Background Coronavirus disease 2019 (COVID-19) vaccination has raised concerns about vaccine hesitancy in general and COVID-19 vaccine hesitancy in particular. Understanding the factors driving the uncertainty regarding vaccination against COVID-19 is crucial. Methods This cross-sectional study was designed to identify the perceptions and attitudes of healthcare workers (HCWs) towards COVID-19 vaccines and determine the predictive factors that affect their willingness to receive the COVID-19 vaccine. An online survey was distributed among HCWs to collect data assessing demographic and general characteristics of the participants and vaccine-related characteristics, including source of information about the vaccine. In addition to items assessing the perception of COVID-19, there were items on COVID-19 vaccines and attitude towards vaccination in general and towards COVID-19 vaccines in particular. Results The participants were classified according to their willingness to take the COVID-19 vaccine as follows: hesitant (41.9%), refusing (32.1%), and willing (26%). Statistically significant differences were observed among the three groups for the perception of COVID-19 vaccines, attitude towards vaccination in general, and COVID-19 vaccines in particular (p < 0.01). Conclusions Although the participants adequately perceived COVID-19 severity, prevention, and COVID-19 vaccine safety, they were widely hesitant or refused to be vaccinated. A multidimensional approach is required to increase the vaccine acceptability rate. Higher income and increased years of work experience are positive predictors of willingness to receive a vaccine. Thus, further studies addressing the scope of COVID-19 vaccine hesitancy are warranted as an initial step to build trust in COVID-19 vaccination efforts with continuous monitoring of attitudes and practices of HCWs towards COVID-19 vaccines in the future.

Background: COVID-19 can be accompanied by acute neurological complications of both central and peripheral nervous systems (CNS and PNS). In this study, we estimate the frequency of such complications among hospital inpatients with COVID-19 in Assiut and Aswan university hospitals. Materials and Methods: We screened all patients with suspected COVID-19 admitted from 1 June to 10 August 2020 to the university hospitals of Assiut and Aswan in Upper Egypt. Clinical and laboratory tests, CT/MRI of the chest and brain, and neurophysiology study were performed for each patient if indicated. Results: 439 patients had confirmed/probable COVID-19; neurological manifestations occurred in 222. Of these, 117 had acute neurological disease and the remainder had nonspecific neuropsychiatric symptoms such as headache, vertigo, and depression. The CNS was affected in 75 patients: 55 had stroke and the others had convulsions (5), encephalitis (6), hypoxic encephalopathy (4), cord myelopathy (2), relapse of multiple sclerosis (2), and meningoencephalitis (1). The PNS was affected in 42 patients: the majority had anosmia and ageusia (31) and the others had Guillain-Barré syndrome (4), peripheral neuropathy (3), myasthenia gravis (MG, 2), or myositis (2). Fever, respiratory symptoms, and headache were the most common general symptoms. Hypertension, diabetes mellitus, and ischemic heart disease were the most common comorbidities in patients with CNS affection. Conclusion: In COVID-19, both the CNS and PNS are affected. Stroke was the most common complication for CNS, and anosmia and/or ageusia were common for PNS diseases. However, there were 6 cases of encephalitis, 2 cases of spinal cord myelopathy, 2 cases of MG, and 2 cases of myositis.

Background Being highly infectious disease, COVID-19 exhausts most of efficient healthcare systems worldwide. Simple and rapid risk stratification methods are mandatory to recognize severe patients. This study aims to highlight the simple available laboratory biomarkers of good predictive value for COVID-19 severity. Results Three hundred fifty-one COVID-19 positive patients admitted to two University Hospitals between the 1st of June and the 31st of July 2020 were retrospectively collected and classified to severe and non-severe COVID-19 patients according to need for ICU admission. All basic laboratory biomarkers at time of admission were recorded. Of included patients, 145 (41.3%) needed ICU admission. Anemia, leukocytosis, lymphopenia, NLR, and PLR together with liver enzymes, INR, ferritin, CRP, and D-dimer were significantly higher in patients needed ICU admission (p < 0.001). However, by applying multivariate logistic regression, only anemia, high NLR, high PLR, and high D-dimer levels showed significant risk for ICU admission with OR equal 3.6 (95% CI 1.8–7.0), 9.0 (95% CI 3.6–22.6), 3.0 (95% CI 1.3–7.1), and 2.5 (95% CI 1.3–4.7), respectively. Conclusion Anemia, increased neutrophil-to-lymphocyte ratio (> 8), platelet-to-lymphocyte ratio (> 192), and D-dimer level (> 0.9 mg\L) at time of admission could be simple available predictors for severe COVID-19 infection requiring ICU admission.

Background: COVID 19 can be accompanied by acute neurological complications of both central and peripheral nervous systems (CNS and PNS). In this study we estimate the frequency of such complications among hospital in-patients with COVID-19 in Assiut and Aswan University Hospitals. Material and Methods: We screened all patients with suspected COVID-19 admitted from 1 June to 10 August 2020 to the university hospitals of Assiut and Aswan in Upper Egypt. Clinical and laboratory data, CT/MRI of chest and brain, and neurophysiology were performed for each patient if indicated. Results: 439 patients had confirmed/probable COVID-19; neurological manifestations occurred in 222. Of these 117 had acute neurological disease; the remainder had non-specific neuropsychiatric symptoms such as headache, vertigo, and depression. The CNS was affected in 75 patients: 55 had stroke; the others had convulsions (5), encephalitis (6), hypoxic encephalopathy (4), cord myelopathy (2), relapse of RR-MS (2), and meningoencephalitis (1). The PNS was affected in 42 patients: the majority had anosmia and ageusia (31); the others had GBS (4), peripheral neuropathy (3), myasthenia gravis (2), or myositis (2). Fever, respiratory symptoms and headache, were the most common general symptoms. Hypertensions, Diabetes Mellitus, ischemic heart disease were the most common comorbidities in patients with CNS affection. Conclusion: In COVID‑19, both the CNS and PNS are affected. Stroke was the most common complication for CNS and anosmia and/or ageusia were common for PNS diseases. However there were 6 cases encephalitis, 2 cases of spinal cord myelopathy, 2 cases of MG and 2 cases of myositis.

Background Healthcare workers (HCWs) are at a high risk for disease exposure. Given the limited availability of nucleic acid testing by PCR in low resource settings, serological assays can provide useful data on the proportion of HCWs who have recently or previously been infected. Therefore, in this study, we conducted an immunologic study to determine the seroprevalence of anti-SARS-CoV-2 antibodies in two university hospitals in Egypt. Methods in this cross sectional study, HCWs who were working in SARS-CoV-2 Isolation Hospitals were interviewed. Estimating specific antibodies (IgM and IgG) against SARS-CoV-2 was carried out using an enzyme-linked immunosorbent assay targeting the Spike antigen of SARS-CoV-2 virus. Results Out of 111, 82 (74%) HCWs accepted to participate with a mean age of 31.5 ± 8.5 years. Anti-SARS-COV2 antibodies were detected in 38/82 (46.3%) of cases with a mean age of 31 years and female HCWs constituted 57.6% of cases. The highest rate of seropositivity was from the nurses (60.5%), and physicians (31.6%) with only (7.9%) technicians. Only 28/82 (34.1%) HCWs reported previous history of COVID19. We reported a statistically significant difference in the timing of exposure (p = 0.010) and the frequency of contact with COVID-19 cases (p = 0.040) between previously infected and on-infected HCWs. Longer time of recovery was reported from IgG positive HCWs (p = 0.036). Conclusion The high frequency of seropositive HCWs in investigated hospitals is alarming, especially among asymptomatic personnel. Confirmation of diseased HCWs (among seropositive ones) are warranted.