80%) had nosocomial meningitis with neurosurgery being the most frequent associated condition. Fever and altered consciousness were the most frequent symptom. Cerebrospinal fluid showed elevated protein and glucose levels. Gram stain showed Gram-negative rods in 50% of cases, while positive cerebrospinal fluid culture results were found in all patients. Multidrug resistance was observed in two cases, and all patients had received appropriate empirical and definitive antibiotic treatments. The mean duration of intravenous antimicrobial treatment was (19.3±7.0) d and all patients with external ventricular drains underwent removal of the device, while in-hospital mortality was 50%.ConclusionsThe number of cases was too small to come up with therapeutic and prognostic conclusions. Further large-scale prospective study is needed

Risk Assessment and Travelers Characteristics: 6-Month Travel Clinic Experience From Qatar

Introduction: The number of international travelers is increasing, yet currently, there is no data on risk assessment and travelers’ characteristics from Qatar. To identify and minimize the risks associated with travel, a detailed knowledge of travelers’ characteristics is needed. Methods: This retrospective descriptive study was conducted in a travel clinic in the Communicable Disease Center, Qatar. All patients seen in the clinic from February 2017 to August 2017 were included. Data was analyzed using SPSS version 22 software. Results: A total of 279 travelers were included in this study. The top 2 most visited countries were Tanzania and Kenya. Tourism (57.3%) was the number one purpose for travel, while travelers visiting friends and relatives (VFRs) accounted for 10.7% of travel. Among the study population, 21% of participants had pre-existing medical conditions with hypertension and diabetes as the most common comorbidities. Mean travel duration was 46.5 days (range = 3 to 90 days). Vaccinations were required by 97% of the study population with the most commonly prescribed vaccines being the typhoid (69%), Tdap (62%), hepatitis A (55%), flu (49.3%), and yellow fever (39%) vaccines. Conclusion: Travelers from Qatar tend to visit high-risk destinations; the lack of proper travel medicine services and awareness among travelers may increase the risk of illness, especially in Qatar where a large number of expatriates reside and travel frequently to and from their home countries (VFRs).</jats:p

The Course of COVID-19 in a Patient with Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria Clone: A Case Report and Literature Review

&lt;b&gt;&lt;i&gt;Introduction:&lt;/i&gt;&lt;/b&gt; Aplastic anemia (AA) and paroxysmal nocturnal hemoglobinuria (PNH) are bone marrow failure syndromes. A 20–40% of patients with AA have a PNH clone at diagnosis. To date, there are little data about the course of COVID-19 in patients with AA and PNH. &lt;b&gt;&lt;i&gt;Case Presentation:&lt;/i&gt;&lt;/b&gt; A 36-year-old gentleman, who was previously diagnosed as a case of AA with PNH clones off immune-suppressive therapy, presented with fever and cough and was diagnosed with mild pneumonia due to COVID-19 with positive nasopharyngeal swab polymerase chain reaction (PCR) for severe acute respiratory syndrome coronavirus 2. His clinical course was benign except transient thrombocytopenia. He was asymptomatic after day 4, and viral PCR was negative on day 21. &lt;b&gt;&lt;i&gt;Discussion:&lt;/i&gt;&lt;/b&gt; Though studies have shown that COVID-19 is associated with lymphopenia, our patient had a normal to high lymphocyte count. The neutrophil to lymphocyte ratio (NLR) was &amp;#x3c;1 during COVID-19, which correlates with the mild course of the disease. To know whether elevated lymphocyte count, low NLR, and benign course of COVID-19 is a standard feature for all patients with underlying AA, we need more case reports and series. The significance of this case report is that it describes the course of COVID-19 in a patient with AA and PNH clones and, up to our knowledge, is the first report showcasing the association between these rare combinations of diseases. </jats:p

Clinical manifestations and outcome of Mpox infection in Qatar: An observational study during the 2022 outbreak

Mpox emerged in May 2022 as a global outbreak, mostly in hitherto non-endemic countries. To describe the epidemiological and clinical characteristics of mpox in Qatar, data were retrospectively retrieved for all laboratory-confirmed mpox cases diagnosed in Qatar between May and November 2022. Twelve cases were identified; of which 10 were males, and the median age was 33.5 years (IQR 24.5–37.5). Recent sexual exposure was reported in 9 patients, 6 of which were outside Qatar. Seven individuals reported exclusive heterosexual contact. Pleomorphic skin lesions were present in all cases, with anogenital involvement in 11. Fever (7/12) and lymphadenopathy (4/12) were relatively common. All cases were HIV-negative. The majority of cases had an uncomplicated and self-limiting clinical illness. In conclusion, the majority of early mpox infections in Qatar were purportedly acquired through heterosexual contact, primarily among middle-aged men. The clinical course was mostly uneventful. In the absence of active case finding and the mild and self-limiting nature of the clinical illness, undetected community transmission cannot be ruled out