Introduction Venous thromboembolism (VTE) has been observed as a frequent complication in patients with severe novel coronavirus disease 2019 (COVID-19) infection requiring hospital admission. Aim This study was aimed to evaluate the epidemiology of VTE in hospitalized intensive care unit (ICU) and non-ICU patients. Materials and Methods PubMed was searched up to November 13, 2020, and updated in December 12, 2020. We included studies that evaluated the epidemiology of VTE, including pulmonary embolism (PE) and/or deep vein thrombosis (DVT), in patients with COVID-19. Results A total of 91 studies reporting on 35,017 patients with COVID-19 was included. The overall frequency of VTE in all patients, ICU and non-ICU, was 12.8% (95% confidence interval [CI]: 11.103–14.605), 24.1% (95% CI: 20.070–28.280), and 7.7% (95% CI: 5.956–9.700), respectively. PE occurred in 8.5% (95% CI: 6.911–10.208), and proximal DVT occurred in 8.2% (95% CI: 6.675–9.874) of all hospitalized patients. The relative risk for VTE associated with ICU admission was 2.99 (95% CI: 2.301–3.887, p <0.001). DVT and PE estimated in studies that adopted some form of systematic screening were higher compared with studies with symptom-triggered screening. Analysis restricted to studies in the 5th quintile of sample size reported significantly lower VTE estimates. Conclusion This study confirmed a high risk of VTE in hospitalized COVID-19 patients, especially those admitted to the ICU. Nevertheless, sensitivity analysis suggests that previously reported frequencies of VTE in COVID-19 might have been overestimated.

Introduction Venous and arterial thromboses are frequently observed complications in patients with severe novel coronavirus disease 2019 (COVID-19) infection who require hospital admission. In this study, we evaluate the epidemiology of venous and arterial thrombosis events in ambulatory and postdischarge patients with COVID-19 infection. Materials and Method EMBASE and MEDLINE were searched up to July 21, 2021, in addition to other sources. We included studies that assessed the epidemiology of venous and arterial thrombosis events in ambulatory and postdischarge COVID-19 patients. Results A total of 16 studies (102,779 patients) were identified. The overall proportion of venous thromboembolic events in all patients, that is, ambulatory and postdischarge, was 0.80% (95% confidence interval [CI]: 0.44–1.28), 0.28% (95% CI: 0.07–0.64), and 1.16% (95% CI: 0.69–1.74), respectively. Arterial events occurred in 0.75% (95% CI: 0.27–1.47) of all patients, 1.45% (95% CI: 1.10–1.86) of postdischarge patients, and 0.23% (95% CI: 0.019–0.66) of ambulatory patients. The pooled incidence rate estimates per 1,000 patient-days for VTE events were 0.06 (95% CI: 0.03–0.08) and 0.12 (95% CI: 0.07–0.19) for outpatients and postdischarge, respectively, whereas for arterial events were 0.10 (95% CI: 0–0.30) and 0.26 (95% CI: 0.16–0.37). Conclusion This study found a low risk of venous and arterial thrombi in ambulatory and postdischarge COVID-19 patients, with a higher risk in postdischarge patients compared with ambulatory patients. This suggests that regular universal thromboprophylaxis in these patient populations is probably not necessary.

Though patients with sickle cell disease (SCD) are at risk of developing venous thromboembolism (VTE), clear estimates of its incidence and predisposing factors in hospitalized SCD patients are not available. Therefore, this issue was addressed to facilitate an early diagnosis and initiate appropriate prophylactic and treatment strategies. A retrospective observational study was conducted on patients with SCD who were admitted to an academic center in Saudi Arabia over a 10-year period. We identified 1054 admissions of 394 patients with SCD. Of the 3% of patients identified with VTE, 50% experienced pulmonary embolism (PE), 34.3% exhibited deep vein thrombosis (DVT), 6.3% exhibited cerebral vein thrombosis, and 9.4% showed other forms of VTE. In pregnant SCD patients, 6.4% developed a VTE event during their hospital admission. Of the risk factors, high white blood cell count, length of stay, and presence of any additional risk factor for VTE was associated significantly with higher risk of VTE. In our study, this risk seems to be much lower, which is likely attributed to the use of VTE prophylactic strategies implemented in our center. Nevertheless, further studies are needed to establish the ideal prophylactic strategy in patients with SCD.

Background: Sickle cell disease is an inherited blood disorder which can lead to severe complications, particularly in the cardiovascular and respiratory systems, potentially resulting in arrhythmias, pulmonary hypertension (PH), and cardiomegaly. This study aims to investigate the risk of PH and arrhythmias in adult SCD patients. Methods: Retrospective analysis of medical records from King Abdulaziz University Hospital (KAUH) for patients with SCD aged 15 and above between 2009 and 2021. The study included 517 patients, with echocardiograms and electrocardiograms assessed according to the European Society of Cardiology/the European Respiratory Society (ESC/ERS) guidelines for categorizing PH risk (low, moderate, high) and detecting arrhythmias. Data analysis employed the Statistical Package for the Social Sciences (SPSS), utilizing quantitative and qualitative data representation. Multivariate logistic regression identified independent risk factors with odds ratios at a 95% confidence interval (CI). Results: Among participants, 50.3% were male, with a total sample average age of 34.45 ± 9.28 years. Results indicated that 1.4% of patients experienced arrhythmias, 3.7% had a moderate PH risk, and 3.3% were classified as high PH risk. Logistic regression revealed significant independent risk factors for PH and arrhythmia in patients with SCD, with chronic kidney disease (CKD) carrying the highest odds (26.4 times higher odds of PH and 15.36 times higher odds of arrhythmias). Conclusion: Patients with SCD are at risk for developing PH and various arrhythmias but are often underdiagnosed. Key risk factors for PH included CKD, liver cirrhosis, and pre-existing cardiac conditions. Arrhythmias were significantly associated with CKD and pre-existing cardiac conditions. To mitigate these risks, we recommend involving a multidisciplinary healthcare team in the care of adult patients with SCD. Future prospective studies are advised for early detection of PH and arrhythmias in hemoglobinopathy patients, potentially reducing mortality.

Thalassemia is an inherited blood disorder that leads to significant mortality and morbidity. Saudi Arabia has one of the highest prevalences of thalassemia in the world, based on available data. The high prevalence in the country and the associated significant healthcare needs resulting from the disease certainly lead to major health costs, where there is currently a knowledge gap. This is a single-center, retrospective, prevalence-based, bottom-up approach to estimating the cost of illness for thalassemia major. Data on transfusion-dependent β-thalassemia (TDT) patients were collected through medical health records at a tertiary center in Saudi Arabia between 2018 and 2022. Direct costs were calculated by summing up the unit costs of each intervention multiplied by the number of episodes. A total of 152 β-thalassemia major patients were eligible for our study. The mean age was 17 years, 49% of the patients were female, and 72% were expatriates. The direct cost of TDT was estimated at $28,097.24 per patient-year. Most of these expenses were directed toward regular transfusion services and medications, primarily driven by the cost of chelation agents. Based on the most recent data on the prevalence of thalassemia in the population, the annual cost of thalassemia in Saudi Arabia is estimated at $393.3 million. TDT imposes a significant cost burden in Saudi Arabia, and the cost is likely to be exponentially higher if indirect expenses are incorporated. Ongoing national efforts in premarital testing and genetic counseling are expected to help reduce these costs. Export

Women contribute modestly to the blood supply in the Eastern Mediterranean region. The capability, opportunity, motivation-behavior model can be used to understand this phenomenon further. The framework suggests that capability, opportunity, and motivation are prerequisites for behavior. Most of the previously published research in Saudi Arabia has focused on motivation. This study aimed to evaluate the capability of donating blood among women who present to blood banks for donation and to compare the findings with those of men. A retrospective analysis of blood donor records was conducted to identify the outcomes of donor evaluation for women and men in a hospital blood bank over 13 months. Of 10,175 visits for whole blood donation, 9138 were by men and 1037 were by women. Donation was successful in 8641 visits by men (94%) and 616 visits by women (59%). In men, the most common cause of deferral was responses to the donor history questionnaire; in women, it was low hemoglobin. Compared with men, women were 12 times more likely to be deferred when presenting to donate blood. Logistic regression analysis revealed that women were less likely to be deferred for low hemoglobin levels as their age increased. The capability of women to donate blood is significantly lower than that of men, even if they are motivated and have opportunities. Anemia is the most common cause of deferral in women. Interventions are necessary to prevent, screen, and manage anemia in women in general and potential blood donors in particular.