Browsing by Author "ElSaban, Mariam"

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Clinical Characteristics of Children with COVID-19 in the United Arab Emirates: Cross-sectional Multicenter Study
(2021) Ennab, Farah; ElSaban, Mariam; Khalaf, Eman; Tabatabaei, Hanieh; Hassan Khamis, Amar; Saravanan, Ketharanathan; Cremonesini, David; Popatia, Rizwana; Malik, Zainab; Ho, Samuel B; Abusamra, Rania
Background: COVID-19 has infected over 123 million people globally. The first confirmed case in the United Arab Emirates (UAE) was reported on January 29, 2020. According to studies conducted in the early epicenters of the pandemic, COVID-19 has fared mildly in the pediatric population. To date, there is a lack of published data about COVID-19 infection among children in the Arabian region. Objective: This study aims to investigate the clinical characteristics, laboratory findings, treatment, and outcomes of children with COVID-19. Methods: This cross-sectional, multicenter study included children with confirmed COVID-19 infection admitted to 3 large hospitals in Dubai, UAE, between March 1 and June 15, 2020. Serial COVID-19 polymerase chain reaction (PCR) testing data were collected, and patients’ demographics, premorbid clinical characteristics, and inpatient hospital courses were examined. Results: In all, 111 children were included in our study and represented 22 nationalities. Of these, 59 (53.2%) were boys. The mean age of the participants was 7 (SD 5.3) years. About 15.3% of children were younger than 1 year. Only 4 (3.6%) of them had pre-existing asthma, all of whom had uneventful courses. At presentation, of the 111 children, 43 (38.7%) were asymptomatic, 68 (61.2%) had mild or moderate symptoms, and none (0%) had severe illness requiring intensive care. Fever (23/111, 20.7%), cough (22/111, 19.8%), and rhinorrhea (17/111, 15.3%) were the most common presenting symptoms, and most reported symptoms resolved by day 5 of hospitalization. Most patients had no abnormality on chest x-ray. The most common laboratory abnormalities on admission included variations in neutrophil count (22/111, 24.7%), aspartate transaminase (18/111, 22.5%), alkaline phosphatase (29/111, 36.7%), and lactate dehydrogenase (31/111, 42.5%). Children were infrequently prescribed targeted medications, with only 4 (3.6%) receiving antibiotics. None of the 52 patients tested for viral coinfections were positive. COVID-19 PCR testing turned negative at a median of 10 days (IQR: 6-14) after the first positive test. Overall, there was no significant difference of time to negative PCR results between symptomatic and asymptomatic children. Conclusions: This study of COVID-19 presentations and characteristics presents a first look into the burden of COVID-19 infection in the pediatric population in the UAE. We conclude that a large percentage of children experienced no symptoms and that severe COVID-19 disease is uncommon in the UAE. Various laboratory abnormalities were observed despite clinical stability. Ongoing surveillance, contact tracing, and public health measures will be important to contain future outbreaks.
COVID‐19 under 19: A meta‐analysis
(2021) Toba, Nagham; Gupta, Shreya; Ali, Abdulrahman; ElSaban, Mariam; Hassan Khamis, Amar; Ho, Samuel B; Popatia, Rizwana
Background: The coronavirus disease 2019 (COVID‐19) pandemic continues to cause global havoc posing uncertainty to educational institutions worldwide. Understanding the clinical characteristics of COVID‐19 in children is important because of the potential impact on clinical management and public health decisions. Methods: A meta‐analysis was conducted for pediatric COVID‐19 studies using PubMed and Scopus. It reviewed demographics, co‐morbidities, clinical manifestations, laboratory investigations, radiological investigations, treatment, and outcomes. The 95% confidence interval (CI) was utilized. Results: Out of 3927 articles, 31 articles comprising of 1816 patients were selected from December 2019 to early October 2020 and were defined by 77 variables. Of these studies 58% originated from China and the remainder from North America, Europe and the Middle East. This meta‐analysis revealed that 19.2% (CI 13.6%–26.4%) of patients were asymptomatic. Fever (57%, CI 49.7%–64%) and cough (44.1%, CI 38.3%–50.2%) were the most common symptoms. The most frequently encountered white blood count abnormalities were lymphopenia 13.5% (CI 8.2%–21.4%) and leukopenia 12.6% (CI 8.5%–18.3%). Ground glass opacities were the most common radiological finding of children with COVID‐19 (35.5%, CI 28.9%–42.7%). Hospitalization rate was 96.3% (CI 92.4%–98.2%) of which 10.8% (CI 4.2%–25.3%) were ICU admissions, and 2.4% (CI 1.7%–3.4%) died. Conclusion: The majority of pediatric patients with COVID‐19 were asymptomatic or had mild manifestations. Among hospitalized patients there remains a significant number that require intensive care unit care. Overall across the literature, a considerable level of understanding of COVID‐19 in children was reached, yet emerging data related to multisystemic inflammatory syndrome in children should be explored.
An Inquiry-Based Distance Learning Tool for Medical Students Under Lockdown (“COVID-19 Rounds”): Cross-Sectional Study
(2023) Akhras, Aya; ElSaban, Mariam; Selvan, Varshini Tamil; Alzaabi, Shaika Zain; Senok, Abiola; Zary, Nabil; Ho, Samuel B
Background: The COVID-19 pandemic presented significant challenges to both clinical practice and the delivery of medical education. Educators and learners implemented novel techniques, including distance learning and web-based rounds, while trying to stay updated with the surge of information regarding COVID-19 epidemiology, pathogenesis, and treatment. Hence, we designed and implemented a technologically enhanced course called “COVID-19 Rounds” to educate students about the rapidly evolving pandemic. Objective: The objectives of this study are to describe a technologically enhanced course called “COVID-19 Rounds” and evaluate the following: (1) student satisfaction and program usefulness in achieving preset objectives, (2) perceived improvement in literacy regarding the pandemic, and (3) the impact of student engagement by designing infographics and initiating COVID-19–related research projects. Methods: This is a cross-sectional study measuring the impact of the implementation of the web-based “COVID-19 Rounds” course. This program included web-based clinical experiences with physicians on actual rounds in COVID-19 wards in the hospital, weekly updates on evolving data and new research, and engagement in student-led projects. The study population included 47 fourth-year medical students at the Mohamed Bin Rashid University of Medicine and Health Sciences in Dubai, the United Arab Emirates, who attended the course. We designed and administered a 47-item survey to assess student satisfaction, program usefulness, impact on knowledge, and student engagement. Data were collected at the end of program delivery via Microsoft Forms. Results: In total, 38 (81%) out of 47 fourth-year medical students participated in this study. The final course evaluation revealed an overall high satisfaction rate, with a mean rating of 3.9 (SD 0.94) on the 5-point Likert scale. Most students were satisfied with the course format (27/38, 71%), organization (31/38, 82%), and the learning experience (28/38, 74%) that the course offered. The course was particularly appreciated for offering evidence-based talks about aspects of the pandemic (34/38, 90%), providing weekly updates regarding emerging evidence (32/38, 84%), and enhancing understanding of the challenges of the pandemic (34/38, 90%). Satisfaction with distance learning was moderate (23/37, 62%), and a minority of students would have preferred an in-person version of the course (10/37, 27%). Student engagement in the course was high. All students participated in small group presentations of infographics of pandemic-related topics. Perceived advantages included conciseness and visual appeal, and disadvantages included the lack of detail and the time-consuming nature of infographic design, especially for students with no prior design experience. After the course ended, 27 (57%) students began research projects. This resulted in 6 abstracts presented at local meetings and 8 scientific papers published or submitted for publication. Conclusions: This inquiry-based adaptive approach to educating medical students about updates on COVID-19 via web-based learning was successful in achieving objectives and encouraging engagement in research. However, shortcomings of the course related to the lack of in-person teaching and clinical activities were also highlighted.
Relevance of Anthropometric Measurements in a Multiethnic Obesity Cohort: Observational Study
(2021) ElSaban, Mariam; Nawaz, Faisal A; Hassan Khamis, Amar
Background: The prevalence of obesity is increasing worldwide, and the Middle East is not an exception to this increasing trend. Obesity increases the risk of multiple metabolic complications, such as diabetes mellitus. Measurement of obesity has primarily relied on the BMI to identify risk; however, both bedside and office-based anthropometric measures of obesity can provide more detailed information on risk. Objective: This study aimed to investigate the prevalence of obesity-related diseases in a multidisciplinary weight management population and to determine its relationship with obesity anthropometric indices. Methods: This cross-sectional study was conducted at Mediclinic Parkview Hospital (Dubai, the United Arab Emirates). In total, 308 patients have been evaluated from January to September 2019 as part of a multidisciplinary weight management program. Key demographics, anthropometrics, and clinical data were analyzed using SPSS (version 25, SPSS Inc). Results: Our cohort of 308 patients included 103 (33%) males and 205 (67%) females of 38 nationalities. The mean age of the cohort was 41 (SD 9.6) years, with a median BMI of 34.5 (IQR 6.7) and 33.7 (IQR 7.8) for males and females, respectively. The mean waist circumference (WC) was 113.4 (SD 23.3) cm and 103.5 (SD 16.2) cm, fat percentage was 33.7% (SD 11.6%) and 45% (SD 6.8%), fat mass was 41 (SD 15.2) kg and 41.1 (SD 14.1) kg, and visceral fat mass was 6.5 (SD 3.2) kg and 3.1 (SD 1.8) kg for males and females, respectively. There was a strong correlation between BMI and WC (r=0.65 and r=0.69 in males and females, respectively; P=.01) and visceral fat (r=0.78 and r=0.90 in males and females, respectively). Furthermore, visceral fat was significantly associated with WC in both sexes (r=0.73 and r=0.68 in females and males respectively; P=.01). Furthermore, WC was significantly associated with a risk of diabetes, hypertension, and nonalcoholic fatty liver disease. Conclusions: BMI and WC are the most representative measures of obesity in our population and correlate with abdominal adiposity– and obesity-related diseases. Further studies are required to assess the benefits of these measures during weight reduction interventions.