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Objectives: To investigate the impact of COVID-19 vaccines in the United Arab Emirates (UAE) on the trend of COVID-19-related hospitalization, intensive care unit (ICU) admissions, and case fatality rate (CFR), this retrospective chart review was conducted. background: Real-world evidence from the Middle East about the effectiveness of COVID-19 vaccination is still lacking. Methods: We included patients admitted to two tertiary hospitals from October 2020 to July 2022. Patients were categorized into non-vaccinated, partially-vaccinated, and fully-vaccinated groups. objective: To investigate the impact of COVID-19 vaccines in the United Arab Emirates (UAE) on the trend of COVID-19-related hospitalization, intensive care unit (ICU) admissions, and case fatality rate (CFR), this retrospective chart review was conducted. Results: A total of 2277 cases were included, with 27.49% being non-vaccinated. The monthly trend of admitted patients dropped from 1264 (56.50%) cases in the first half of 2021 to 194 (8.67%) cases in the first half of 2022, with a reduction rate of 84.65%. The trend of ICU admission followed the overall hospital admission rate, with an overall CFR of 0.88%, 95% CI (0.54% to 1.35%), and a virulence rate of 1.76%, 95% CI (1.26% to 2.38%). The incidence of ICU admission in the unvaccinated group was 4.79%, compared to 0% and 0.97% in the partially-vaccinated and fully-vaccinated groups, respectively (p Conclusion: Among the study population, COVID-19 vaccines showed promising efficacy in reducing the trend of COVID-19-related hospitalization, ICU admission, and mortality. Full vaccination might reduce the burden of COVID-19 on healthcare. result: A total of 2277 cases were included, with 27.49 other: None

In the United Arab Emirates (UAE), lung cancer (LC) was the third leading cause of deaths due to cancer in 2017. Around 80% of the patients in the UAE are diagnosed at a late stage, rendering the treatment less effective in improving survival outcomes. Lack of awareness of disease symptomatology, deficient screening initiatives, misdiagnosis, and delayed referral to the specialist are contributing factors for delayed diagnosis. Effective screening at a primary care setting can be crucial for early diagnosis, referral to specialists, and enhancing patient outcomes. It is important to establish screening and referral guidelines through which each suspected case can be identified and provided timely intervention. Although the international screening and referral pathway framework are comprehensive, several regional barriers need to be addressed before they can be adapted at the national level. A group of LC experts from the UAE deliberated on issues like delayed diagnosis of LC and strategic recommendations for overcoming the challenges. The discussion was based on the review of the published evidence, international and regional guidelines for screening and early diagnosis of LC. Herein, we present a guideline, endorsed by the esteemed panel of experts, for aiding early diagnosis and optimizing the management of LC in the UAE.

The prevalence and incidence of asthma are increasing globally because of genetic and environmental influences. Prevalence of asthma in the Gulf has been reported to range from 4.7% to 32.0% and has a substantial economic burden. In this paper, we summarize current asthma management guidance for adults, present insights, and recommendations by key opinion leaders (KOLs) in the Gulf region, and key performance indicators for guiding clinical practice for asthma diagnosis, management, and treatment in the Gulf. While it is recommended that the Global Initiative for Asthma (GINA) guidelines should be followed wherever possible for the management of asthma, KOLs in the Gulf region have presented additional recommendations based on regional challenges and insights. There is a need for better diagnosis using objective testing, increased efforts in tackling the burden of comorbidities in the region, and greater provision of the necessary tools for phenotyping severe asthma. Furthermore, there is a need for greater education for physicians regarding asthma treatment, including the importance of inhaled-corticosteroid-containing controller medication. Regionally, there is also a need for specialist asthma clinics and asthma educators, which would serve to educate physicians and their patients as well as to improve the management of patients. Finally, the use of asthma registries, digital devices, and electronic templates would be of benefit in the management of asthma patients in the region.

Low levels of adherence to asthma medication is reported in many countries worldwide. Improved knowledge of adherence in the Middle East and North Africa (MENA) is needed to address this major public healthcare burden.Assess the level of adherence in patients attending a routine consultation and the relationship between adherence, patient/disease characteristics, disease control, and quality of life.A large-scale cross-sectional epidemiological study was performed on adults suffering from asthma for at least 1 year and without an acute asthma episode within 4 weeks. Adherence was assessed using the MMAS-4 questionnaire©. Predictive factors of adherence were analyzed with logistic regressions.Overall 7203 eligible patients were included in 577 sites. Mean age was 45.4 years (±14.7), 57.2% were female, mean BMI was 28.5 kg/m2 (±6.0), and 11% were active smokers. Good adherence was observed in 23.6% with a country effect (p 0.001). Higher age, higher SF-8 Mental component score, and high level of control were associated with good adherence (p 0.001). Patients treated with a fixed combination (ICS + LABA) have better adherence and patients treated with short-acting beta agonist alone have a lower adherence. Good adherence has been noted in 528 uncontrolled patients suggesting the existence of a subgroup difficult to treat and who have severe asthma.Asthma adherence in the MENA is unsatisfactory with less than one quarter of asthma patients having good adherence. This finding highlights the need to improve access to treatment, ensure better control follow-up and improved education among healthcare providers and patients.

Bassam H Mahboub,1,2 Mayank Gian Vats,2 Ashraf Al Zaabi,3 Mohammed Nizam Iqbal,2 Tarek Safwat,4 Fatma Al-Hurish,5 Marc Miravitlles,6 Dave Singh,7 Khaled Asad,8 Salah Zeineldine,9,10 Mohamed SAl Hajjaj11College of Medicine, University of Sharjah, Sharjah, 2Department of Pulmonary Medicine, Rashid Hospital, Dubai Health Authority, Dubai, 3Department of Pulmonary Medicine, Zayed Military Hospital, Abu Dhabi, United Arab Emirates; 4Chest Department, Ain Shams University, Cairo, Egypt; 5Department of Pulmonology and Allergy, Al-Sabah Hospital, Kuwait City, Kuwait; 6Department of Pneumology, Hospital Universitari Vall d’Hebron, Barcelona, Spain; 7Centre for Respiratory Medicine and Allergy, University of Manchester, University Hospital of South Manchester, Manchester, UK; 8Pulmonary and Critical Care, Istishari Hospital, Amman, Jordan; 9Faculty of Medicine, 10Hariri School of Nursing, American University of Beirut, Beirut, Lebanon Abstract: Smoking and subsequent development of COPD is an ever-increasing epidemic in Arabian Gulf and Middle East countries, with no signs of decline. The important fact to be highlighted is that this COPD epidemic of increasing incidence and prevalence is mostly unrecognized by patients, due to the common attribution of symptoms to “smoker’s cough”, and the underdiagnosis and undertreatment by physicians because the common signs and symptoms masquerade as asthma. Consequently, there are long-term adverse effects of missing the diagnosis. Thepurpose of this review article is to focus upon the status of COPD in Arabian Gulf and Middle East countries, stressing the increasing burden of smoking and COPD, to emphasize the specific factors leading to rise in prevalence of COPD, to bring to light the underdiagnosis and undermanagement of COPD, and to treat COPD in conformity with standard guidelines with local and regional modifications. This review ends with suggestions and recommendations to the health department to formulate policies and to generate awareness among the general public about the side effects of smoking and consequences of COPD. Keywords: COPD, Gulf Cooperation Council countries, Middle East, prevalence of smoking, water pipe, shisha, medwakh, bakhour

A pandemic of obesity is sweeping all across the globe and the Middle East region also does not remain untouched by this prevailing pandemic. In fact, as per WHO report, Kuwait has the second highest obesity prevalence followed closely by other Middle East (ME) countries, namely, Qatar, Saudi Arabia, and United Arab Emirates (UAE). Apart from direct medical, psychological, and quality of life related adverse effects of obesity, many indirect medical comorbidities, namely, obstructive sleep apnea (OSA), obesity hypoventilation syndrome (OHS), diabetes mellitus (DM), hypertension (HTN), and metabolic syndrome, imposes a significant health burden on the individual and community with consequent morbidity and mortality. The purpose of this review is to shed light on the very high prevalence of obesity, undiagnosed sleep apnea, and other obesity related disorders with discussion of the contributing factors specific to the region including the fair insight into the current status of sleep medicine services in Middle East and UAE despite huge number of patients having undiagnosed sleep disorders. We will also suggest to control this epidemic of obesity and OSA so that the corrective measure could be taken at health ministry level to help people of this region to fight against obesity and related disorders, primarily OSA.

Background Very few data exist on the management of community-acquired pneumonia (CAP) in patients admitted to hospitals in the Gulf region. The objectives of this study were to describe treatment patterns for CAP in 38 hospitals in five Gulf countries (United Arab Emirates, Kuwait, Bahrain, Oman, and Qatar) and to compare the findings to the most recent Infectious Diseases Society of America (IDSA) / American Thoracic Society (ATS) guidelines. Methods This was a prospective, observational study conducted between January 2009 and February 2011. Adult patients hospitalised (excluding intensive care units) for CAP and subsequently discharged were included. Data were collected retrospectively at hospital discharge, and prospectively during two follow-up visits. Data on medical history, mortality-risk scores, diagnostic criteria, antibiotic treatment, isolated pathogens and clinical and radiographic outcomes were collected. Care practices were compared to the IDSA/ATS guidelines. Results A total of 684 patients were included. The majority (82.9 %) of patients were classified as low risk for mortality (pneumonia severity index II and III). The majority of patients fulfilled criteria for treatment success at discharge, although only 77.6 % presented a normalised leukocyte count. Overall, the management of CAP in Gulf countries is in line with the IDSA/ATS guidelines. This applied to the diagnosis of CAP, to the identification of high-risk CAP patients, to the identification of etiologic agent responsible for CAP and to the type of treatment despite the fact that combinations of antimicrobial agents were not consistent with the guidelines in 10 % of patients. In all patients, information about Gram’s staining was not captured as recommended by the IDSA/ATS and in the majority of patients (>85 %) chest radiography was not systematically performed at the post-discharge follow-up visits. Discussion The management of CAP in the Gulf region is globally in line with current IDSA/ATS guidelines, although rates of pathogen characterisation and post-discharge follow-up need to be improved. Conclusion Compliance with established guidelines should be encouraged in order to improve the management of the disease in this region.

Summary Background The prevalence of chronic obstructive pulmonary disease (COPD) in Abu Dhabi, United Arab Emirates is unknown. Methods We conducted a cross-sectional survey in a random sample of individuals 40–80 years old in Abu Dhabi, with a particular interest to explore local risk factors other than cigarette smoking. Airflow limitation compatible with COPD was defined as a post-bronchodilator ratio FEV 1 /FVC Results From 520 participants surveyed (93.7% response rate), 55% male and with a mean age of 52 years, the prevalence of COPD was 3.7% and 95% C.I. (2.0–5.3). There were no differences by gender, and COPD prevalence only significantly increased in those 70 year and older. Among those with COPD, cigarette smoking use was relatively low (12% current- and 12% former-smokers), and it was even lower the use of shisha (5%), pipe (0%), or exposure to passive smoking (5%), while exposure to biomass was higher (33%). Interestingly, bakhour use was very high (78%), but neither bakhour nor any of the above-mentioned exposures were associated with the risk of COPD. Conclusions COPD prevalence in 40–80 years old in Abu Dhabi was 3.7%, and associations with cigarette smoking or with other local inhaled exposures were not observed.

Respiratory diseases affect individuals worldwide and United Arab Emirates (UAE) is no exception. The burden of respiratory diseases is varied and over the past two decades, several studies have been carried out across UAE to estimate the load of respiratory diseases in the area and compare this with the international respiratory disease burden. The purpose of the present study was to compile most of the studies conducted in UAE in order to have a panoramic view of the situation in this area. Comparison of the respiratory disease status in UAE and internationally will improve our knowledge about the situation, which will help us to implement strategies for improved respiratory care and respiratory disease outcome at a reasonable cost.