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.