Background Coronavirus disease-2019 (COVID-19) has infected over 20 million people globally. The first confirmed case in the United Arab Emirates (UAE)  was reported on 29th  January 2020. To date there is no published data about COVID-19 infection among children in the  Arabian region. Objective To describe the epidemiologic, clinical and laboratory characteristics of children hospitalized with COVID-19 infection in Dubai, UAE Methods A cross-sectional multicentre study of children with confirmed COVID-19 infection admitted between March 1st and June 15th, 2020  to three large hospitals in Dubai, UAE. Their demographics, clinical characteristics and inpatient hospital course were investigated. Results 111 children were included in our study and represented 22 nationalities. Fifty-nine (53.2%) were boys. The mean age was 7 years, with 15.3% younger than 1 year. At presentation 43 (38.7%) were asymptomatic, 68 (61.2%) had mild or moderate symptoms and none had severe symptoms. Fever, cough and rhinorrhoea were common presenting symptoms and resolved by day 5 of hospitalization. Most of our patients had no abnormality on chest x-ray. The most common laboratory abnormalities on admission included variations in neutrophil count (24.7%), aspartate transaminase (22.5%), alkaline phosphatase (36.7%) and lactate dehydrogenase (42.5%). COVID-19 PCR turned negative at a median of 10 days after first positive. There was no significant difference to time of negative PCR between symptomatic and asymptomatic children. Conclusion A large percentage of children with COVID19 experience no symptoms, and severe disease is uncommon in the UAE. Ongoing surveillance and contact tracing will be important to contain future outbreaks.

Tobacco in any form is harmful. There is an alarming increase consumption of Alternative Tobacco Products (ATPs). Midwakh is one of the most used ATP in UAE, particularly amongst adolescents. In addition to harmful levels of cobalt, chromium, cadmium, Iron and lead, Midwakh has higher nicotine and tar content when compared to shisha and cigarettes. We report a 14-year-old adolescent male, who presented with Acute Lung Injury within 24 hours following a first attempt of Midwakh smoking, a presentation remarkably similar to E-Cigarettes or Vaping Associated Lung Injury. A high-resolution computerized tomogram of the chest (HRCT) showed bilateral interstitial pneumonia with ground glass appearance and patchy consolidation. A flexible bronchoscopy revealed bilateral petechial hemorrhages with erythematous bronchial walls. Mechanical ventilation was required for two weeks with high ventilatory settings due to poor lung compliance. The criteria for moderately severe ARDS was met, and a good response was achieved to a high dose of steroids, prone ventilation with ultra-short lung protective strategy. Initial spirometry tests done post extubation were compatible with severe restrictive lung disease. Significant clinical and radiological recovery was achieved at three months. To our knowledge and as per the literature reviewed, this is the first case of Midwakh associated acute lung injury reported till date. We wish to emphasize that physicians should be well informed about the use of ATPs, both existing and emerging ones and its potential severe complications.