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We statistically analyzed 31 published studies comprising 113 water samples collected from 17 countries for SARS-CoV-2 positivity. The pooled estimated prevalence of viral RNA in the tested samples was 64.1% [95% CI:51.6%, 74.9%] with considerable heterogeneity (I2: 90.1%, P<0.001). Notably, wastewater, sewage, hospital septic-tank, biological sludge, and effluent demonstrated statistical significance (P<0.05) for RNA positivity. The country-wise pooled estimated prevalence for Germany, India, Turkey, Spain, the Netherlands, Italy, the USA, and Japan were 88% (76%, 94%), 85% (33%, 98%), 83% (43%, 97%), 78% (54%, 92%), 60% (41%, 77%), 53% (36%, 70%), 53% (27%, 77%), and 25% (13%,43%), respectively. Further subgroup analyses showed that the prevalence of SARS-CoV-2 among the tested water samples was significantly higher in middle-income countries compared to high-income groups. Our data, therefore, suggests wastewater-based epidemiological surveillance as an important tool for community-wide monitoring of SARS-CoV-2. Doi: 10.28991/SciMedJ-2022-04-03-02 Full Text: PDF

Background: Delirium in critically ill patients is independently associated with poor clinical outcomes. There is a scarcity of published data on the prevalence of delirium among critically ill patients in Saudi Arabia. Therefore, we sought to determine, in a multicenter fashion, the prevalence of delirium in critically ill patients in Saudi Arabia and explore associated risk factors. Methods: A cross-sectional point prevalence study was conducted on January 28, 2020, at 14 intensive care units (ICUs) across 3 universities and 11 other tertiary care hospitals in Saudi Arabia. Delirium was screened once using the Intensive Care Delirium Screening Checklist. We excluded patients who were unable to participate in a valid delirium assessment, patients admitted with traumatic brain injury, and patients with documented dementia in their medical charts. Results: Of the 407 screened ICU patients, 233 patients were enrolled and 45.9% were diagnosed with delirium. The prevalence was higher in mechanically ventilated patients compared to patients not mechanically ventilated (57.5% vs. 33.6%; P < 0.001). In a multivariate model, risk factors independently associated with delirium included age (adjusted odds ratio [AOR], 1.021; 95% confidence interval [CI], 1.01–1.04; P = 0.008), mechanical ventilation (AOR, 2.39; 95% CI, 1.34–4.28; P = 0.003), and higher severity of illness (AOR, 1.01; 95% CI, 1.001–1.021; P = 0.026). Conclusion: In our study, delirium remains a prevalent complication, with distinct risk factors. Further studies are necessary to investigate long-term outcomes of delirium in critically ill patients in Saudi Arabia.