Papers by Hoda M. Abdel-Hamid
Infection, Feb 21, 2024
Purpose This aimed to identify the factors associated with severe/critical coronavirus disease 20... more Purpose This aimed to identify the factors associated with severe/critical coronavirus disease 2019 (COVID-19) infection in rheumatoid arthritis (RA) patients. Methods Two-hundred RA patients diagnosed according to the American College of Rheumatology/ European League Against Rheumatism (ACR/EULAR) classification criteria with proven COVID-19 infection were recruited and categorized according to the world health organization (WHO) COVID-19 severity grading into 2 groups: patients with mild/moderate COVID-19 (n = 164) and patients with severe/critical COVID-19 (n = 36). Comparison between both groups was done to identify the risk factors associated with severe/critical infection. Incidence of RA disease activity flare defined as increase in clinical disease activity index (CDAI) more than 10 points following infection was calculated. Results Multivariate analysis identified history of previous serious infection, age > 60 years, and diabetes as factors positively associated, whereas COVID-19 vaccination was negatively associated with severe/critical infection. Following COVID-19 infection, the number of patients with severe/critical COVID-19 who had high RA disease activity and the incidence of flares was significantly higher in comparison to patients with mild/moderate COVID-19 (P < 0.001 and 0.003; respectively). Conclusion Age > 60 years, diabetes, and history of previous serious infections are risk factors for severe/critical COVID-19, while vaccination has a protective role in RA patients. Infection particularly when severe is associated with risk of disease flare.
Journal of Headache and Pain, Aug 12, 2022
Background: The burden of post-coronavirus disease (COVID)-19 symptoms has been increasing and is... more Background: The burden of post-coronavirus disease (COVID)-19 symptoms has been increasing and is of great concern in patients with pre-existing chronic medical conditions.This study aimed to delineate the post-COVID-19 neuropsychiatric symptoms among migraine patients compared to the non-migraine control group. Methods: Two groups, each of 204 COVID-19 survivors, were enrolled in the study after 3 months of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, one group fulfilling the episodic migraine criteria and the other serving as a matching control group. Subjects were evaluated through an in-person interview for post-COVID-19 neuropsychiatric symptoms, including detailed headache patterns and severity, using the visual analogue scale. Results: The Frequency of headache during the acute phase of COVID-19 was more frequent in migraine patients (OR = 1.60, 95%CI = 1.04-2.45, P-value = 0.031). The reported significant post-COVID-19 neuropsychiatric symptoms in migraine patients compared to controls were fatigue (OR = 1.662, 95%CI = 1.064-2.596, P-value = 0.025), anosmia/hyposmia (OR = 2.06, 95%CI = 1.164-3.645, P-value = 0.012), cacosmia (OR = 2.663, 95%CI = 1.145-6.195, P-value = 0.019), depression (OR = 2.259, 95%CI = 1.284-3.975, P-value = 0.004), anxiety (OR = 3.267, 95%CI = 1.747-6.108, P-value ≤ 0.001), insomnia (OR = 2.203, 95%CI = 1.298-3.739, P-value = 0.003), and headache (OR = 3.148, 95%CI = 1.616-6.136, P-value = ≤ 0.001).While there was no statistically significant difference between migraine patients and controls regarding the post-COVID-19 functional status score (P-value = 0.102). The pattern of post-COVID-19 headache was reported as chronic headache transformation in 17.6% of the migraine group, with the median intensity rate being 5.5 and IQR (3-7). In the control group, 14% experienced chronic headache attributed to systemic viral infection with a median intensity rate of 2 and IQR (2-5), while 12% experienced a new daily persistent headache with a median intensity of 5 and IQR (1-6). Conclusion: The study highlighted the importance of follow-up migraine patients upon recovery from COVID-19 infection, being more vulnerable to post-COVID-19 symptoms.
Egyptian Journal of Bronchology, Nov 6, 2023
Background Identifying patients with comorbid pulmonary disease may guide prognosis and aid in de... more Background Identifying patients with comorbid pulmonary disease may guide prognosis and aid in developing strategies regarding who would benefit the most from vaccines. This study was designed to clarify the influence of comorbid lung disease on COVID-19 severity and outcome. Methods This is a retrospective cohort analysis of 587 COVID-19 patients. The clinical, laboratory, and imaging data and comorbidities as reported by the patients were obtained from the Kasr Alainy Hospital medical records. Also, data regarding whether the patient is hospitalized or not, the length of hospital stay, complications, and mortality are gathered from the records. Results The patients' mean ages are 51 ± 15 years (63.9% are males with the remaining 36.1% which are females). Patients with chronic comorbid pulmonary diseases represented 113 patients among the whole study population. with the COPD being 11.4%. Patients with comorbid lung diseases associated or not with other comorbidities were at higher risk of acquiring severe COVID-19 and had higher complication and mortality rates compared to patients without comorbidities (p-value < 0.001). Patients with preexisting diabetes, hypertension, COPD, and chronic kidney disease have a significantly higher risk of severe infection (p-value < 0.001, 0.001, 0.001, < 0.001), complications (p-value 0.038, 0.005, < 0.001, < 0.001), and mortality (p-value 0.021, 0.001, < 0.001, < 0.001), respectively. Conclusion This study provides a better understanding of COVID-19 patients with comorbid lung disease and highlights the importance of the data deduced from our study and similar studies in aiding the designation of vaccination programs for those patients if needed.
European Archives of Psychiatry and Clinical Neuroscience
The potential long-term neuropsychiatric effects of COVID-19 are of global concern. This study ai... more The potential long-term neuropsychiatric effects of COVID-19 are of global concern. This study aimed to determine the prevalence and predictors of neuropsychiatric post-acute sequelae of COVID-19 among Egyptian COVID-19 survivors and to study the impact of full vaccination before COVID-19 infection on the occurrence and severity of these manifestations. Three months after getting COVID-19 infection, 1638 COVID-19 survivors were screened by phone for possible neuropsychiatric sequelae. Subjects suspected to suffer from these sequelae were invited to a face-to-face interview for objective evaluation. They were requested to rate the severity of their symptoms using visual analogue scales (VAS). The mean age of participants was 38.28 ± 13 years. Only 18.6% were fully vaccinated before COVID-19 infection. Neuropsychiatric post-acute sequelae of COVID-19 were documented in 598 (36.5%) subjects, fatigue was the most frequent one (24.6%), followed by insomnia (16.4%), depression (15.3%), and anxiety (14.4%). Moderate and severe COVID-19 infection and non-vaccination increased the odds of developing post-COVID-19 neuropsychiatric manifestations by 2 times (OR 1.95, 95% CI = 1.415-2.683), 3.86 times (OR 3.86, 95% CI = 2.358-6.329), and 1.67 times (OR 1.67, 95% CI = 1.253-2.216), respectively. Fully vaccinated subjects before COVID-19 infection (n = 304) had significantly lesser severity of post-COVID-19 fatigue, ageusia/hypogeusia, dizziness, tinnitus, and insomnia (P value = 0.001, 0.008, < 0.001, 0.025, and 0.005, respectively) than non-vaccinated subjects. This report declared neuropsychiatric sequelae in 36.5% of Egyptian COVID-19 survivors, fatigue being the most prevalent. The effectiveness of COVID-19 vaccines in reducing the severity of some post-COVID-19 neuropsychiatric manifestations may improve general vaccine acceptance.
Scientific Reports
Hypersensitivity pneumonitis (HP) is an interstitial lung disease that develops after inhalation ... more Hypersensitivity pneumonitis (HP) is an interstitial lung disease that develops after inhalation of a variety antigens in susceptible individuals. The nasal mucosa is constantly exposed to these antigens that can irritate the respiratory mucosa. So, the purpose of this study was to study nasal histopathological changes in order to identify any shared pathological changes between the upper airways and the well-known pathological features of HP. 40 HP patients diagnosed at the Chest Department, Kasr Alainy hospital following ATS/JRS/ALAT guidelines were included. Patients were subjected to thorough history, high-resolution computed tomography, spirometry, cough evaluation test (CET), sinonasal outcome test-22 (SNOT-22), sinonasal examination and nasal mucosal biopsy by an otolaryngologist under visualization by a rigid nasal endoscope. The mean age of the patients was 46.2 ± 13.5 (85% were females and 15% were males). 90% of patients presented with cough and the mean CET was 17.15 ± 5...
Thrombosis Journal
Background Thromboembolism was a chief cause of mortality in 70% of patients with COVID-19. Our o... more Background Thromboembolism was a chief cause of mortality in 70% of patients with COVID-19. Our objective was to see if serum interleukins 1 beta (IL-1β) and soluble platelets selectin (sP-selectin) could serve as novel markers of thromboembolism in COVID-19 patients. Methods This cross sectional study involved 89 COVID-19 patients who were recruited from 1st of February to 1st of May 2021. Clinical and laboratory data were collected, and chest imaging was performed. The levels of IL-1β and sP-selectin were assessed in all cases through ELISA kits. Comparisons between groups were done using an unpaired t-test in normally distributed quantitative variables. In contrast, a non-parametric Mann-Whitney test was used for non-normally distributed quantitative variables. Results Severe COVID-19 infection was associated with higher serum levels of CRP, Ferritin, LDH, D dimer, IL-1β and sP-selectin (P < 0.001) with significant correlation between levels of IL-1β and sP-selectin (r 0.37, ...
Egyptian Journal of Chest Diseases and Tuberculosis, 2016
Introduction: Obstructive sleep apnea (OSA) is a condition characterized by repetitive collapse o... more Introduction: Obstructive sleep apnea (OSA) is a condition characterized by repetitive collapse of upper airway during sleep. The associated hypoxemia characteristic of OSA may lead to sporadic perfusion abnormalities of the optic nerve and subsequent glaucomatous optic neuropathy. Objectives: To assess the possible coexistence of OSA and primary open angle glaucoma (POAG) and to find out to what extent this may differ by the site of primary referral. Methods: Two groups of patients were involved; group 1: sixteen patients with a confirmed diagnosis of OSA recruited from the Chest Department, Faculty of Medicine, Cairo University, with no history suggestive of ophthalmological complaints, and group 2: fifteen patients with POAG referred from the glaucoma clinic. All patients were subjected to; full history taking, Epworth Sleepiness Scale, anthropometric measures, polysomnography (PSG), and ophthalmological examination. Results: Forty percent of patients presented from the glaucoma outpatient clinic had OSA as proved by PSG; 50% had mild OSA and 50% had moderate OSA, compared to patients with OSA who were primarily presented at the chest department and evaluated for POAG [(6.25%), p-value = 0.037]. The intraocular pressure among group 2 patients did not significantly differ between patients with and without OSA for the right and left eyes [(p-value = 0.78) and (p-value = 0.96), respectively]. Conclusion: The study supports the coexistence of OSA and POAG and highlights the great need for physician awareness. Accurate assessment is needed taking into consideration the serious effects of untreated OSA on the optic nerve.
The Journal of Headache and Pain
Background The burden of post-coronavirus disease (COVID)-19 symptoms has been increasing and is ... more Background The burden of post-coronavirus disease (COVID)-19 symptoms has been increasing and is of great concern in patients with pre-existing chronic medical conditions.This study aimed to delineate the post-COVID-19 neuropsychiatric symptoms among migraine patients compared to the non-migraine control group. Methods Two groups, each of 204 COVID-19 survivors, were enrolled in the study after 3 months of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, one group fulfilling the episodic migraine criteria and the other serving as a matching control group. Subjects were evaluated through an in-person interview for post-COVID-19 neuropsychiatric symptoms, including detailed headache patterns and severity, using the visual analogue scale. Results The Frequency of headache during the acute phase of COVID-19 was more frequent in migraine patients (OR = 1.60, 95%CI = 1.04–2.45, P-value = 0.031). The reported significant post-COVID-19 neuropsychiatric symptoms in mig...
The Egyptian Journal of Bronchology, 2022
Background Due to limited capacity, health care systems worldwide have been put in challenging si... more Background Due to limited capacity, health care systems worldwide have been put in challenging situations since the emergence of COVID-19. To prioritize patients who need hospital admission, a better understanding of the clinical predictors of disease severity is required. In the current study, we investigated the predictors of mortality and severity of illness in COVID-19 from a single center in Cairo, Egypt. Methods This retrospective cohort study included 175 patients hospitalized with COVID-19 pneumonia and had positive real-time polymerase chain reaction (RT-PCR) results for SARS-CoV-2 from 1 May 2020 to 1 December 2020. Severe COVID-19 was defined as requiring high-flow oxygen (flow rate of more than 8 L/min or use of high flow oxygen cannula), noninvasive ventilation, or invasive mechanical ventilation at any time point during the hospitalization. We used univariate and multivariate regression analyses to examine the differences in patient demographics and clinical and labora...
Brain Sciences, 2022
Background: The COVID-19 pandemic has reached over 276 million people globally with 5.3 million d... more Background: The COVID-19 pandemic has reached over 276 million people globally with 5.3 million deaths as of 22nd December 2021. COVID-19-associated acute and long-term neurological manifestations are well recognized. The exact profile and the timing of neurological events in relation to the onset of infection are worth exploring. The aim of the current body of work was to determine the frequency, pattern, and temporal profile of neurological manifestations in a cohort of Egyptian patients with confirmed COVID-19 infection. Methods: This was a prospective study conducted on 582 hospitalized COVID-19 patients within the first two weeks of the diagnosis of COVID-19 to detect any specific or non-specific neurological events. Results: The patients’ mean (SD) age was 46.74 (17.26) years, and 340 (58.42%) patients were females. The most commonly encountered COVID-19 symptoms were fever (90.72%), cough (82.99%), and fatigue (76.98%). Neurological events (NE) detected in 283 patients (48.63...
Journal of Nervous & Mental Disease, 2021
Stigma and uncertainty are noticed in global pandemics. Their impacts on health care providers te... more Stigma and uncertainty are noticed in global pandemics. Their impacts on health care providers tend to persist notably during and after the outbreaks. Our objective was to assess stigma, uncertainty, and coping among health care providers through an online survey using the Discrimination and Stigma Scale Version 12 (DISC-12) modified version to assess stigma related to treating COVID-19, the Intolerance of Uncertainty Scale, and the Brief Resilient Coping Scale (BRCS). Of the respondents (n = 65), 63.1% treated patients with COVID-19, and 21.5% worked in isolation hospitals. Physicians who treated patients with COVID-19 had significantly higher scores in all DISC subscales: unfair treatment (8.73 ± 6.39, p = 0.001), stopping self from doing things (2.05 ± 1.41, p = 0.019), overcoming stigma (1.17 ± 0.80, p = 0.035), and positive treatment (1.90 ± 1.65, p = 0.005). Unfair treatment was negatively correlated with BRCS (r = −0.279, p = 0.024). On the other hand, physicians who did not treat patients with COVID-19 had significantly higher BRCS scores. We concluded that frontline physicians experienced greater stigma associated with lower resilient coping strategies.
Pain Medicine, 2021
Objectives Headache is considered one of the most frequent neurological manifestations of coronav... more Objectives Headache is considered one of the most frequent neurological manifestations of coronavirus disease 2019 (COVID-19). This work aimed to identify the relative frequency of COVID-19-related headache and to clarify the impact of clinical, laboratory findings of COVID-19 infection on headache occurrence and its response to analgesics. Design Cross-sectional study. Setting Recovered COVID-19 patients. Subjects In total, 782 patients with a confirmed diagnosis of COVID-19 infection. Methods Clinical, laboratory, and imaging data were obtained from the hospital medical records. Regarding patients who developed COVID-19 related headache, a trained neurologist performed an analysis of headache and its response to analgesics. Results The relative frequency of COVID-19 related headache among our sample was 55.1% with 95% confidence interval (CI) (.516–.586) for the estimated population prevalence. Female gender, malignancy, primary headache, fever, dehydration, lower levels of hemogl...
Cephalalgia, 2020
Objective To study the characteristics of headache attributed to COVID-19 infection and predictor... more Objective To study the characteristics of headache attributed to COVID-19 infection and predictors of its severity. Methods A cross-sectional study involved 172 individuals who had headache due to COVID-19 infection. A detailed analysis of such headache was done through a face-to-face interview. Patients with any other form of secondary headache were excluded. Labs, including lymphocytic count, C-reactive protein, D-dimer and ferritin and chest imaging, were made available. Results: The majority of our patients had a diffuse headache (52.9%). It was pressing in 40.7%, with median intensity of 7 (assessed by visual analogue scale) and median frequency of 7 days/week. Patients with preexisting primary headache (52.9%) had significantly more frequent COVID-19 related headache than those without (47.1%) ( p = 0.001). Dehydrated patients (64.5%) had more frequent COVID-19 related headache than those who were not dehydrated (35.5%) ( p = 0.029). Patients with fever (69.8%) had significant...
British Journal of Nutrition, 2021
COVID-19 pandemic continues to be a global health crisis. The gut microbiome critically affects t... more COVID-19 pandemic continues to be a global health crisis. The gut microbiome critically affects the immune system, and some respiratory infections are associated with changes in the gut microbiome; here, we evaluated the role of nutritional and lifestyle habits that modulate gut microbiota on COVID-19 outcomes in a longitudinal cohort study that included 200 patients infected with COVID-19. Of these, 122 cases were mild and seventy-eight were moderate, according to WHO classification. After detailed explanation by a consultant in clinical nutrition, participants responded to a written questionnaire on daily sugar, prebiotic intake in food, sleeping hours, exercise duration and antibiotic prescription, during the past 1 year before infection. Daily consumption of prebiotic-containing foods, less sugar, regular exercise, adequate sleep and fewer antibiotic prescriptions led to a milder disease and rapid virus clearance. Additionally, data on these factors were compiled into a single s...
Indian Journal of Tuberculosis, 2021
Background: Moderate and severe COVID-19 patients typically present with pneumonia. In this study... more Background: Moderate and severe COVID-19 patients typically present with pneumonia. In this study we aimed to detect the occurrence of pulmonary residuals as a late sequela of COVID-19 and to identify it's predictors among moderate and severe cases. Methods: This observational prospective study involved 85 COVID-19 patients confirmed by real time polymerase chain reaction (RT-PCR) nasopharyngeal swab, patients were recruited in the period of 1 st of June to 1 st of July. Demographic and clinical data were obtained for each patient. Chest imaging was performed initially and after 3 weeks to detect post COVID pulmonary residuals. Results: The study population included 74 (87.1%) moderate and 11 (12.9%) severe patients. Patients with older age, male gender, high BMI and initial chest CT of consolidation/mixed consolidation and ground glass opacities (GGOs) had more frequent post COVID-19 pulmonary residuals (P 0.003, 0.026, 0.031, 0.035) respectively. There was a statistically significant difference between patients who showed complete resolution and patients who developed pulmonary residuals regarding the lymphocyte count, serum CRP and ferritin levels (P 0.0001). After logistic regression, male gender, high BMI, initial chest CT of consolidation/mixed consolidation and GGOs, lymphocytopenia, high serum CRP and ferritin levels were the predictors of pulmonary residuals. While the age wasn't statistically significant. Conclusion: 38.5% of moderate and severe COVID-19 patients tend to have pulmonary residuals. Independent predictors of pulmonary residuals as a sequela of COVID-19 are male gender, high BMI, initial chest CT of consolidation and mixed consolidation/GGOs, lymphocytopenia, high serum CRP and ferritin levels.
Clinical and Experimental Gastroenterology, 2021
The novel coronavirus disease 2019 presents an urgent threat to global health. As the epidemic gr... more The novel coronavirus disease 2019 presents an urgent threat to global health. As the epidemic grows, prognosis prediction is essential for monitoring risky patient. It is thus important to consider gastrointestinal manifestations and the duration of symptoms as predictors of prognosis. Our aim was to determine the correlation of gastrointestinal symptoms and laboratory markers with disease outcomes and whether symptom duration varies substantially between patients. We also undertook this study to determine the optimal time to predict COVID-19 outcome. Patients and Methods: A total of 190 patients with polymerase chain reaction-confirmed COVID-19 were followed up until recovery. We proposed a correlation between gastrointestinal symptoms and disease severity (based on clinical data, and diagnostic investigations) to estimate the duration of symptoms as a predictor of COVID-19 prognosis. Results: The prevalence of gastrointestinal symptoms was 49.5%, consisting mainly of diarrhea in 27.9% of patients. In addition, a longer disease duration and higher temperature were observed in patients with diarrhea. Symptom duration was variable, with a median of 12 days and a range of 1-55 days. Statistical analysis indicated that patients with a duration of symptoms ≥12 day had more severe symptoms and a worse prognosis. Patients who complained of diarrhea had 2.7 times the odds of a longer duration of symptoms, and those with a history of chronic lung disease have 7.2 times the odds of a longer duration of symptoms. Conclusion: GIT manifestations (mainly diarrhea) and the duration of symptoms of COVID-19 provide prognostic evidence of COVID-19 outcomes, irrespective of earlier categorization by the World Health Organization. Thus, patients with mild symptoms who present with diarrhea and a duration of symptoms longer than 12 days are expected to have a worse prognosis.
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Papers by Hoda M. Abdel-Hamid