Impact of Ethnicity and Underlying Comorbidity on COVID-19 Inhospital Mortality: An Observational Study in Abu Dhabi, UAE

Abstract

Background. The UAE reported its first cluster of COVID 2019 in a group of returned travellers from Wuhan in January 2020. Various comorbidities are associated with worse disease prognosis. Understanding the impact of ethnicity on the disease outcome is an important public health issue but data from our region is lacking. Aim. We aim to identify comorbidities among patients hospitalized for COVID-19 that are associated with inhospital death. Also, to assess if ethnicity is correlated with increased risk of death. Patients and Method. The study is a single-centre, observational study in Shaikh Shakhbout Medical City, Abu Dhabi. Patients admitted with COVID-19, between 1st of March and the end of May, were enrolled. Records were studied for demography, comorbidity, and ethnicity. Ethnicity was divided into Arabs (Gulf, North Africa, and the Levant), South Asia (India, Pakistan, Bangladesh, Nepal, and Afghanistan), Africans, the Philippines, and others. The study was approved by the Department of Health of Abu Dhabi. Results. 1075 patients (972 males) were enrolled. There were 24 nationalities under 5 ethnicity groups. Mean (average) age was 51 years (20–81). 101 (9.4%) died with deceased patients being significantly older. Death risk was not significantly influenced by sex. Duration of hospitalization among survivors was 6.2 days (0.2–40.4) with older patients and men staying longer ( P < 0.01 ). Comorbidities of diabetes, hypertension, cardiovascular disease, chronic renal disease, liver disease, and malignancy were associated with higher risk of mortality univariate, but only liver disease reached statistical significance after adjustment for age. The highest percentage of death was seen in Arab Levant (21.2) followed by the Asian Afghan (18.8); however, differences among ethnicities did not reach statistical significance ( P = 0.086 ). Conclusion. COVID-19 outcome was worse in older people and those with comorbidities. Men and older patients required longer hospitalization. Ethnicity is not seen to impact the risk of mortality.

Association of Underlying Comorbidities and progression of COVID-19 Infection Among 2586 Patients Hospitalized in the National Capital Region of India: A Retrospective Cohort Study

“…The rate of ICU admission among the COVID-19 infected patients is reported to be lower in other countries such as Republic of Korea [26], Mexico [27], America [28,29], United Arab Emirates [30] and Iran [31] than the present study. Similarly, the mortality rate reported in our study was lower than that reported in other studies from different countries like the United States of America [29,32], the United Arab Emirates [33].…”

Factors Associated for Mortality of Older People With COVID 19: A Systematic Review and Meta-analysis

“…Further, this review consists of studies from nine countries; China, Italy, United Kingdom, Spain, Belgium, Sweden, Korea, Switzerland and Brazil. Navar et al (2021) and Deeb et al (2021) found significant difference in mortality between race and ethnicity. However, no study included in our review elaborated such an association.…”

Ethnicity-Specific Features of COVID-19 Among Arabs, Africans, South Asians, East Asians, and Caucasians in the United Arab Emirates

“…Some studies provide descriptive statistics on ethnicity and citizenship of the participants ( Al-Rifai et al., 2021 ; Hannawi et al., 2021 ) including pediatric patients ( Elghoudi et al., 2020 ; Al-Rifai et al., 2021 ). Few of them categorize patients into Arabs and Asians to analyze their racial difference in disease severity and outcomes with adjustment for comorbidities ( Ali et al., 2021 ; Deeb et al., 2021 ). Unique research of antibody titers and epitope coverage is carried out predominantly on Caucasians and South Asians with few Middle Eastern patients included ( Smith et al., 2021 ).…”