Discussion
In our study, we compared a hospital in the Saudi Western province
(Medina) to a hospital in the Saudi Eastern Province (Dammam). The
COVID-related mortalities during the observed duration were similar
between the two hospitals/provinces. This is consistent with the Saudi
official records where the total cases in the Eastern Province were
82,072 with overall deaths of 557 (mortality rate of 0.68%) [28].
In the same context, the total cases in Medina were 23,272 with overall
deaths of 132 (mortality rate of 0.57%) [28]. Overall, Saudi
Arabia’s case-fatality rate is also among the lowest fatality rates in
the world that range from 0% and up to 28.9% [29], and according
to our results, it is consistent in different regions of Saudi Arabia
which supports that quality of health care is relatively homogenous and
of adequate quality.
Our results showed a relatively consistent presentation of clinical
symptoms/signs among the included patients in comparing the two
hospitals. Nevertheless, there were some differences in the initial
presentation including the initial body temperature, initial heart rate,
breathing rhythms, breathing quality, and added sounds. Many of the
previously reported MERS-CoV [30] and SARS-CoV [31] patients
also showed similar comorbidities, which predisposed to increasing the
risk of infection with MERS-CoV and increasing the case fatality rates
[32]. Regarding clinical presentation, the predominant presentations
among COVID-19 patients were low-grade high fever (mean temperature
37.7) and cough, which seems to be consistent with the initial reports
from different countries [33-36; 16]. According to our results,
treatments used were homogenous among the two hospitals, except for
heparin use. Others have reported that many COVID-19 patients suffer
from hypercoagulability state [37; 38].
To our knowledge, this is the first study to compare COVID-patients in
two Saudi hospitals in two different provinces. However, the study has
some limitations. The relatively small number of the included patients
may affect the magnitude of differences and the statistical
significance. Moreover, some patients’ data were missing, which may also
affect our results.