the World Health Organization (WHO) was notified about a cluster of pneumonia cases of unknown cause in Wuhan, China. a novel coronavirus disease, COvId-19, caused by severe acute respiratory syndrome coronavirus 2 virus (SaRS-Cov-2) was identified in the cluster. The disease rapidly progressed into a pandemic. 1,2 as of 22 may 2020, it has affected 5 106 686 individuals globally with 333 003 deaths and a 6.5% fatality rate. 3 nationwide, as of 22 may 2020, an aggregate of 6370 cases has been reported, with 1821 cases recovered and 30 deaths giving a mortality rate of 0.5%. 3,4 The first two cases were reported on 24 February from the muscat governorate, the capital of Oman, linked to travel to Iran. In this study, we characterize the epidemiological aspects of the first 1304 laboratory-confirmed cases in Oman. M ET H O D Sall patients with laborator y-confirmed COvId-19 by SaRS-Cov-2 real-time reverse transcriptase-polymerase chain reaction (RT-PCR) were enrolled between 24 February and 17 april 2020. The COvId-19 diagnosis was based on the national case definition and confirmed COvd-19 interim guidance. 5 The data was retrieved from published national surveillance data 6 and included the demographic characteristics (gender, age, place of residency, and nationality), patients' outcomes (including recovery, hospitalization, and mortality), and severity of illness (including mild, moderate, and severe) based on the WHO definition. 7 descriptive statistics were used to describe the data. For categorical variables, frequencies and percentages were reported. differences between groups were analyzed using Pearson's chi-squared tests (or Fisher's exact tests for expected cells < 5). For continuous variables, mean and standard deviation were used to present the data, while analyses were performed using a Student's t-test. an a priori two-tailed level of significance was set at 0.05. Statistical analyses were conducted using STaTa version 16.1.This study was approved by the internal institutional review board and adhered to the declaration of Helsinki.

Introduction To identify the clinical characteristics and outcomes of hospitalized patients with COVID-19 in Oman. Methods A case series of hospitalized COVID-19 laboratory-confirmed patients between February 24th through April 24th, 2020, from two hospitals in Oman. Analyses were performed using univariate statistics. Results The cohort included 63 patients with an overall mean age of 48 ± 16 years and 84% ( n = 53) were males. A total of 38% ( n = 24) of the hospitalized patients were admitted to intensive care unit (ICU). Fifty one percent ( n = 32) of patients had at least one co-morbidity with diabetes mellitus (DM) (32%; n = 20) and hypertension (32%; n = 20) as the most common co-morbidities followed by chronic heart and renal diseases (12.8%; n = 8). The most common presenting symptoms at onset of illness were fever (84%; n = 53), cough (75%; n = 47) and shortness of breaths (59%; n = 37). All except two patients (97%; n = 61) were treated with either chloroquine or hydroxychloroquine, while the three most prescribed antibiotics were ceftriaxone (79%; n = 50), azithromycin (71%; n = 45), and the piperacillin/tazobactam combination (49%; n = 31). A total of 59% ( n = 37), 49% ( n = 31) and 24% ( n = 15) of the patients were on lopinavir/ritonavir, interferons, or steroids, respectively. Mortality was documented in (8%; n = 5) of the patients while 68% ( n = 43) of the study cohort recovered. Mortality was associated with those that were admitted to ICU (19% vs 0; p = 0.009), mechanically ventilated (31% vs 0; p = 0.001), had DM (20% vs 2.3%; p = 0.032), older (62 vs 47 years; p = 0.045), had high total bilirubin (43% vs 2.3%; p = 0.007) and those with high C-reactive protein (186 vs 90 mg/dL; p = 0.009) and low corrected calcium (15% vs 0%; p = 0.047). Conclusions ICU admission, those on mechanical ventilation, the elderly, those with high total bilirubin and low corrected calcium were associated with high mortality in hospitalized COVID-19 patients.

Oman, like other countries in the world, was affected by the COVID-19 pandemic. Since the WHO's declaration of the pandemic, the Ministry of Health of Oman has initiated its preparedness and response to the pandemic, with community participation as one of the key components of the national preparedness and response plan. This paper is a descriptive study aims at describing the three community approaches that exist in Oman and reviewing their role in preparedness and response strategies to COVID-19 pandemic and discuss the lessons learned. Community participation approaches in Oman were translated into action during the pandemic through empowering community members, mobilizing resources, and strengthening the ownership among the local community to ensure effective advocacy, proper networking, and dissemination of information and, subsequently, actions at the level of the community. The first community participation approach is community organizations within the healthy cities and villages initiative, which facilitated networking and acted as a platform for community engagement, reviewing the health information and updating them accordingly to meet evloving demands. The second approach is Willayat (District) health committees, with their unique multi-sectoral structure, that enhanced collaboration at the state level with different community leaders and groups to develop pandemic action plans, which were implemented using available local resources. The third approach is community volunteers that remain the key information providers, particularly when physical access becomes limited due to physical distancing measures. Based on this review, we advocate to further strengthen these approaches and recommends that they are implemented for the protection and promotion of health and well-being, including for health emergencies.

BackgroundRotavirus gastroenteritis (RGE) is the leading cause of diarrhea in young children in Oman, incurring substantial healthcare and economic burden. We propose to formally assess the potential cost effectiveness of implementing universal vaccination with a pentavalent rotavirus vaccine (RV5) on reducing the health care burden and costs associated with rotavirus gastroenteritis (RGE) in OmanMethodsA Markov model was used to compare two birth cohorts, including children who were administered the RV5 vaccination versus those who were not, in a hypothetical group of 65,500 children followed for their first 5 years of life in Oman. The efficacy of the vaccine in reducing RGE-related hospitalizations, emergency department (ED) and office visits, and days of parental work loss for children receiving the vaccine was based on the results of the Rotavirus Efficacy and Safety Trial (REST). The outcome of interest was cost per quality-adjusted life year (QALY) gained from health care system and societal perspectives.ResultsA universal RV5 vaccination program is projected to reduce, hospitalizations, ED visits, outpatient visits and parental work days lost due to rotavirus infections by 89%, 80%, 67% and 74%, respectively. In the absence of RV5 vaccination, RGE-related societal costs are projected to be 2,023,038 Omani Rial (OMR) (5,259,899 United States dollars [USD]), including 1,338,977 OMR (3,481,340 USD) in direct medical costs. However, with the introduction of RV5, direct medical costs are projected to be 216,646 OMR (563,280 USD). Costs per QALY saved would be 1,140 OMR (2,964 USD) from the health care payer perspective. An RV5 vaccination program would be considered cost saving, from the societal perspective.ConclusionsUniversal RV5 vaccination in Oman is likely to significantly reduce the health care burden and costs associated with rotavirus gastroenteritis and may be cost-effective from the payer perspective and cost saving from the societal perspective.