Bright and Dark Aspects of COVID-19 in the UAE: A Cross-Sectional study

Introduction
The global repercussions of the COVID-19 pandemic were triggered by the identification of Acute Respiratory Syndrome Coronavirus 2 in Wuhan, China. In March 2020, the World Health Organization (WHO) officially classified it as a pandemic due to its widespread infection rate and high mortality rate worldwide1. Several studies unveiled a major gap in the recorded number of deaths, undermining the widely accepted scale of the pandemic2. The United Arab Emirates (UAE) achieved a reduced mortality rate as a result of prompt emergency response systems and the implementation of travel restrictions3. The negative consequences encompassed post-traumatic stress disorder, psychosocial consequences, and body image concerns. Gender-based disparities in mental health issues were observed, with females exhibiting elevated affective symptoms4.

The pandemic has also brought favorable aspects, such as heightened consciousness of public health protocols, enhanced hand hygiene practices, and ecological advantages resulting from reduced emissions. It has significantly changed multiple facets of life, emphasizing the need for extensive research and an understanding of its diverse effects. The UAE demonstrated commendable responsiveness to the COVID-19 pandemic, swiftly implementing effective measures that yielded favorable results. Lockdowns led to notable environmental enhancements, such as decreased pollution and waste. E-commerce flourished, demonstrating technological expertise, while online learning, despite obstacles, offered benefits5,6. The nation actively participated in clinical research and vaccination, demonstrating a strong dedication to scientific advancement7.

Despite numerous positive findings, there remains limited information regarding its specific impact on the depth of knowledge concerning respiratory infections and the ensuing influence on individuals' behaviors in relation to respiratory infections. The UAE's expatriates, grappled with economic uncertainties, intensifying anxiety about job loss, and financial struggles. They also experienced negative transformations in physical appearance and self-perception by developing habits such as increased dietary intake, weight gain, decreased physical activity, increased smoking, and decreased sleep8. Frontline workers faced heightened stress, and patients experienced anxiety and depression during hospitalisation. Students, teachers, and administrators faced challenges adapting to the new learning environment, and despite efforts, the psychological impact persisted, reflecting the enduring stress related to health concerns, unemployment fears, and limitations on international travel9. Various factors precipitated an escalation in anxiety, stress, and negative mental health among individuals. Notably, limited travel, prolonged durations spent at home, and the concomitant anxiety and stress levels engendered a cascade of detrimental habits. It is imperative to elucidate the repercussions of COVID-19 on individuals' body perception and self-image.

Nevertheless, the UAE sustained its global competitiveness and demonstrated its ability to adapt to unforeseen changes. The response serves as a worldwide illustration, highlighting the significance of tackling mental health, educational difficulties, and non-COVID health issues in pandemic responses.

Objectives of the study

1. To compare the incidence and change in knowledge of respiratory infections before and after COVID-19 in the general population of UAE.

2. To compare the changes in self-esteem and body perception before and after COVID-19 in the general population of UAE.

 
Materials and Methods

A cross sectional survey was conducted on adults within the general population of the UAE. The survey consisted of exactly 466 respondents. Prior to commencing the study, ethical permission was obtained from the University Institutional Review Board (IRB) and the survey was validated by three experts. Upon receiving authorization, data was collected. Prior to completing the questionnaire, all participants were obligated to sign a consent form affirming their understanding of the study's confidentiality agreement and having the option to withdraw at any time. In addition, the study ensured the preservation of participants' personal identity by maintaining anonymity. Participants were required to be at least 18 years old in order to partake in the survey. The self-administered questionnaire was used to collect socio-demographic information to ensure that the sample was broadly representative of the general population of the UAE. The questionnaire additionally gathered data regarding personal hygiene practices, frequency of mask utilisation, occurrence of respiratory infections, details on self-esteem, and perception of body image.

The assessment of self-esteem and body perception involved a series of closed-ended questions that were derived from a modified combination of the Rosenberg scale of self-esteem and the Body Image scale. Descriptive statistics were used to determine the percentage and frequency of respiratory infections that occurred as well as participants’ self-esteem and body perception before and after the pandemic of COVID-19. A chi-square test was performed to ascertain the association between age, gender, and education in relation to the knowledge of transmission of respiratory infections. The Statistical Package for Social Sciences (SPSS) application was utilised to analyse the data collected.

Results

The study comprised 466 participants, with 57.7% being females and 42.3% males. The age distribution included 20% in the 18-20 age group, 40% in the 20-25 range, 12.4% aged 26-35, and around 27.5% older than the age of 35. Educationally, 12.9% were high school graduates, 61.4% held a bachelor's degree, and 25.8% had a postgraduate degree. Nationality distribution showed 47.7% from the South-East Asian Region, 40.4% from the East Mediterranean Region, and smaller percentages from other regions. Geographically, 42.1% of participants were located in Sharjah, 29.0% in Ajman, 8.8% in Abu Dhabi, and the rest in other emirates. Regarding occupation, 53.9% were No Collar, 21.0% White Collar, 8.6% Pink Collar, 3.4% Blue Collar, 0.2% Red Collar, and 12.9% were retired.

Figure No. 1: Frequency Distribution of Sociodemographic Variables

The study assessed the frequency of respiratory symptoms before and after COVID-19. Initially, 20.8% had no fever, decreasing to 15.5% after COVID-19. Cough increased from 55.4% to 62.4%, with a decrease in those coughing four-to-six times or more after COVID-19. Sore throat occurrences rose from 52.8% to 55.4%, and runny nose occurrences remained relatively stable. More participants reported no stuffy nose or only one-to-three instances after COVID-19. Headache frequency slightly increased, with 36.7% having one to three headaches before and 42.3% after COVID-19. Body aches and dyspnea occurrences varied, with a marginal rise in difficulty breathing after COVID-19. Loss of taste or smell instances increased post-COVID-19.

Table No.1: Frequency of Symptoms Before and After COVID-19