Objectives: We aimed to describe the epidemiological and clinical characteristics of patients with COVID-19 in Saudi Arabia in various severity groups. Methods: Data for 485 patients were extracted from the medical records from the infectious disease center of Prince Mohammed bin Abdul Aziz Hospital in Riyadh. Patients' basic information, laboratory test results, signs and symptoms, medication prescribed, other comorbidities, and outcome data were collected and analyzed. Descriptive data were reported to examine the distribution of study variables between the severe and not severe groups. Results: Of 458 included patients, 411 (89.7%) were classified as not severe, 47 (10.3%) as severe. Most (59.1%) patients were aged between 20 and 39 years. Patients with severe conditions were non-Saudi, with a chronic condition history, and tended to have more chronic conditions compared with those without severe disease. Diabetes, hypertension, and thyroid disease were significantly higher in patients with severe disease. Death was reported in only 4.26% of severe patients. Only 16 (34.04%) patients remained in the hospital in the severe group. Conclusions: Severe cases were more likely to have more comorbidities, diabetes, hypertension, and thyroid disorders were most common compared with non-severe cases.

Objectives: Medication safety program started at Riyadh city of Ministry of Health in 2014. Identifying, resolving and preventing drug therapy problems are the unique contributions of the pharmaceutical care practitioner. The research aimed to estimate cost-efficiency of Medication Safety program at the hospital in East province, Saudi Arabia by using American model of pharmacist intervention cost avoidance. Methods: This cross-sectional study with a 9-month recruitment period was conducted in a 300-bed public hospital through preventing and documentation of medication errors in adults and pediatrics at Ministry of Health hospitals in 2015. The program led by trained pharmacist and delivered basic patient safety in medical education to all healthcare professionals. The predictable cost calculated using International Study Model, expressed in USD, the cost measured were the expected results of medication errors outcome if not stopped; starting from physician visit, additional laboratory test, further treatment, hospital admission and critical care admission to death stage. Results: The total number of prevented medication errors were 3,378 at 805 prescribed to 805 patients with an estimated cost avoidance of avoiding medication errors was (98,195.97 USD) for the study period and (10,910 USD) per month. The pharmacist avoided medication errors with estimated cost avoidance of drugrelated problem (29 USD) per each mistake and (122 USD) per prescription and patient. The most type inquiries estimated cost avoidance was prescribing stage 86,939.05 USD (99.86%), followed by drugrelated errors 7,061.26 USD (7.2%) and dosage form-related errors 6,084.98 USD (6.2%). The highest drug of cost avoidance were Musculoskeletal and joint disease (8,397.2 USD) followed by Infections (5,731.17 USD) and Nutrition (4,717.99 USD), while the largest drug of cost avoidance was Paracetamol Injection (5,812.17 USD), followed by oral Ferrous Sulfate (3,562.79 USD) and Ceftriaxone 1g (2,861.70 USD). Conclusion: Medication safety program is a cost-efficiency simulation at the public hospital in Saudi Arabia, prevents medication disasters, improve patient safety. Increasing drug safety program associated with preventing drug-related problems and cost avoidance simulation for Healthcare development and better care and better patient consequences.

Background The uncertainty about COVID-19 outcomes in angiotensin-converting enzyme inhibitors (ACEI)/angiotensin receptor blockers (ARB) users continues with contradictory findings. This study aimed to determine the effect of ACEI/ARB use in patients with severe COVID-19. Methods This retrospective cohort study was done in two Saudi public specialty hospitals designated as COVID-19 referral facilities. We included 354 patients with a confirmed diagnosis of COVID-19 between April and June 2020, of which 146 were ACEI/ARB users and 208 were non-ACEI/ARB users. Controlling for confounders, we conducted multivariate logistic regression and sensitivity analyses using propensity score matching (PSM) and Inverse propensity score weighting (IPSW) for high-risk patient subsets. Results Compared to non-ACEI/ARB users, ACEI/ARB users had an eight-fold higher risk of developing critical or severe COVID-19 (OR = 8.25, 95%CI = 3.32-20.53); a nearly 7-fold higher risk of intensive care unit (ICU) admission (OR = 6.76, 95%CI = 2.88-15.89) and a nearly 5-fold higher risk of requiring noninvasive ventilation (OR = 4.77,95%CI = 2.15-10.55). Patients with diabetes, hypertension, and/or renal disease had a five-fold higher risk of severe COVID-19 disease (OR = 5.40,95%CI = 2.0-14.54]. These results were confirmed in the PSM and IPSW analyses. Conclusion In general, but especially among patients with hypertension, diabetes, and/or renal disease, ACEI/ARB use is associated with a significantly higher risk of severe or critical COVID-19 disease, and ICU care.

Objectives: In 2013, The General Administration of Pharmaceutical Care started the National Total Parenteral Nutrition (TPN) Program in Saudi Arabia. The pharmacist can provide neonates' TPN services. In this study, we aimed to estimate the economic outcomes and cost avoidance in relation to pharmacist prescribing TPN. Methods: A total of 20 hospitals provide TPN services for neonates, pediatrics and adult patients. Cost avoidance stimulation in relation to the pharmacist prescribing and running neonates, pediatrics TPN services and replacement physician of a pharmacist as prescriber with adults TPN services. All costs were calculated by using US dollar currency. One-way sensitivity analysis was conducted for a list of discount prices and variety of wage cost with 10-20%. Results: The total annual estimated cost avoidance of pharmacist by providing TPN services for 20 hospitals for all types of patients was (1,569,865.40 USD) and with a discount of 10-20%, it was (1,412,878.86-1,255,892.32 USD). Of those, the total annual estimated cost avoidance of pharmacist providing the TPN services for 20 hospitals for neonates was (562,027.40 USD) and with discount of 10-20%, it was (505,824.66-449,621.92 USD). The total annual estimated cost avoidance of pharmacist providing the TPN services for 20 hospitals for adults was (523,337.00 USD) and with discount of 10-20%, it was (471,003.30-418,669.60 USD). The total annual estimated cost avoidance of pharmacist providing the TPN services for 20 hospitals for pediatrics was (484,501.00 USD) and with a discount of 10-20%, it was (436,050.90-387,600.80 USD). Conclusion: The pharmacist prescribing TPN prevents high economic burden on the healthcare system at Ministry of Health. Expanding the role of a pharmacist in the nutrition support services with an emphasis on prescribing TPN services is highly recommended at healthcare institutions in the Kingdom of Saudi Arabia.

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