TY - JOUR
T1 - Ethnicity-Specific Features of COVID-19 Among Arabs, Africans, South Asians, East Asians, and Caucasians in the United Arab Emirates
AU - Al Zahmi, Fatmah
AU - Habuza, Tetiana
AU - Awawdeh, Rasha
AU - Elshekhali, Hossam
AU - Lee, Martin
AU - Salamin, Nassim
AU - Sajid, Ruhina
AU - Kiran, Dhanya
AU - Nihalani, Sanjay
AU - Smetanina, Darya
AU - Talako, Tatsiana
AU - Neidl-Van Gorkom, Klaus
AU - Zaki, Nazar
AU - Loney, Tom
AU - Statsenko, Yauhen
N1 - Funding Information:
The authors would like to acknowledge Mediclinic Parkview Hospital (Dubai, UAE) and UAE University (Al Ain, UAE) for the support provided and the facilities used for conducting this research.
Publisher Copyright:
Copyright © 2022 Al Zahmi, Habuza, Awawdeh, Elshekhali, Lee, Salamin, Sajid, Kiran, Nihalani, Smetanina, Talako, Neidl-Van Gorkom, Zaki, Loney and Statsenko.
PY - 2022/3/16
Y1 - 2022/3/16
N2 - Background: Dubai (United Arab Emirates; UAE) has a multi-national population which makes it exceptionally interesting study sample because of its unique demographic factors. Objective: To stratify the risk factors for the multinational society of the UAE. Methods: A retrospective chart review of 560 patients sequentially admitted to inpatient care with laboratory confirmed COVID-19 was conducted. We studied patients’ demographics, clinical features, laboratory results, disease severity, and outcomes. The parameters were compared across different ethnic groups using tree-based estimators to rank the ethnicity-specific disease features. We trained ML classification algorithms to build a model of ethnic specificity of COVID-19 based on clinical presentation and laboratory findings on admission. Results: Out of 560 patients, 43.6% were South Asians, 26.4% Middle Easterns, 16.8% East Asians, 10.7% Caucasians, and 2.5% are under others. UAE nationals represented half of the Middle Eastern patients, and 13% of the entire cohort. Hypertension was the most common comorbidity in COVID-19 patients. Subjective complaint of fever and cough were the chief presenting symptoms. Two-thirds of the patients had either a mild disease or were asymptomatic. Only 20% of the entire cohort needed oxygen therapy, and 12% needed ICU admission. Forty patients (~7%) needed invasive ventilation and fifteen patients died (2.7%). We observed differences in disease severity among different ethnic groups. Caucasian or East-Asian COVID-19 patients tended to have a more severe disease despite a lower risk profile. In contrast to this, Middle Eastern COVID-19 patients had a higher risk factor profile, but they did not differ markedly in disease severity from the other ethnic groups. There was no noticeable difference between the Middle Eastern subethnicities—Arabs and Africans—in disease severity (p = 0.81). However, there were disparities in the SOFA score, D-dimer (p = 0.015), fibrinogen (p = 0.007), and background diseases (hypertension, p = 0.003; diabetes and smoking, p = 0.045) between the subethnicities. Conclusion: We observed variations in disease severity among different ethnic groups. The high accuracy (average AUC = 0.9586) of the ethnicity classification model based on the laboratory and clinical findings suggests the presence of ethnic-specific disease features. Larger studies are needed to explore the role of ethnicity in COVID-19 disease features.
AB - Background: Dubai (United Arab Emirates; UAE) has a multi-national population which makes it exceptionally interesting study sample because of its unique demographic factors. Objective: To stratify the risk factors for the multinational society of the UAE. Methods: A retrospective chart review of 560 patients sequentially admitted to inpatient care with laboratory confirmed COVID-19 was conducted. We studied patients’ demographics, clinical features, laboratory results, disease severity, and outcomes. The parameters were compared across different ethnic groups using tree-based estimators to rank the ethnicity-specific disease features. We trained ML classification algorithms to build a model of ethnic specificity of COVID-19 based on clinical presentation and laboratory findings on admission. Results: Out of 560 patients, 43.6% were South Asians, 26.4% Middle Easterns, 16.8% East Asians, 10.7% Caucasians, and 2.5% are under others. UAE nationals represented half of the Middle Eastern patients, and 13% of the entire cohort. Hypertension was the most common comorbidity in COVID-19 patients. Subjective complaint of fever and cough were the chief presenting symptoms. Two-thirds of the patients had either a mild disease or were asymptomatic. Only 20% of the entire cohort needed oxygen therapy, and 12% needed ICU admission. Forty patients (~7%) needed invasive ventilation and fifteen patients died (2.7%). We observed differences in disease severity among different ethnic groups. Caucasian or East-Asian COVID-19 patients tended to have a more severe disease despite a lower risk profile. In contrast to this, Middle Eastern COVID-19 patients had a higher risk factor profile, but they did not differ markedly in disease severity from the other ethnic groups. There was no noticeable difference between the Middle Eastern subethnicities—Arabs and Africans—in disease severity (p = 0.81). However, there were disparities in the SOFA score, D-dimer (p = 0.015), fibrinogen (p = 0.007), and background diseases (hypertension, p = 0.003; diabetes and smoking, p = 0.045) between the subethnicities. Conclusion: We observed variations in disease severity among different ethnic groups. The high accuracy (average AUC = 0.9586) of the ethnicity classification model based on the laboratory and clinical findings suggests the presence of ethnic-specific disease features. Larger studies are needed to explore the role of ethnicity in COVID-19 disease features.
KW - COVID-19
KW - Gulf region
KW - Middle East
KW - UAE
KW - ethnicity
KW - host organism
KW - machine learning
KW - viral pneumonia
UR - http://www.scopus.com/inward/record.url?scp=85126713159&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85126713159&partnerID=8YFLogxK
U2 - 10.3389/fcimb.2021.773141
DO - 10.3389/fcimb.2021.773141
M3 - Article
C2 - 35368452
AN - SCOPUS:85126713159
SN - 2235-2988
VL - 11
JO - Frontiers in cellular and infection microbiology
JF - Frontiers in cellular and infection microbiology
M1 - 773141
ER -