Higher Mortality from Covid19 in Patients with Renal Dysfunction in A Multicultural Multi-Ethnic Population

Higher Mortality from Covid19 in Patients with Renal Dysfunction in A Multicultural Multi-Ethnic Population | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Higher Mortality from Covid19 in Patients with Renal Dysfunction in A Multicultural Multi-Ethnic Population Satish Chandrasekhar Nair, Huda Imam Gasmelseed, Asad Afroz Khan, and 21 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-243317/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Despite previous exposure to coronavirus epidemics a few years ago, limited clinical and epidemiological information is available from the United Arab Emirates (UAE). The UAE is the second most affected country amongst the Gulf Cooperation Council Countries by Covid19. Distinctly, the UAE has a population of almost 9.2 million, with fewer than 12% UAE nationals, and the rest immigrants, mainly unskilled labourers. The disparate socio-economic structure, crowded housing conditions, multi-ethnic, multicultural population offers a unique set of challenges in Covid19 disease management. Methods In order to assess patient characteristics and survival for patients infected with Covid19, electronic patient data was retrospectively abstracted from the medical records of two designated public Covid19 referral hospitals, and subjected to statistical analysis. Results From, the total of 3072 patients, less than one-fifth were females, the Asian population (71.2%), followed by Middle Eastern Arabs (23.3%) were the most infected by the virus. Mortality was low among the Asian population. Diabetes Mellitus (26.8%, p < 0.001), hypertension (25.7%, p < 0.001), and heart disease (9.6%, p < 0.01) were the most prevalent comorbidities observed and decreased survival by 2–3 fold. Kidney disease escalated mortality rate by almost eight-fold high (19.4%, p < 0.001), as compared to patients without kidney disease. Higher age of patients between 51 and 65 years, significantly decreased the odds for survival (Crude OR 14.1, p<,0.001) and (Adjusted OR 12.3, p < 0.001), and patient age beyond 66 years, further significantly decreased the odds for survival (Crude OR 36.1, p < 0.001) and (Adjusted OR 26.6,p < 0.001). Kidney disease as comorbidity significantly diminished the survival rates (Crude OR 9.6,p < 0.001) and (Adjusted OR 5.7, p < 0.001), as compared to those without kidney dysfunction. Conclusion Although Asian population was the highest infected by Covd19, their mortality rate was low (2.6%), compared to other nationalities. Older ages above 51 years decreased the odds of survival significantly. Despite other comorbidity risks, kidney dysfunction contributed to enhanced mortality by over eight-fold and reduced the odds of survival (Adjusted OR 26.6), compared to those patients without kidney dysfunction. Our findings are important in the management of the Covid19 disease in the region with similar economic, social, cultural and ethnic background. Health Economics & Outcomes Research Infectious Diseases Health Policy Gulf United Arab Emirates Infectious Disease Kidney Disease Mortality Figures Figure 1 Background The Covid19 viral infection outbreak following the first report from Wuhan, China, in December 2019, has headlined for global attention [ 1 ]. The rapid infectivity of the severe acute respiratory syndrome (SARS-CoV-2), a novel and highly communicable pathogen, prompted the World Health Organization (WHO) to escalate the outbreak to a pandemic on March 11, 2020 [ 2 ]. The SARS-CoV-2 or Covid19 causing severe acute respiratory failure, needing hospitalization for less than thirty percent of those severely ill eroded healthcare resources and medical supplies, culminating in a global public health crisis that mankind had not witnessed before [ 3 ]. Since the first report of the outbreak, SARS-CoV-2 (Covid19) has infected almost 109 million people, and caused almost 2.4 million fatalities in 218 countries of the world, until February 14, 2021 [ 4 ]. The UAE United Arab Emirates (UAE) occupies a strategic location between Europe, Asia, and Africa, and is geographically closer to China. The UAE is a member country of the Gulf Cooperation Council, a political and economic union of five other Arab states, including Bahrain, Kuwait, Oman, Qatar, and Saudi Arabia [ 5 ]. In recent years, the UAE has transformed from a traditional to a state-of-the-art modern country, diversifying away from financial reliance on oil, to develop into a knowledge-based economy [ 6 – 7 ]. The strategic location and a growing economy have catapulted the UAE to become the epicenter for travel, transit, trade, and business [ 7 ]. Distinctively, the citizens of the UAE contribute to less than twelve percent of the total nine million population. The vast majority are immigrants from almost eighty other countries [ 6 ]. Southeast Asians, especially unskilled laborers and the Middle Eastern Arabs constitute the bulk of the immigrant population. The Covid19 outbreak was first reported in the United Arab Emirates on February 29, 2020, when the first five cases were identified. Almost ten weeks later the number of positive Covid19 cases surged to 1695. Despite, 346,000 positive Covid19 cases, the number of deaths in the UAE remained low at less than 0.3% until February 14, 2021 [ 4 , 8 ]. Social disparity is a significant contributor for the spread of infectious diseases. The disparate socioeconomic structure among the immigrants, and the multiethnic multicultural patient population in the UAE, offers unique set of challenges in Covid19 disease management [ 9 ]. Therefore, the objectives of this study were to assess the mortality rate for Covid19 infected patients in a multicultural multiethnic population of the United Arab Emirates, and to describe their characteristics and risk factors. Methods Setting The study was conducted at the two government hospitals, Tawam and Al Ain hospital, both designated regional primary referral centers for Covid19 patient care, Joint Commission accredited, in Al Ain, the eastern region of the United Arab Emirates. The Covid19 Preparedness at Tawam and Al Ain hospitals (COPTA), a research group consisting of twenty-four physician-researchers, blinded to the study hypothesis conducted the retrospective review of patient electronic medical records (Cerner, USA). Ethics Statement : The methods of the study were carried out in accordance with the International Conference for Harmonization (ICH), and Good Clinical Practice guidelines, and any other local and national guidelines from the Department of Health, Abu Dhabi, UAE. The study obtained research ethics approval from the Department of Health, Abu Dhabi, centralized research ethics committee. Study Design : Following a cross-sectional design, data, including but not limited to, demographics, RT-PCR test results, date of admission and discharge, disease severity, lab work, radiological examinations, and treatment, were retrospectively collected for the patients between March until June 2020, the highly active phase of the contagion [ 8 ]. Inclusion and Exclusion Criteria : Patient data were abstracted from the records provided the following inclusion criteria were met: a) patients were aged above 18 years of age, irrespective of their nationality, b) had a confirmed positive COVID-19 nuclei acid test detected using the real-time reverse transcriptase-polymerase chain reaction, c) both male and female, and d) cases presented to the emergency department, in-patient units of the two hospitals, and the local screening tents which were designated for COVID-19. Patients not meeting the above criteria, seen at the private hospitals and other regions, and with incomplete charts or missing data were excluded. Data Analysis Data were analysed using SPSS (IBM, Chicago) Version 26, and results presented using descriptive statistics. Interrater reliability to assess the data differences between the data abstractors was evaluated using Cohen’s kappa coefficient [ 10 ]. Interrater reliability for the 24 data abstractors was 0.79, indicating good agreement of the data collected between them. Selection and operator bias were excluded by involving multiple data abstracters and subjecting the data to Interrater reliability test. The Chi-square test was applied to assess the association between the outcome of the disease and other comorbidity conditions and sociodemographic variables. A p-value of ≤ 0.05 was considered statistically significant. The variables, which showed statistically significant association, was included in the simple and multiple binary logistic regression to determine the crude and adjusted Odds Ratio (OR) [ 11 ]. The 95% confidence interval for crude and adjusted Odds Ratio was calculated to find the statistically significant variables. All the variables indicating statistical significance using simple logistic regression were also analyzed for multiple logistic regression. Results A total of 3072 patients, meeting the inclusion and exclusion criteria and confirmed positive for Covid19 by the reverse-transcriptase polymerase chain reaction (RT-PCR) constituted the study population. More than half (1630/3072, 53%) of the patients were in the age group between 31–50 years (Table 1 ), followed by older patients above 51 years of age (966/3072, 31.5%). Less than one-fifth of the total Covid19 patients were females (659/3072, 21.5%), the majority being male patients (table). Covid19 was widespread among the Asian population (2187/3072, 71.2%), followed by Middle Eastern Arabs (716/3072, 23.3%). Patients with social habits, irrespective of the social habit were more likely for Covid19 infection (1712/3072, 85.8%), compared to those without any social habit (Table 1 ). Table 1 Demographics of Adult Covid19 Patients Admitted to the Public Hospitals in Al Ain, the Eastern Region of the United Arab Emirates Characteristics Category n % Age (Years) 18–30 476 15.5 31–50 1630 53.1 51–65 770 25.1 > 66 196 6.4 Gender Male 2413 78.5 Female 659 21.5 Nationality Asian 2187 71.2 Middle East 716 23.3 Others 167 5.4 Social Habit Some Habit 1712 85.8 No Habit 283 14.2 Diabetes Mellitus was the most predominant comorbidity observed among adult Covid19 patients, more than one quarter of the patients presented with Diabetes Mellitus (792/3072, 26.8%) (Fig. 1 ). Hypertension (759/3072, 25.7%) was the second most common comorbidity among Covid19 patients, followed by heart disease including patients with dyslipidemia (283/3072, 9.6%). Respiratory (130/3072, 4.4%) Kidney (112/3072, 3.8%), Obesity (102/3072, 3.4%), Immunocompromised (80/3072, 2.7%), diseases were below five percent for Covid19 patients. Hematological and Liver diseases were not common, less than one percent of the patients (Fig. 1 ). Subgroup analysis of the data indicated a statistically significant (p < 0.001) positive association between age and survival. Higher age enhanced mortality rate. The mortality rate was less than 0.5% for the Covid19 patients in the age group of 18–30 Years. Between 31–50 years, the death rate was less than 2% and escalated to 5.7% and 13.5%, for the older age group of 51–65 years and 66 + years, respectively (Table 2 ). Statistically significant association was not observed for the disease outcomes either for the gender differences and for patients with some social habits (Table 2 ). In contrast, despite the large number of Asian patients who contracted Covid19 infection (2080/3072, 97.4%), the mortality rate was low at 2.6%, compared to statistically significant (P < 0.005) higher mortality in the Middle Eastern Arab (4.6%) and other’s (immigrants from the America’s, Europe and Africa, 6.3%, Table 2 ). Table 2 Association between Patient Characteristics and Survival of Adult Covid19 Patients Admitted to the Public Hospitals in Al Ain, the Eastern Region of the United Arab Emirates Characteristics Category Outcome P Survival Deceased n % n % Age (Years) 18–30 462 99.6 2 0.4 66 160 86.5 25 13.5 Gender Male 2273 96.7 77 3.3 Not Significant Female 621 97.2 18 2.8 Nationality Asian 2080 97.4 55 2.6 < 0.005 Middle East Arab 665 95.7 30 4.3 Others 149 93.7 10 6.3 Social Habit Some Habit 1638 97.4 44 2.6 Not Significant No Habit 249 97.6 6 2.4 Further, subgroup analysis of the association between the patient comorbidities and disease outcome yielded interesting results. Kidney disease as a comorbidity for adult Covid19 patients was found to be detrimental for survival. The mortality rate was almost eight-fold high (19.4%) and statistically significant (p < 0.001), as compared to other Covid19 infected patients without kidney disease (2.4%) (Table 3 ). Comorbidities such as heart disease (p < 0.01), hypertension (p < 0.001), and diabetes mellitus (p < 0.001), escalated mortality significantly by 2–3 fold, as compared to the patients without these comorbidities (Table 3 ). Other associated comorbidities such as respiratory, hematological, liver diseases, and immunocompromising disease and obesity did not significantly impact Covid19 adult patients survived when compared with other Covid19 patients without these comorbidities (Table 3 ). Table 3 Assessment of Association between Patient Comorbidities and Survival for Adult Covid19 Patients Admitted to the Public Hospitals in Al Ain, the Eastern Region of the United Arab Emirates Comorbidity Category Outcome P Value Survived Deceased n % n % Kidney disease No 2716 97.6 68 2.4 < 0.001 Yes 83 80.6 20 19.4 Heart disease/Dyslipidemia No 2546 97.2 73 2.8 < 0.01 Yes 253 94.4 15 5.6 Diabetes Mellitus No 2069 97.9 45 2.1 < 0.001 Yes 730 94.4 43 5.6 Hypertension No 2100 97.6 52 2.4 < 0.001 Yes 699 95.1 36 4.9 Respiratory disease No 2681 97.1 81 2.9 Not Significant Yes 118 94.4 7 5.6 Hematology No 2781 97 87 3 Not Significant Yes 18 94.7 1 5.3 Immunocompromised No 2727 97 83 3 Not Significant Yes 72 93.5 5 6.5 Liver Disease No 2792 97 87 3 Not Significant Yes 7 87.5 1 12.5 Obesity No 2706 97 83 3 Not Significant Yes 93 94.9 5 5.1 In order to predict the association between critical patient characteristics and comorbidity, against mortality, the Odds Ratio was estimated. Patient age and nationality were chosen for patient characteristics and, the comorbidities identified included heart disease/dyslipidemia, hypertension, kidney disease, and patients with diabetes mellitus. Higher age of Covid19 patients between 51 and 65 years, significantly decreased the odds for survival (Crude OR 14.1, Confidence Interval 3.4–58.4, p < 0.001) and (Adjusted OR 12.3, Confidence Interval 2.9–52.4, p < 0.001), and patient age beyond 66 years, further significantly decreased the odds for survival (Crude OR 36.1, Confidence Interval 8.5-154.1, P,0.001) and (Adjusted OR 26.6, Confidence Interval 5.7-123.8, p < 0.001) (Table 4 ). Kidney disease as comorbidity significantly diminished the survival rates for Covid19 patients (Crude OR 9.6, Confidence Interval 5.6–16.6, p < 0.001) and (Adjusted OR 5.7, Confidence Interval 3.0-10.8, p < 0.001, Table 4 ), as compared to those without kidney dysfunction. Patient nationality and other comorbidity related risk factors such as heart disease, hypertension, and diabetes did not significantly alter the odds (adjusted OR) for the survival of Covid19 patients in our study. Additionally, the majority of patients were not treated with antibiotics (70%, 2154/3072), those severely ill received Augmentin, Tazocin, Amoxicillin and Doxycycline. Less than 10% (7.2%, 224/3072) of the patients did not receive any antiviral therapy, others received hydroxyquinoline and Favipiravir as monotherapy, or in combination (data not shown). Table 4 Odds ratio (crude and adjusted) for predicting the association between critical patient characteristics and comorbidities against mortality for Covid19 infection Characteristics Group Crude Adjusted OR CI P OR CI P Age (Years) 18–30 1 -- -- 1 -- -- 31–50 3.7 0.9–15.6 Not Significant 3.3 0.8–14.2 Not Significant 51–65 14.1 3.4–58.4 < 0.001 12.3 2.9–52.4 65 36.1 8.5-154.1 < 0.001 26.6 5.7-123.8 < 0.001 Nationality Asia 1 -- -- 1 -- -- Middle East Arab 1.7 1.1–2.7 < 0.05 0.9 0.5–1.5 Not Significant Others 2.5 1.3–5.1 < 0.01 2.1 1.0-4.5 Not Significant Heart disease/Dyslipidemia No 1 -- -- 1 -- -- Yes 2.1 1.2–3.7 < 0.05 0.6 0.3–1.3 Not Significant Hypertension No 1 -- -- 1 -- -- Yes 2.1 1.4–3.2 < 0.001 0.8 0.5–1.3 Not Significant Kidney disease No 1 -- -- 1 -- -- Yes 9.6 5.6–16.6 < 0.001 5.7 3.0-10.8 < 0.001 Diabetes Mellitus No 1 -- -- 1 -- -- Yes 2.7 1.8–4.1 < 0.001 1.3 0.8–2.1 Not Significant Discussion The UAE was exposed to other coronavirus epidemics, such as the Severe Acute Respiratory Syndrome (SARS) outbreak in 2002 and the spread of Middle East Respiratory Syndrome (MERS) in 2012 [ 12 – 13 ]. In spite, limited information about patient characteristics and clinical management of the epidemics are available [ 5 , 12 ]. The UAE is the second worst affected country, among the GCC countries, by the Covid19 disease, preceded by Saudi Arabia with a total of 361,000 positive cases and approximately 6000 deaths [ 14 ]. Men were disproportionately affected by Covid19 as compared to women, less that one quarter of the Covid19 patients were women in our study [ 15 ]. Higher neutralizing antibodies, smaller lung size, lower chance of immune dysregulation and the differential expression of the angiotensin-converting enzyme 2-the viral receptor, are postulated to contribute to the gender difference in Covid19 infectivity [ 16 ]. A large proportion of the UAE population are Asian, especially the South East Asian’s from Pakistan, India, Bangladesh, Sri Lanka, Philippines and Nepal [ 17 ]. A vast majority of the South East Asian workforce are laborers who often live-in crowded housing conditions, and are at a higher risk for contracting communicable diseases [ 17 ] thus explaining the higher Covid19 infectivity amongst the Asian population (Table 1 ). Lower social status is also reported to be a risk factor for Covid19 infection [ 18 – 19 ]. A national cohort study of over 7000 subjects has shown that diabetes, impaired fasting glucose, hypercholesterolemia, and hypertension are highly prevalent in young adulthood in the UAE [ 20 ]. Comorbidities such as diabetes and hypertension were observed in more than one quarter of our Covid19 patients, supporting earlier observations reported by Guan [ 21 ] and Xu [ 22 ], that patients with diabetes and hypertension were at a higher risk for severe Covid19. Despite the fact that the Asian population was the most Covid19 infected, their mortality rate (2.6%, Table 2 ) was the lowest compared to the Middle East Arabs (4.3%, Table 2 ) and other combined nationalities from the Americas, Europe and Africa (6.3%, Table 2 ). Similar mortality rates from Covid19 disease between the Asian population and the Caucasian white population was observed in the United States [ 23 ]. The observed mortality rates were almost 1.7 times lower than that for the Black and Hispanic population [ 23 ]. Despite the myriad of comorbidities for Covid19 patients observed in our study, kidney disease, heart disease, diabetes and hypertension, significantly contributed to the mortality rates (Table 3 ). Almost, two-fold increase in mortality rate was observed for Covid19 patients with heart disease, diabetes and hypertension, when compared with the patients without these comorbidities (Table 3 ). An eight-fold increase (19.4%, p < 0.001) in mortality rate was observed in Covid19 patients with kidney disease, as compared to those without kidney disease (2.4%). Odds Ratio estimation further validated that kidney disease as a comorbidity significantly diminished the survival rates for Covid19 patients (Crude OR 9.6, Confidence Interval 5.6–16.6, p < 0.001) and (Adjusted OR 5.7, Confidence Interval 3.0-10.8, p < 0.001, Table 4 ), as compared to those without kidney dysfunction. Gansevoort & Hilbrands, recently demonstrated that Covid19 patients with kidney dysfunction had higher rates of mortality, when compared to the patients with heart disease, diabetes and hypertension comorbidities [ 24 ]. Advanced ages of Covid19 patients between 51 and 65 years, significantly decreased the odds for survival (Adjusted OR 12.3, Confidence Interval 2.9–52.4, p < 0.001), and patient age beyond 66 years significantly enhanced mortality (Adjusted OR 26.6, Confidence Interval 5.7-123.8, p < 0.001) (Table 4 ). Advancing age may also be associated with various comorbidities and therefore older patient age has been noted as an independent risk factor for Covid19 mortality [ 25 ]. Interestingly, despite the lower social status of the immigrant labourers and, the multicultural and multi-ethnic patient population in our study, the observations are in accordance with the previously published reports from other Covid19 disease affected countries [ 21 , 23 , 25 ]. The strengths of the study is the facts that this is the first report describing patient characteristics and outcomes for Covid19 patients from the UAE, and the data was collected from Covid19 patients hospitalized at the only two public hospitals in Al Ain, that catered to more than 98% of the total positive Covid19 case load. Our study has several limitations: a) the data for the study was retrospectively collected from pre-recorded patent medical records making it difficult to assess any temporal relationships between the variables; b) the retrospective design of the study enables assessment of association and not causation; c) other confounding factors may have been overlooked, and d) although 85.8% of the Covid19 patients had some social habit (Table 1 ), the risk did not affect their survival (2.6 Vs 2.4, Social Habit Vs No Social Habit, Table 2 ), the reasons for which need to be investigated. Data abstraction by multiple abstractors blinded to the study hypothesis and assessment of interrater reliability for the data collected helped to prevent selection bias. In summary, our study highlights that although Asian population was the highest infected by Covd19, their mortality rate was low (2.6%), compared to other nationalities. Older ages above 51 years decreased the odds of survival significantly. Despite other comorbidity risks, kidney dysfunction contributed to enhanced mortality by over eight-fold and reduced the odds of survival (Adjusted OR 26.6), compared to those patients without kidney dysfunction. Our findings are important in the management of the Covid19 disease in the region with similar economic, social, cultural and ethnic background. Declarations Funding This study was not supported by funds or grants. No funding sources to declare. Availability of data and materials The datasets generated and/or analyzed during the current study ae not publicly available due to the institutions policy to code and archive data in a central repository of the hospital, but are available from the corresponding author on reasonable request. Competing interests The authors declare that they have no competing interests. Consent for publication Obtaining written informed consents were exempted by the central human research ethics committee at the department of health Abu Dhabi, for retrospective review of patient charts. No personal identifying information was collected for the patients, both subject privacy and patient data confidentiality was strictly adhered to in accordance with the international and national guidelines. ICH-GCP Guidelines and Research Ethics approval: The methods of the study were carried out in accordance with the International Conference for Harmonization (ICH), and Good Clinical Practice guidelines, and any other local and national guidelines from the Department of Health, Abu Dhabi, UAE. The study obtained research ethics approval from the Department of Health, Abu Dhabi, centralized research ethics committee. Acknowledgements The authors are thankful to the management of Tawam Hospital and the Al Ain hospital for providing the time to conduct the study. Author Contribution Statement Concept and design (SCN, HIG). Feasibility Assessment (AAK, INK, AAS), Patient Care (HIG, AAK, AAS) Literature Search & Updates (AAS, SCN, AAK, INK), Data Acquisition & Organization (INK, HIA, AAS, AHA, ARS, ARA, AIS, MMF, ARA, AMH, KMB, HBC, MNA, SSA, MAA, FAS, RSS, FWH, AWA, WFD), Data Analysis (JS, AAK, HIG, INK, SCN), Data Interpretation (SCN, HIG, AAK), Manuscript Preparation (SCN, AAK, HIG), Manuscript Review & Approval (all authors). References Zhu H., Wei L, Niu, P. The novel coronavirus outbreak in Wuhan, China. Global health research and policy 2020, 5, 135-136. Cucinotta D, Vanelli M. WHO Declares COVID-19 a Pandemic. Acta Biomed. 2020, Mar 19;91(1):157-160. Singhal T. A Review of Coronavirus Disease (COVID-19). Indian journal of pediatrics, 2020, 87(4), 281–286. https://www.worldometers.info/coronavirus/?fbclid=IwAR2RSsOMsu6XxMiOJ1WHNcSfC2TCYYrj4a0bUMdJW3VUXwSrj3WSNSCxY0Q Accessed on December 20, 2020 Nair SC, Ibrahim H, Celentano DD. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-243317","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":12701083,"identity":"32838436-fdd8-4932-b322-27b2c15b972b","order_by":0,"name":"Satish Chandrasekhar 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Ain","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Huda","middleName":"Imam","lastName":"Gasmelseed","suffix":""},{"id":12701085,"identity":"b8ab1223-503f-455d-94b5-b289a2ab185a","order_by":2,"name":"Asad Afroz Khan","email":"","orcid":"","institution":"Tawam Hospital, Department of Infectious Disease, Internal Medicine, Al Ain","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Asad","middleName":"Afroz","lastName":"Khan","suffix":""},{"id":12701086,"identity":"e80247c1-39d4-4276-a4c9-9de23f259b2a","order_by":3,"name":"Ibrahim Nageh Khafagy","email":"","orcid":"","institution":"Al Ain Hospital Department of Pharmacy, Al Ain","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Ibrahim","middleName":"Nageh","lastName":"Khafagy","suffix":""},{"id":12701087,"identity":"997bc44c-aea0-430e-9a7b-98c02f74f145","order_by":4,"name":"Hashim Ibrahim Abdrhman","email":"","orcid":"","institution":"Al Ain Hospital, Department of Infectious Disease, Internal Medicine, Al Ain","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Hashim","middleName":"Ibrahim","lastName":"Abdrhman","suffix":""},{"id":12701088,"identity":"0a5cad9d-ca6a-4427-85e6-d8c5c048f591","order_by":5,"name":"Aqeel Aziz Saleem","email":"","orcid":"","institution":"Tawam Hospital, Department of Infectious Disease, Internal Medicine, Al Ain","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Aqeel","middleName":"Aziz","lastName":"Saleem","suffix":""},{"id":12701089,"identity":"bbfebf4c-455e-4dee-bc7a-509cfa22b92f","order_by":6,"name":"Jayadevan Sreedharan","email":"","orcid":"","institution":"Gulf Medical University, Department of Epidemiology, Ajman","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Jayadevan","middleName":"","lastName":"Sreedharan","suffix":""},{"id":12701090,"identity":"3c6fd6c7-454d-4e69-8648-bdae8239296f","order_by":7,"name":"Ahmed Husain Alhosani","email":"","orcid":"","institution":"Tawam Hospital, Department of Academic Affairs, Internal Medicine, Al Ain","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Ahmed","middleName":"Husain","lastName":"Alhosani","suffix":""},{"id":12701091,"identity":"f3c0d465-d0e6-496b-ac49-2c330214b89f","order_by":8,"name":"Amatur Rahman Siddiqua","email":"","orcid":"","institution":"Tawam Hospital, Department of Academic Affairs, Internal Medicine, Al Ain","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Amatur","middleName":"Rahman","lastName":"Siddiqua","suffix":""},{"id":12701092,"identity":"f6bfdaac-dbea-4c3a-a140-95abcdcd7c32","order_by":9,"name":"Amna Riaz Ahmed","email":"","orcid":"","institution":"Tawam Hospital, Department of Academic Affairs, Internal Medicine, Al Ain","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Amna","middleName":"Riaz","lastName":"Ahmed","suffix":""},{"id":12701093,"identity":"d133dca8-6fca-40ba-ae1a-1083753379af","order_by":10,"name":"Aya Imad Shubbar","email":"","orcid":"","institution":"Tawam Hospital, Department of Academic Affairs, Internal Medicine, Al Ain","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Aya","middleName":"Imad","lastName":"Shubbar","suffix":""},{"id":12701094,"identity":"2f726db9-5f3a-484f-bef3-0cacbad2938b","order_by":11,"name":"Majd Munir Farajallah","email":"","orcid":"","institution":"Tawam Hospital, Department of Academic Affairs, Internal Medicine, Al Ain","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Majd","middleName":"Munir","lastName":"Farajallah","suffix":""},{"id":12701095,"identity":"3f748e60-ed09-4513-9741-4732bdbdedcd","order_by":12,"name":"Abdul Rahman Aleissaee","email":"","orcid":"","institution":"Tawam Hospital, Department of Academic Affairs, Internal Medicine, Al Ain","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Abdul","middleName":"Rahman","lastName":"Aleissaee","suffix":""},{"id":12701096,"identity":"c86e03ec-e786-48d0-9ce0-cdd6ce977707","order_by":13,"name":"Alan Mohammad Hamadeh","email":"","orcid":"","institution":"Tawam Hospital, Department of Academic Affairs, Internal Medicine, Al Ain","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Alan","middleName":"Mohammad","lastName":"Hamadeh","suffix":""},{"id":12701097,"identity":"2e555bbc-6c65-403a-b2f4-df422c400d26","order_by":14,"name":"Khlood Mustafa Bashir","email":"","orcid":"","institution":"Tawam Hospital, Department of Academic Affairs, Internal Medicine, Al Ain","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Khlood","middleName":"Mustafa","lastName":"Bashir","suffix":""},{"id":12701098,"identity":"5573bfbc-2436-4576-b2a5-6162f76942d7","order_by":15,"name":"Haneen Bassam Choker","email":"","orcid":"","institution":"Tawam Hospital, Department of Academic Affairs, Internal Medicine, Al Ain","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Haneen","middleName":"Bassam","lastName":"Choker","suffix":""},{"id":12701099,"identity":"9f222a2c-cbbd-4bf7-b99a-1bd428c730fc","order_by":16,"name":"Mohamed Nasir Alzaabi","email":"","orcid":"","institution":"Tawam Hospital, Department of Academic Affairs, Internal Medicine, Al Ain","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Mohamed","middleName":"Nasir","lastName":"Alzaabi","suffix":""},{"id":12701100,"identity":"a7ff14c8-8004-4ca8-b47a-a52918fc53b1","order_by":17,"name":"Saif Saeed Alshehhi","email":"","orcid":"","institution":"Tawam Hospital, Department of Academic Affairs, Internal Medicine, Al Ain","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Saif","middleName":"Saeed","lastName":"Alshehhi","suffix":""},{"id":12701101,"identity":"3e4d60f7-846c-4d5a-956c-77f523671489","order_by":18,"name":"Maitha Ali Alblooshi","email":"","orcid":"","institution":"Tawam Hospital, Department of Academic Affairs, Internal Medicine, Al Ain","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Maitha","middleName":"Ali","lastName":"Alblooshi","suffix":""},{"id":12701102,"identity":"ff387f2a-94e0-40bf-9df9-86439ea02d9f","order_by":19,"name":"Fatmah Ali Safdani","email":"","orcid":"","institution":"Tawam Hospital, Department of Academic Affairs, Internal Medicine, Al Ain","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Fatmah","middleName":"Ali","lastName":"Safdani","suffix":""},{"id":12701103,"identity":"b7ece5a9-1daf-4735-bea4-4f907adff4c7","order_by":20,"name":"Rajish Sanjit Shil","email":"","orcid":"","institution":"Tawam Hospital, Department of Academic Affairs, Internal Medicine, Al Ain","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Rajish","middleName":"Sanjit","lastName":"Shil","suffix":""},{"id":12701104,"identity":"c8759d3a-8cf8-47b2-a50d-3ce2556bc58b","order_by":21,"name":"Fuad Wardan Habbal","email":"","orcid":"","institution":"Tawam Hospital, Department of Academic Affairs, Internal Medicine, Al Ain","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Fuad","middleName":"Wardan","lastName":"Habbal","suffix":""},{"id":12701105,"identity":"922507e6-6346-43d2-aa96-16f48075cd52","order_by":22,"name":"Abdulrahman Wael Alanqar","email":"","orcid":"","institution":"Tawam Hospital, Department of Academic Affairs, Internal Medicine, Al Ain","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Abdulrahman","middleName":"Wael","lastName":"Alanqar","suffix":""},{"id":12701106,"identity":"89fa5e70-acca-45f6-9ee9-82a6602e8ae1","order_by":23,"name":"Wafa Fayez Douleh","email":"","orcid":"","institution":"Al Ain Hospital, Department of Infectious Disease, Internal Medicine, Al Ain","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Wafa","middleName":"Fayez","lastName":"Douleh","suffix":""}],"badges":[],"createdAt":"2021-02-15 07:14:11","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-243317/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-243317/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":6406955,"identity":"e500f400-5076-4212-a9a1-a66f533a0b1b","added_by":"auto","created_at":"2021-02-26 20:34:49","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":90543,"visible":true,"origin":"","legend":"Percentage of total patients infected with Covid19 presenting with various comorbidities","description":"","filename":"Fig1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-243317/v1/3e7b3f872e52d3df62eef8a9.jpg"},{"id":13672431,"identity":"7cd7467d-ccc4-48a6-8f28-314d66b3bd12","added_by":"auto","created_at":"2021-09-17 11:13:33","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":458455,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-243317/v1/5fb6ceb4-023f-4f1a-87b1-9920bac0ff82.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eHigher Mortality from Covid19\u0026nbsp;in Patients with Renal Dysfunction in A Multicultural Multi-Ethnic Population\u003c/p\u003e","fulltext":[{"header":"Background","content":" \u003cp\u003eThe Covid19 viral infection outbreak following the first report from Wuhan, China, in December 2019, has headlined for global attention [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. The rapid infectivity of the severe acute respiratory syndrome (SARS-CoV-2), a novel and highly communicable pathogen, prompted the World Health Organization (WHO) to escalate the outbreak to a pandemic on March 11, 2020 [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. The SARS-CoV-2 or Covid19 causing severe acute respiratory failure, needing hospitalization for less than thirty percent of those severely ill eroded healthcare resources and medical supplies, culminating in a global public health crisis that mankind had not witnessed before [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Since the first report of the outbreak, SARS-CoV-2 (Covid19) has infected almost 109\u0026nbsp;million people, and caused almost 2.4\u0026nbsp;million fatalities in 218 countries of the world, until February 14, 2021 [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe UAE United Arab Emirates (UAE) occupies a strategic location between Europe, Asia, and Africa, and is geographically closer to China. The UAE is a member country of the Gulf Cooperation Council, a political and economic union of five other Arab states, including Bahrain, Kuwait, Oman, Qatar, and Saudi Arabia [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. In recent years, the UAE has transformed from a traditional to a state-of-the-art modern country, diversifying away from financial reliance on oil, to develop into a knowledge-based economy [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. The strategic location and a growing economy have catapulted the UAE to become the epicenter for travel, transit, trade, and business [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Distinctively, the citizens of the UAE contribute to less than twelve percent of the total nine million population. The vast majority are immigrants from almost eighty other countries [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Southeast Asians, especially unskilled laborers and the Middle Eastern Arabs constitute the bulk of the immigrant population. The Covid19 outbreak was first reported in the United Arab Emirates on February 29, 2020, when the first five cases were identified. Almost ten weeks later the number of positive Covid19 cases surged to 1695. Despite, 346,000 positive Covid19 cases, the number of deaths in the UAE remained low at less than 0.3% until February 14, 2021 [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Social disparity is a significant contributor for the spread of infectious diseases. The disparate socioeconomic structure among the immigrants, and the multiethnic multicultural patient population in the UAE, offers unique set of challenges in Covid19 disease management [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Therefore, the objectives of this study were to assess the mortality rate for Covid19 infected patients in a multicultural multiethnic population of the United Arab Emirates, and to describe their characteristics and risk factors.\u003c/p\u003e "},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eSetting\u003c/strong\u003e\u003cp\u003e The study was conducted at the two government hospitals, Tawam and Al Ain hospital, both designated regional primary referral centers for Covid19 patient care, Joint Commission accredited, in Al Ain, the eastern region of the United Arab Emirates. The Covid19 Preparedness at Tawam and Al Ain hospitals (COPTA), a research group consisting of twenty-four physician-researchers, blinded to the study hypothesis conducted the retrospective review of patient electronic medical records (Cerner, USA).\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003e\u003cb\u003eEthics Statement\u003c/b\u003e:\u003c/strong\u003e\u003cp\u003eThe methods of the study were carried out in accordance with the International Conference for Harmonization (ICH), and Good Clinical Practice guidelines, and any other local and national guidelines from the Department of Health, Abu Dhabi, UAE. The study obtained research ethics approval from the Department of Health, Abu Dhabi, centralized research ethics committee.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eStudy Design\u003c/b\u003e: Following a cross-sectional design, data, including but not limited to, demographics, RT-PCR test results, date of admission and discharge, disease severity, lab work, radiological examinations, and treatment, were retrospectively collected for the patients between March until June 2020, the highly active phase of the contagion [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e\u003cp\u003e\u003cb\u003eInclusion and Exclusion Criteria\u003c/b\u003e: Patient data were abstracted from the records provided the following inclusion criteria were met: a) patients were aged above 18 years of age, irrespective of their nationality, b) had a confirmed positive COVID-19 nuclei acid test detected using the real-time reverse transcriptase-polymerase chain reaction, c) both male and female, and d) cases presented to the emergency department, in-patient units of the two hospitals, and the local screening tents which were designated for COVID-19. Patients not meeting the above criteria, seen at the private hospitals and other regions, and with incomplete charts or missing data were excluded.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eData Analysis\u003c/strong\u003e\u003cp\u003eData were analysed using SPSS (IBM, Chicago) Version 26, and results presented using descriptive statistics. Interrater reliability to assess the data differences between the data abstractors was evaluated using Cohen\u0026rsquo;s kappa coefficient [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Interrater reliability for the 24 data abstractors was 0.79, indicating good agreement of the data collected between them. Selection and operator bias were excluded by involving multiple data abstracters and subjecting the data to Interrater reliability test. The Chi-square test was applied to assess the association between the outcome of the disease and other comorbidity conditions and sociodemographic variables. A p-value of \u0026le;\u0026thinsp;0.05 was considered statistically significant. The variables, which showed statistically significant association, was included in the simple and multiple binary logistic regression to determine the crude and adjusted Odds Ratio (OR) [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. The 95% confidence interval for crude and adjusted Odds Ratio was calculated to find the statistically significant variables. All the variables indicating statistical significance using simple logistic regression were also analyzed for multiple logistic regression.\u003c/p\u003e\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 3072 patients, meeting the inclusion and exclusion criteria and confirmed positive for Covid19 by the reverse-transcriptase polymerase chain reaction (RT-PCR) constituted the study population. More than half (1630/3072, 53%) of the patients were in the age group between 31\u0026ndash;50 years (Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e), followed by older patients above 51 years of age (966/3072, 31.5%). Less than one-fifth of the total Covid19 patients were females (659/3072, 21.5%), the majority being male patients (table). Covid19 was widespread among the Asian population (2187/3072, 71.2%), followed by Middle Eastern Arabs (716/3072, 23.3%). Patients with social habits, irrespective of the social habit were more likely for Covid19 infection (1712/3072, 85.8%), compared to those without any social habit (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab1\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eDemographics of Adult Covid19 Patients Admitted to the Public Hospitals in Al Ain, the Eastern Region of the United Arab Emirates\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eCharacteristics\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eCategory\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003en\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003e%\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eAge (Years)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e18\u0026ndash;30\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e476\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e15.5\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e31\u0026ndash;50\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1630\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e53.1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e51\u0026ndash;65\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e770\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e25.1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026gt;\u0026thinsp;66\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e196\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e6.4\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eGender\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMale\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2413\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e78.5\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eFemale\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e659\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e21.5\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"3\" align=\"left\"\u003e\n\u003cp\u003eNationality\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAsian\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2187\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e71.2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMiddle East\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e716\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e23.3\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eOthers\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e167\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5.4\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eSocial Habit\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSome Habit\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1712\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e85.8\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNo Habit\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e283\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e14.2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eDiabetes Mellitus was the most predominant comorbidity observed among adult Covid19 patients, more than one quarter of the patients presented with Diabetes Mellitus (792/3072, 26.8%) (Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e). Hypertension (759/3072, 25.7%) was the second most common comorbidity among Covid19 patients, followed by heart disease including patients with dyslipidemia (283/3072, 9.6%). Respiratory (130/3072, 4.4%) Kidney (112/3072, 3.8%), Obesity (102/3072, 3.4%), Immunocompromised (80/3072, 2.7%), diseases were below five percent for Covid19 patients. Hematological and Liver diseases were not common, less than one percent of the patients (Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003eSubgroup analysis of the data indicated a statistically significant (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) positive association between age and survival. Higher age enhanced mortality rate. The mortality rate was less than 0.5% for the Covid19 patients in the age group of 18\u0026ndash;30 Years. Between 31\u0026ndash;50 years, the death rate was less than 2% and escalated to 5.7% and 13.5%, for the older age group of 51\u0026ndash;65 years and 66\u0026thinsp;+\u0026thinsp;years, respectively (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e). Statistically significant association was not observed for the disease outcomes either for the gender differences and for patients with some social habits (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e). In contrast, despite the large number of Asian patients who contracted Covid19 infection (2080/3072, 97.4%), the mortality rate was low at 2.6%, compared to statistically significant (P\u0026thinsp;\u0026lt;\u0026thinsp;0.005) higher mortality in the Middle Eastern Arab (4.6%) and other\u0026rsquo;s (immigrants from the America\u0026rsquo;s, Europe and Africa, 6.3%, Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab2\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eAssociation between Patient Characteristics and Survival of Adult Covid19 Patients Admitted to the Public Hospitals in Al Ain, the Eastern Region of the United Arab Emirates\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"3\" align=\"left\"\u003e\n\u003cp\u003eCharacteristics\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"3\" align=\"left\"\u003e\n\u003cp\u003eCategory\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eOutcome\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"3\" align=\"left\"\u003e\n\u003cp\u003eP\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eSurvival\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eDeceased\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003en\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e%\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003en\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e%\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eAge (Years)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e18\u0026ndash;30\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e462\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e99.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e31\u0026ndash;50\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1566\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e98.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e25\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.6\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e51\u0026ndash;65\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e706\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e94.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e43\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5.7\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026gt;\u0026thinsp;66\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e160\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e86.5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e25\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e13.5\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eGender\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMale\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2273\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e96.7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e77\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eNot Significant\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eFemale\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e621\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e97.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e18\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.8\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"3\" align=\"left\"\u003e\n\u003cp\u003eNationality\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAsian\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2080\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e97.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e55\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"3\" align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;0.005\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMiddle East Arab\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e665\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e95.7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e30\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4.3\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eOthers\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e149\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e93.7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e10\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6.3\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eSocial Habit\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSome Habit\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1638\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e97.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e44\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eNot Significant\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNo Habit\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e249\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e97.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.4\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eFurther, subgroup analysis of the association between the patient comorbidities and disease outcome yielded interesting results. Kidney disease as a comorbidity for adult Covid19 patients was found to be detrimental for survival. The mortality rate was almost eight-fold high (19.4%) and statistically significant (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), as compared to other Covid19 infected patients without kidney disease (2.4%) (Table \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e). Comorbidities such as heart disease (p\u0026thinsp;\u0026lt;\u0026thinsp;0.01), hypertension (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and diabetes mellitus (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), escalated mortality significantly by 2\u0026ndash;3 fold, as compared to the patients without these comorbidities (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e). Other associated comorbidities such as respiratory, hematological, liver diseases, and immunocompromising disease and obesity did not significantly impact Covid19 adult patients survived when compared with other Covid19 patients without these comorbidities (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab3\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eAssessment of Association between Patient Comorbidities and Survival for Adult Covid19 Patients Admitted to the Public Hospitals in Al Ain, the Eastern Region of the United Arab Emirates\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth rowspan=\"3\" align=\"left\"\u003e\n\u003cp\u003eComorbidity\u003c/p\u003e\n\u003c/th\u003e\n\u003cth rowspan=\"3\" align=\"left\"\u003e\n\u003cp\u003eCategory\u003c/p\u003e\n\u003c/th\u003e\n\u003cth colspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eOutcome\u003c/p\u003e\n\u003c/th\u003e\n\u003cth rowspan=\"3\" align=\"left\"\u003e\n\u003cp\u003eP Value\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003cth colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eSurvived\u003c/strong\u003e\u003c/p\u003e\n\u003c/th\u003e\n\u003cth colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eDeceased\u003c/strong\u003e\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eKidney disease\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2716\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e97.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e68\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e83\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e80.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e20\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e19.4\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eHeart disease/Dyslipidemia\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2546\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e97.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e73\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e253\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e94.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e15\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eDiabetes Mellitus\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2069\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e97.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e45\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e730\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e94.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e43\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eHypertension\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2100\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e97.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e52\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e699\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e95.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e36\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4.9\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eRespiratory disease\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2681\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e97.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e81\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eNot Significant\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e118\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e94.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5.6\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eHematology\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2781\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e97\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e87\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eNot Significant\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e18\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e94.7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5.3\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eImmunocompromised\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2727\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e97\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e83\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eNot Significant\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e72\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e93.5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6.5\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eLiver Disease\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2792\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e97\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e87\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eNot Significant\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e87.5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e12.5\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eObesity\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2706\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e97\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e83\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eNot Significant\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e93\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e94.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5.1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eIn order to predict the association between critical patient characteristics and comorbidity, against mortality, the Odds Ratio was estimated. Patient age and nationality were chosen for patient characteristics and, the comorbidities identified included heart disease/dyslipidemia, hypertension, kidney disease, and patients with diabetes mellitus. Higher age of Covid19 patients between 51 and 65 years, significantly decreased the odds for survival (Crude OR 14.1, Confidence Interval 3.4\u0026ndash;58.4, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and (Adjusted OR 12.3, Confidence Interval 2.9\u0026ndash;52.4, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and patient age beyond 66 years, further significantly decreased the odds for survival (Crude OR 36.1, Confidence Interval 8.5-154.1, P,0.001) and (Adjusted OR 26.6, Confidence Interval 5.7-123.8, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e). Kidney disease as comorbidity significantly diminished the survival rates for Covid19 patients (Crude OR 9.6, Confidence Interval 5.6\u0026ndash;16.6, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and (Adjusted OR 5.7, Confidence Interval 3.0-10.8, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001, Table \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e), as compared to those without kidney dysfunction. Patient nationality and other comorbidity related risk factors such as heart disease, hypertension, and diabetes did not significantly alter the odds (adjusted OR) for the survival of Covid19 patients in our study. Additionally, the majority of patients were not treated with antibiotics (70%, 2154/3072), those severely ill received Augmentin, Tazocin, Amoxicillin and Doxycycline. Less than 10% (7.2%, 224/3072) of the patients did not receive any antiviral therapy, others received hydroxyquinoline and Favipiravir as monotherapy, or in combination (data not shown).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab4\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eOdds ratio (crude and adjusted) for predicting the association between critical patient characteristics and comorbidities against mortality for Covid19 infection\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eCharacteristics\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eGroup\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"3\" align=\"left\"\u003e\n\u003cp\u003eCrude\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"3\" align=\"left\"\u003e\n\u003cp\u003eAdjusted\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eOR\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eCI\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eP\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eOR\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eCI\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eP\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eAge (Years)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e18\u0026ndash;30\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e--\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e--\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e--\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e--\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e31\u0026ndash;50\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.9\u0026ndash;15.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNot Significant\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.8\u0026ndash;14.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNot Significant\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e51\u0026ndash;65\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e14.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.4\u0026ndash;58.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e12.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.9\u0026ndash;52.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026gt;\u0026thinsp;65\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e36.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e8.5-154.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e26.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5.7-123.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"3\" align=\"left\"\u003e\n\u003cp\u003eNationality\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAsia\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e--\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e--\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e--\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e--\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMiddle East Arab\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.1\u0026ndash;2.7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;0.05\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.5\u0026ndash;1.5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNot Significant\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eOthers\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.3\u0026ndash;5.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.0-4.5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNot Significant\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eHeart disease/Dyslipidemia\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e--\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e--\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e--\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e--\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.2\u0026ndash;3.7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;0.05\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.3\u0026ndash;1.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNot Significant\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eHypertension\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e--\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e--\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e--\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e--\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.4\u0026ndash;3.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.5\u0026ndash;1.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNot Significant\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eKidney disease\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e--\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e--\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e--\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e--\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e9.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5.6\u0026ndash;16.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5.7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.0-10.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eDiabetes Mellitus\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e--\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e--\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e--\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e--\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.8\u0026ndash;4.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.8\u0026ndash;2.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNot Significant\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e"},{"header":"Discussion","content":" \u003cp\u003eThe UAE was exposed to other coronavirus epidemics, such as the Severe Acute Respiratory Syndrome (SARS) outbreak in 2002 and the spread of Middle East Respiratory Syndrome (MERS) in 2012 [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. In spite, limited information about patient characteristics and clinical management of the epidemics are available [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. The UAE is the second worst affected country, among the GCC countries, by the Covid19 disease, preceded by Saudi Arabia with a total of 361,000 positive cases and approximately 6000 deaths [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Men were disproportionately affected by Covid19 as compared to women, less that one quarter of the Covid19 patients were women in our study [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Higher neutralizing antibodies, smaller lung size, lower chance of immune dysregulation and the differential expression of the angiotensin-converting enzyme 2-the viral receptor, are postulated to contribute to the gender difference in Covid19 infectivity [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. A large proportion of the UAE population are Asian, especially the South East Asian\u0026rsquo;s from Pakistan, India, Bangladesh, Sri Lanka, Philippines and Nepal [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. A vast majority of the South East Asian workforce are laborers who often live-in crowded housing conditions, and are at a higher risk for contracting communicable diseases [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e] thus explaining the higher Covid19 infectivity amongst the Asian population (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Lower social status is also reported to be a risk factor for Covid19 infection [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. A national cohort study of over 7000 subjects has shown that diabetes, impaired fasting glucose, hypercholesterolemia, and hypertension are highly prevalent in young adulthood in the UAE [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Comorbidities such as diabetes and hypertension were observed in more than one quarter of our Covid19 patients, supporting earlier observations reported by Guan [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e] and Xu [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e], that patients with diabetes and hypertension were at a higher risk for severe Covid19. Despite the fact that the Asian population was the most Covid19 infected, their mortality rate (2.6%, Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e) was the lowest compared to the Middle East Arabs (4.3%, Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e) and other combined nationalities from the Americas, Europe and Africa (6.3%, Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Similar mortality rates from Covid19 disease between the Asian population and the Caucasian white population was observed in the United States [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. The observed mortality rates were almost 1.7 times lower than that for the Black and Hispanic population [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eDespite the myriad of comorbidities for Covid19 patients observed in our study, kidney disease, heart disease, diabetes and hypertension, significantly contributed to the mortality rates (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). Almost, two-fold increase in mortality rate was observed for Covid19 patients with heart disease, diabetes and hypertension, when compared with the patients without these comorbidities (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). An eight-fold increase (19.4%, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) in mortality rate was observed in Covid19 patients with kidney disease, as compared to those without kidney disease (2.4%). Odds Ratio estimation further validated that kidney disease as a comorbidity significantly diminished the survival rates for Covid19 patients (Crude OR 9.6, Confidence Interval 5.6\u0026ndash;16.6, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and (Adjusted OR 5.7, Confidence Interval 3.0-10.8, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001, Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e), as compared to those without kidney dysfunction. Gansevoort \u0026amp; Hilbrands, recently demonstrated that Covid19 patients with kidney dysfunction had higher rates of mortality, when compared to the patients with heart disease, diabetes and hypertension comorbidities [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Advanced ages of Covid19 patients between 51 and 65 years, significantly decreased the odds for survival (Adjusted OR 12.3, Confidence Interval 2.9\u0026ndash;52.4, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and patient age beyond 66 years significantly enhanced mortality (Adjusted OR 26.6, Confidence Interval 5.7-123.8, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). Advancing age may also be associated with various comorbidities and therefore older patient age has been noted as an independent risk factor for Covid19 mortality [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eInterestingly, despite the lower social status of the immigrant labourers and, the multicultural and multi-ethnic patient population in our study, the observations are in accordance with the previously published reports from other Covid19 disease affected countries [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. The strengths of the study is the facts that this is the first report describing patient characteristics and outcomes for Covid19 patients from the UAE, and the data was collected from Covid19 patients hospitalized at the only two public hospitals in Al Ain, that catered to more than 98% of the total positive Covid19 case load. Our study has several limitations: a) the data for the study was retrospectively collected from pre-recorded patent medical records making it difficult to assess any temporal relationships between the variables; b) the retrospective design of the study enables assessment of association and not causation; c) other confounding factors may have been overlooked, and d) although 85.8% of the Covid19 patients had some social habit (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e), the risk did not affect their survival (2.6 Vs 2.4, Social Habit Vs No Social Habit, Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e), the reasons for which need to be investigated. Data abstraction by multiple abstractors blinded to the study hypothesis and assessment of interrater reliability for the data collected helped to prevent selection bias.\u003c/p\u003e \u003cp\u003eIn summary, our study highlights that although Asian population was the highest infected by Covd19, their mortality rate was low (2.6%), compared to other nationalities. Older ages above 51 years decreased the odds of survival significantly. Despite other comorbidity risks, kidney dysfunction contributed to enhanced mortality by over eight-fold and reduced the odds of survival (Adjusted OR 26.6), compared to those patients without kidney dysfunction. Our findings are important in the management of the Covid19 disease in the region with similar economic, social, cultural and ethnic background.\u003c/p\u003e "},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was not supported by funds or grants. No funding sources to declare.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and/or analyzed during the current study ae not publicly available due to the institutions policy to code and archive data in a central repository of the hospital, but are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eObtaining written informed consents were exempted by the central human research ethics committee at the department of health Abu Dhabi, for retrospective review of patient charts. No personal identifying information was collected for the patients, both subject privacy and patient data confidentiality was strictly adhered to in accordance with the international and national guidelines.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eICH-GCP Guidelines and Research Ethics approval: \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe methods of the study were carried out in accordance with the International Conference for Harmonization (ICH), and Good Clinical Practice guidelines, and any other local and national guidelines from the Department of Health, Abu Dhabi, UAE. The study obtained research ethics approval from the Department of Health, Abu Dhabi, centralized research ethics committee.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors are thankful to the management of Tawam Hospital and the Al Ain hospital for providing the time to conduct the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contribution Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConcept and design (SCN, HIG). Feasibility Assessment (AAK, INK, AAS), Patient Care (HIG, AAK, AAS) Literature Search \u0026amp; Updates (AAS, SCN, AAK, INK), Data Acquisition \u0026amp; Organization (INK, HIA, AAS, AHA, ARS, ARA, AIS, MMF, ARA, AMH, KMB, HBC, MNA, SSA, MAA, FAS, RSS, FWH, AWA, WFD), Data Analysis (JS, AAK, HIG, INK, SCN), Data Interpretation (SCN, HIG, AAK), Manuscript Preparation (SCN, AAK, HIG), Manuscript Review \u0026amp; Approval (all authors).\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eZhu H., Wei L, Niu, P. The novel coronavirus outbreak in Wuhan, China.\u0026nbsp;Global health research and policy 2020,\u0026nbsp;5, 135-136.\u003c/li\u003e\n\u003cli\u003eCucinotta D, Vanelli M. WHO Declares COVID-19 a Pandemic. Acta Biomed. 2020, Mar 19;91(1):157-160.\u003c/li\u003e\n\u003cli\u003eSinghal T. A Review of Coronavirus Disease (COVID-19).\u0026nbsp;Indian journal of pediatrics,\u0026nbsp;2020, 87(4), 281\u0026ndash;286.\u003c/li\u003e\n\u003cli\u003e\u003ca href=\"https://www.worldometers.info/coronavirus/?fbclid=IwAR2RSsOMsu6XxMiOJ1WHNcSfC2TCYYrj4a0bUMdJW3VUXwSrj3WSNSCxY0Q\"\u003ehttps://www.worldometers.info/coronavirus/?fbclid=IwAR2RSsOMsu6XxMiOJ1WHNcSfC2TCYYrj4a0bUMdJW3VUXwSrj3WSNSCxY0Q\u003c/a\u003e Accessed on December 20, 2020\u003c/li\u003e\n\u003cli\u003eNair SC, Ibrahim H, Celentano DD. Clinical trials in the Middle East and North Africa (MENA) Region: grandstanding or grandeur? Contemp Clin Trials. 2013, 36:704-10.\u003c/li\u003e\n\u003cli\u003eIbrahim H, Kamour AM, Harhara T, Gaba WH, Nair SC. Covid-19 pandemic research opportunity: Is the Middle East \u0026amp; North Africa (MENA) missing out? Contemp Clin Trials. 2020, 96:106-110.\u003c/li\u003e\n\u003cli\u003e\u003ca href=\"https://www.arabianbusiness.com/politics-economics/407542-revealed-the-importance-of-china-to-uae-businesses\"\u003ehttps://www.arabianbusiness.com/politics-economics/407542-revealed-the-importance-of-china-to-uae-businesses\u003c/a\u003e Accessed December 20, 2020\u003c/li\u003e\n\u003cli\u003eZattar MT Charting the UAE\u0026rsquo;s battle against Covid19 (commentary) published online 7\u003csup\u003eth\u003c/sup\u003e August 2020, doi:10.1038/nmiddleeast.2020.84 \u003ca href=\"https://www.natureasia.com/en/nmiddleeast/article/10.1038/nmiddleeast.2020.84\"\u003ehttps://www.natureasia.com/en/nmiddleeast/article/10.1038/nmiddleeast.2020.84\u003c/a\u003e Accessed December 2 2020\u003c/li\u003e\n\u003cli\u003eOrganization of Economic Cooperation \u0026amp; Development, October 19 2020, \u003ca href=\"http://www.oecd.org/coronavirus/policy-responses/what-is-the-impact-of-the-covid-19-pandemic-on-immigrants-and-their-children-e7cbb7de/\"\u003ehttp://www.oecd.org/coronavirus/policy-responses/what-is-the-impact-of-the-covid-19-pandemic-on-immigrants-and-their-children-e7cbb7de/\u003c/a\u003e Accessed December 18, 2020\u003c/li\u003e\n\u003cli\u003eMcHugh M. L. (2012). Interrater reliability: the kappa statistic.\u0026nbsp;Biochemia medica,\u0026nbsp;22(3), 276\u0026ndash;282.\u003c/li\u003e\n\u003cli\u003eSzumilas M. (2010). Explaining odds ratios.\u0026nbsp;Journal of the Canadian Academy of Child and Adolescent Psychiatry 19(3), 227\u0026ndash;229.\u003c/li\u003e\n\u003cli\u003eAlkendi F, Nair SC, Hashmey R. Descriptive Epidemiology, Clinical Characteristics and Outcomes for Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Infected Patients in AlAin \u0026ndash; Abu Dhabi Emirate. J Infect Public Health 2019, 12 (1) 37-42.\u003c/li\u003e\n\u003cli\u003eHui DS, Memish ZA, Zumla A. Severe acute respiratory syndrome vs. the Middle East respiratory syndrome. Curr Opin Pulm Med. 2014 May;20(3):233\u003c/li\u003e\n\u003cli\u003e\u003ca href=\"https://www.reuters.com/article/uk-health-coronavirus-gulf/gcc-countries-surpass-1-million-covid-19-cases-reuters-tally-idUKKBN283153%20Accessed%20December%2010%202020\"\u003ehttps://www.reuters.com/article/uk-health-coronavirus-gulf/gcc-countries-surpass-1-million-covid-19-cases-reuters-tally-idUKKBN283153 Accessed December 10 2020\u003c/a\u003e\u003c/li\u003e\n\u003cli\u003eSharma, G., Volgman, A. S., \u0026amp; Michos, E. D. Sex Differences in Mortality From COVID-19 Pandemic: Are Men Vulnerable and Women Protected?.\u0026nbsp;JACC. Case reports,\u0026nbsp;2020, 2(9), 1407\u0026ndash;1410.\u003c/li\u003e\n\u003cli\u003eFalahi, S., \u0026amp; Kenarkoohi, A. (2020). Sex and gender differences in the outcome of patients with COVID-19.\u0026nbsp;\u003cem\u003eJournal of medical virology\u003c/em\u003e, 10.1002/jmv.26243. Advance online publication. \u003ca href=\"https://doi.org/10.1002/jmv.26243\"\u003ehttps://doi.org/10.1002/jmv.26243\u003c/a\u003e\u003c/li\u003e\n\u003cli\u003eSulaiman, N., Elbadawi, S., Hussein, A., et al. Prevalence of overweight and obesity in United Arab Emirates Expatriates: the UAE National Diabetes and Lifestyle Study.\u0026nbsp;Diabetology \u0026amp; metabolic syndrome 2017, 9, 88-91.\u003c/li\u003e\n\u003cli\u003ePatel JA, Nielsen FBH, Badiani AA, et al.. Poverty, inequality and COVID-19: the forgotten vulnerable. Public Health. 2020 Jun;183:110-111.\u003c/li\u003e\n\u003cli\u003eSegerstrom SC, Miller GE. Psychological stress and the human immune system: a meta-analytic study of 30 years of inquiry. Psychol Bull. 2004 Jul;130(4):601-30.\u003c/li\u003e\n\u003cli\u003eAlzaabi A., Al-Kaabi J., Al-Maskari F., Farhood, AF., Ahmed, L. A.Prevalence of diabetes and cardio-metabolic risk factors in young men in the United Arab Emirates: A cross-sectional national survey.\u0026nbsp;\u003cem\u003eEndocrinology, diabetes \u0026amp; metabolism\u003c/em\u003e,\u0026nbsp;2019, \u003cem\u003e2\u003c/em\u003e(4), e00081\u003c/li\u003e\n\u003cli\u003eGuan WJ, Ni ZY, Hu Y, et al; China Medical Treatment Expert Group for Covid-19. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020 Apr 30;382(18):1708-1720.\u003c/li\u003e\n\u003cli\u003eXu Z, Shi L, Wang Y, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020 Apr;8(4):420-422. Erratum in: Lancet Respir Med. 2020 Feb 25\u003c/li\u003e\n\u003cli\u003e\u003ca href=\"https://www.apmresearchlab.org/covid/deaths-by-race\"\u003ehttps://www.apmresearchlab.org/covid/deaths-by-race\u003c/a\u003e Accessed December 2 2020\u003c/li\u003e\n\u003cli\u003eGansevoort RT, Hilbrands LB. CKD is a key risk factor for COVID-19 mortality. Nat Rev Nephrol. 2020 Dec;16(12):705-706.\u003c/li\u003e\n\u003cli\u003eHo FK, Petermann-Rocha F, Gray SR, et al. (2020) Is older age associated with COVID-19 mortality in the absence of other risk factors? General population cohort study of 470,034 participants. PLoS ONE 15(11): e0241824.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Gulf, United Arab Emirates, Infectious Disease, Kidney Disease, Mortality","lastPublishedDoi":"10.21203/rs.3.rs-243317/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-243317/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eDespite previous exposure to coronavirus epidemics a few years ago, limited clinical and epidemiological information is available from the United Arab Emirates (UAE). The UAE is the second most affected country amongst the Gulf Cooperation Council Countries by Covid19. Distinctly, the UAE has a population of almost 9.2\u0026nbsp;million, with fewer than 12% UAE nationals, and the rest immigrants, mainly unskilled labourers. The disparate socio-economic structure, crowded housing conditions, multi-ethnic, multicultural population offers a unique set of challenges in Covid19 disease management.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eIn order to assess patient characteristics and survival for patients infected with Covid19, electronic patient data was retrospectively abstracted from the medical records of two designated public Covid19 referral hospitals, and subjected to statistical analysis.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eFrom, the total of 3072 patients, less than one-fifth were females, the Asian population (71.2%), followed by Middle Eastern Arabs (23.3%) were the most infected by the virus. Mortality was low among the Asian population. Diabetes Mellitus (26.8%, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), hypertension (25.7%, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and heart disease (9.6%, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01) were the most prevalent comorbidities observed and decreased survival by 2\u0026ndash;3 fold. Kidney disease escalated mortality rate by almost eight-fold high (19.4%, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), as compared to patients without kidney disease. Higher age of patients between 51 and 65 years, significantly decreased the odds for survival (Crude OR 14.1, p\u0026lt;,0.001) and (Adjusted OR 12.3, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and patient age beyond 66 years, further significantly decreased the odds for survival (Crude OR 36.1, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and (Adjusted OR 26.6,p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Kidney disease as comorbidity significantly diminished the survival rates (Crude OR 9.6,p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and (Adjusted OR 5.7, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), as compared to those without kidney dysfunction.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eAlthough Asian population was the highest infected by Covd19, their mortality rate was low (2.6%), compared to other nationalities. Older ages above 51 years decreased the odds of survival significantly. Despite other comorbidity risks, kidney dysfunction contributed to enhanced mortality by over eight-fold and reduced the odds of survival (Adjusted OR 26.6), compared to those patients without kidney dysfunction. Our findings are important in the management of the Covid19 disease in the region with similar economic, social, cultural and ethnic background.\u003c/p\u003e","manuscriptTitle":"Higher Mortality from Covid19\u0026nbsp;in Patients with Renal Dysfunction in A Multicultural Multi-Ethnic Population","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2021-02-26 20:31:47","doi":"10.21203/rs.3.rs-243317/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"24673030-7fb6-4803-ac3c-90a1d9d9dce4","owner":[],"postedDate":"February 26th, 2021","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":2644183,"name":"Health Economics \u0026 Outcomes Research"},{"id":2644184,"name":"Infectious Diseases"},{"id":2644185,"name":"Health Policy"}],"tags":[],"updatedAt":"2021-02-26T20:31:48+00:00","versionOfRecord":[],"versionCreatedAt":"2021-02-26 20:31:47","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-243317","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-243317","identity":"rs-243317","version":["v1"]},"buildId":"cBFmMYwuxLRRLfASyISRj","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}