BACKGROUND Coronavirus disease 2019 (COVID-19) pandemic extended to reach most countries in the globe during a few months. The preparedness of healthcare institutions and healthcare workers is crucial for applying effective prevention and control measures. OBJECTIVE This study aimed to assess HCWs and institutional preparedness in facing the new emerging coronavirus (COVID-19) infection at the early phase of the pandemic, and to explore HCWs' risk perception, concerns, and risk acceptance. METHODS A cross-sectional survey was conducted among hospital HCWs in the main hospitals, in Najran city, southwestern Saudi Arabia, at the early phase of the pandemic, during March-April, 2020. RESULTS Overall, 563 completed questionnaires were received (382; 67.9% from KKH and 181; 32.1% from NNH). The majority were females (78.6%), nurses constituted (74.7%). The age range of the participants was 20-63 years, with the mean age of physicians 36.5±9.15 years and 31.8±7.48 years for nurses. Among participants, 65.8% attended training program/s for COVID-19 infection, of whom 69.9% were satisfied with this training. Almost all (97.4%) of the participants reported reading the official circulars assigned for guidelines, case definition and, infection control measures regarding COVID-19 infection, 97.1% received basic infection control training, 98.9% checked for the best-fitted size of N95 mask, and 89.4% were influenza vaccinated. Of the participants, 82.6% reported that they have sufficient knowledge about t COVID-19 pandemic, 82.0% being confident that they can protect themselves and their patients when dealing with COVID-19 cases, 92.9% reported that they understand the risk of COVID-19 infection for patients and healthcare staff and 83.2% reported agreement of accepting the risk of getting the infection being a part of their job. The study participants attained a 20.26±2.60 knowledge score on a scale of 26 maximum points (77.9%), of them 74.5% attained 20 points or more (>75%) indicating good working knowledge about the COVID-19 pandemic. Exploring the participants’ perception about the preparedness of their institutions towards the COVID-19 pandemic, 70.8% agreed that institutional precautionary measures to COVID-19 in the workplace are sufficient, 71.6% agreed that all personal protective equipment (PPE) are provided and always available in the workplace, and 90.6% mentioned that the staff in their institutions have had adequate training. Exploring risk perception and the affective aspect of the pandemic on HCWs, 79.0%, 35.2%, 64.2% of the participants felt that they, their families, and the Najran community are at high risk of getting an infection with the COVID-19 virus respectively, and 54.7% and 55.1% were concerned about their personal and family health respectively. CONCLUSIONS Findings revealed good knowledge about the COVID-19 pandemic among HCWs in Najran hospitals, Saudi Arabia. Concerns and worries were expressed regard working with the highly infectious COVID-19 patients. Participants appreciated important aspects of institutional preparedness. Experience gained from the previous MERS-CoV outbreak may explain good knowledge, risk acceptance, self-efficacy, and good and rapid institutional preparedness at the early stage of the pandemic.

Background The COVID-19 pandemic extended to reach most countries in the world during a few months. The preparedness of health care institutions and health care workers (HCWs) is crucial for applying effective prevention and control measures. Objective This study aims to assess HCWs’ and institutional preparedness in facing the new emerging COVID-19 infection at the early phase of the pandemic and to explore HCWs’ risk perception, concerns, and risk acceptance. Methods A cross-sectional survey was conducted among hospital HCWs in King Khalid and New Najran hospitals, Saudi Arabia, at the early phase of the pandemic, during March and April 2020. Results Overall, 563 completed questionnaires were received (n=382, 67.9% from King Khalid and n=181, 32.1% from New Najran). The majority were female participants (78.6%); nurses constituted 74.7% of the sample. The age range of the participants was 20-63 years, with the mean age of physicians and nurses being 36.5 (SD 9.15) years and 31.8 (SD 7.48) years, respectively. Among participants, 65.8% attended training programs for COVID-19 infection, of whom 69.9% were satisfied with this training. Almost all (97.4%) of the participants reported reading the official circulars assigned for guidelines, case definition, and infection control measures regarding COVID-19 infection; 97.1% received basic infection control training; 98.9% checked for the best-fitted size of an N95 mask; and 89.4% were influenza vaccinated. Of the participants, 82.6% reported that they have sufficient knowledge about the COVID-19 pandemic, 82.0% reported being confident that they can protect themselves and their patients when dealing with COVID-19 cases, 92.9% reported that they understand the risk of COVID-19 infection for patients and health care staff, and 83.2% reported agreement of accepting the risk of getting the infection being a part of their job. The study participants attained a mean 20.26 (SD 2.60) knowledge score on a scale of 26 maximum points (77.9%); of them, 74.5% attained 20 points or more (>75%), indicating good working knowledge about the COVID-19 pandemic. Exploring the participants’ perception about the preparedness of their institutions toward the COVID-19 pandemic, 70.8% agreed that institutional precautionary measures to COVID-19 in the workplace are sufficient, 71.6% agreed that all personal protective equipment is provided and always available in the workplace, and 90.6% mentioned that the staff in their institutions have had adequate training. Exploring risk perception and the affective aspect of the pandemic on HCWs, 79.0%, 35.2%, and 64.2% of the participants felt that they, their families, and the Najran community are at high risk of getting an infection of COVID-19, respectively, and 54.7% and 55.1% were concerned about their personal and family health, respectively. Conclusions The findings revealed good knowledge about the COVID-19 pandemic among HCWs in Najran hospitals, Saudi Arabia. Concerns and worries were expressed regarding working with the highly infectious patients with COVID-19. Participants appreciated important aspects of institutional preparedness. Experience gained from the previous Middle East respiratory syndrome–related coronavirus outbreak may explain good knowledge, risk acceptance, self-efficacy, and good and rapid institutional preparedness at the early stage of the pandemic.

Introduction: Chest pain is a frequent cause for admission to the emergency department (ED). It can be a sign of various conditions, from a minor disorder to a life-threatening disease such as acute myocardial infarction (AMI). Despite the availability of modern-day tools for the diagnosis of AMI, about 5% of patients with AMI are missed in the ED, with subsequent associated morbidity and mortality. QT dispersion as a marker for arrhythmic potential being a marker of in-homogeneity of ventricular repolarization. The QT dispersion is increased in myocardial ischemia. Aims: This study we hypothesized that QTD could accurately identify patients with the acute coronary syndrome (ACS) who presented with chest pain and nondiagnostic initial electrocardiograms (ECGs). Subjects and Methods: The study population included (50) patients (37 males, 13 females) and (10) chronic stable ischemic patients as a control group, they were all in sinus rhythm on admission. All the studied patients were subjected to: History taking; complete physical examination was performed to rule out any other medical problems, standard 12-lead ECG, cardiac markers, echocardiographic examination. QT interval was calculated. The difference between the maximum and minimum QT intervals, occurring in any of the 12 leads, was measured as QTD. A corrected QT interval (QTc) of >440 ms is defined as abnormal, and the difference between QTc max and QTc min was calculated as QTcD. QT dispersion ≤40 ms was considered normal. Results: In the present study, we found that 26 patients (52%) have prolonged QTD (mean 78.800 ms, standard deviation [SD] ±49.555) and 44 patients (88%) have prolonged cQTD (mean 83.322 ms, SD ± 48.491) For patients who were admitted to the ED with chest pain and nondiagnostic initial ECG but later diagnosed as having ACS. Furthermore, we found that only 6 (12%) of patients have a significant prolongation QTD than normal in initial nondiagnostic ECG with elevated cardiac biomarkers (creatine kinase myocardial band at 0 h 48, mean creatine kinase myocardial band (CK MP) at 12 h was 145.833 ± SD 52.660, creatine phosphokinase (CPK) at 0 h: 635.33, mean CPK at 12 h 2448.66 ± SD 538.744). It has been suggested that the initial QTD level has a low predictive power for new cardiac events but that QTD can be more helpful for low-risk patients. Conclusion: Hence, in this study, we found that QTD and QTcD values are higher for ACS patients than for patients without ACS with nondiagnostic initial ECG.