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Background COVID-19 has caused substantial mortality worldwide, with significant economic consequences. In countries with segmented labour markets, such as Kuwait—where most citizens work in the public sector and most non-Kuwaitis occupy high-exposure essential jobs—the economic impact of premature mortality could be considerably high and these losses may differ across population groups. No prior study in the Gulf region has quantified these losses using established valuation methods. Methods We conducted a retrospective analysis of all confirmed COVID-19 deaths in Kuwait between 2020 and 2022. Years of Potential Life Lost (YPLL) was calculated to measure the epidemiological burden of premature mortality. The economic cost of premature mortality was estimated from a societal perspective using three approaches: the Value of Statistical Life (VSL), the Human Capital Approach (HCA), and the Friction Cost Approach (FCA). Consumption, wage, and employment parameters were drawn from national 2021 surveys, and all estimates were expressed in 2021 international dollars (PPP$). Sensitivity analyses assessed the influence of key assumptions for each method. Results A total of 2,891 COVID-19 deaths occurred during the study period, resulting in approximately 68,000 YPLL, of which 61% were among non-Kuwaitis. Mortality among non-Kuwaiti males was concentrated in working ages, while Kuwaiti deaths occurred primarily in older adults. The total economic burden of premature mortality was estimated at 10.4 billion PPP$ using VSL, 548 million PPP$ using HCA, and 33 million PPP$ using FCA. Kuwaitis accounted for a larger share of VSL and HCA losses, whereas non-Kuwaitis bore the greatest share of YPLL and HCA losses in working ages. Sensitivity analyses showed that VSL results were most affected by discount rate and risk aversion, HCA by age-at-death and wage assumptions, and FCA by vacancy multipliers and friction periods; however, the relative ranking of the methods remained consistent. Conclusions Premature COVID-19 deaths in Kuwait generated a significant economic burden, falling most heavily on non-Kuwaiti working-age men. The findings highlight the need for improved occupational protections, stronger support for migrant workers, and targeted preparedness strategies in countries with similar dual labour-market systems.

Obesity is a complex public health issue that has risen to epidemic proportions globally. The aim of this study was to estimate the economic costs associated with obesity from governmental and societal perspectives in the State of Kuwait in 2024. A disease-specific prevalence-based cost-of-illness framework was applied. Key parameters include prevalence of obesity and its related comorbidities, relative risks, healthcare resources, income rate and growth, and lost workdays for patients and relatives, all were derived from literature. The outcomes measured were total healthcare costs, societal costs, and cost per patient, all reported in 2024 Kuwaiti Dinar (KWD), United States dollar ($), and Purchasing Power Parity (PPP). In 2024, there were approximately 2 million morbidity cases and 961 mortality cases directly attributed to obesity in Kuwait. The economic burden of obesity was estimated at KWD 4.3 billion ($ 14 billion; PPP$ 21.6 billion) from societal perspective and KWD 3.9 billion ($12.8 billion, PPP 19.7 billion) from governmental perspective, almost 1.3 times healthcare budget. The mean annual societal cost per patient was KWD 1,737 ($5,676; PPP 8,729)-17.6% of 2024 Kuwaiti gross domestic product per capita. Furthermore, the mean direct medical cost per patient was KWD 1,586 ($5,184 or PPP 7,972); comprised 3 times the healthcare expenditure per capita. Obesity and its comorbidities impose a far greater health and economic burden on Kuwait's healthcare system and national productivity than previously recognized. This study calls for a paradigm shift toward early prevention, culturally tailored strategies, and comprehensive disease management. Expanding access to emerging innovative treatments and leveraging technology-driven tools are essential to support sustained weight management and reduce long-term impacts.

Background Among the GCC countries affected by COVID-19 infections, Kuwait has been significantly impacted, with 658,520 cases and 2,563 deaths reported by the WHO on September 30, 2022. However, the impact of the COVID-19 epidemic on Kuwait’s economy, especially in the healthcare sector, remains unknown. Objective: This study aims to determine the total cost of managing COVID-19 in-patients in Kuwait. Method A cross-sectional design was employed for this study. A total of 485 COVID-19 patients admitted to a general hospital responsible for COVID-19 cases management were randomly selected for this study from May 1st to September 31st, 2021. Data on sociodemographic information, length of stay (LOS), discharge status, and comorbidities were obtained from the patients’ medical records. The data on costs in this study cover administration, utility, pharmacy, radiology, laboratory, nursing, and ICU costs. The unit cost per admission was calculated using a step-down costing method with three levels of cost centers. The unit cost was then multiplied by the individual patient’s length of stay to determine the cost of care per patient per admission. Findings The mean cost of COVID-19 in-patient care per admission was KD 2,216 (SD = 2,018), which is equivalent to USD 7,344 (SD = 6,688), with an average length of stay of 9.4 (SD = 8.5) days per admission. The total treatment costs for COVID-19 in-patients (n = 485) were estimated to be KD 1,074,644 (USD 3,561,585), with physician and nursing care costs constituting the largest share at 42.1%, amounting to KD 452,154 (USD 1,498,529). The second and third-largest costs were intensive care (20.6%) at KD 221,439 (USD 733,893) and laboratory costs (10.2%) at KD 109,264 (USD 362,123). The average cost for severe COVID-19 patients was KD 4,626 (USD 15,332), which is almost three times higher than non-severe patients of KD 1,544 (USD 5,117). Conclusion Managing COVID-19 cases comes with substantial costs. This cost information can assist hospital managers and policymakers in designing more efficient interventions, especially for managing high-risk groups.

Background COVID – 19 has had a profound impact on the economy, health systems within countries, and individuals around the world. To provide insight that may enhance the preparedness for future pandemics, a comprehensive cost assessment is vital. This study aims to estimate the direct cost of illness (CoI), as well as the national burden of treating hospitalised COVID-19 patients. Methods This study is prevalence-based retrospective study containing all patients admitted to a single designated hospital in Kuwait for the treatment of COVID-19. Micro (bottom-up) and macro (top-down) costing methods were used to evaluate direct medical CoI from a hospital perspective. Cost components were grouped as consumables, equipment, and human resources, and sensitivity analysis was used to account for uncertainty of inputs. The cost per admission was reported in local currency and international dollars (PPP$). Results Data on 7569 patients was analysed, 52.8% of whom were male, 69.2% were above 41 years, 22% had previously vaccinated for COVID-19, 22% were admitted to the ICU, and 18% had ≥ 3 pre-existing comorbidities. The mean CoI per admission was 12,063 PPP$, with overheads accounting for 45% of this figure, while consumables, human resources, and equipment accounted for 30%, 19%, and 7%, respectively. The sensitivity analysis demonstrated that overall cost uncertainty was primarily driven by variations in human resource costs rather than by uncertainties related to personal protective equipment (PPE) or ventilator use. Conclusion The substantial economic impact of COVID-19 on Kuwait’s healthcare system has emphasised the significant role human resource costs has on overall expenditure. These findings provide valuable insights for future pandemic preparedness.

The main aim of this study is to estimate the provider's cost, patients' cost (home and institutional quarantine cost) and the total economic burden of COVID-19 for patients with PCR positive in Kuwait. This cross-sectional and retrospective study identified the cost incurred for treating COVID-19 inpatients admitted to a General Hospital in Kuwait, a designated COVID-19 treatment center by the Kuwait Government during pandemic. A total of 485 COVID-19 patients were randomly selected from May 1st to September 31st, 2021. Data on sociodemographic information, length of stay (LOS), discharge status, and comorbidities were obtained from the patients' medical records. A step-down approach was done to estimate the healthcare provider cost per patient per admission. Patient cost (loss of productivity due to hospitalization, institutional and home quarantine) was calculated using human capital approach. The national economic burden of COVID-19 was estimated using costing data from a general hospital for the entire nation. The data were analyzed using the statistical software package SPSS version 25. In all, 485 COVID-19 patients were involved in the research. KD 2216 (USD 7,344) was the average cost per patient per admission. The ICU accounted for 20.6% of the total cost, the physician and nursing staff for 42.1%, and the laboratory services for 10.2%. The estimated annual cost of care for COVID-19 patients in Kuwait was KD 147.4 (USD 488.5) million, or 5.5% of the MOH budget for 2021, given that 9.03% (383,731) of the population had positive COVID-19 PCR results in 2021. The range of the estimated national economic burden, considering both the best and worst-case scenarios, is KD 73.6 (USD 244.2) million to KD 221.0 (USD 732.7) million. COVID-19 poses a substantial financial strain on the healthcare system, estimated at 5.9% to 8.8% of the MOH's annual budget and 0.2% to 0.7% of Kuwait's GDP in 2021. To mitigate costs, prioritizing prevention and health education is crucial. Targeted strategies, such as workforce optimization, are needed to address high expenses. Policymakers and administrators should leverage these insights for enhanced efficiency and sustainability in future epidemic responses.

Background Limited knowledge exists on whether obesity during early life stages demonstrates sex‐specific associations with cardiometabolic conditions. Therefore, this study aimed to determine if the association of obesity with prediabetes and dyslipidemia differs according to sex among adolescents. Methods Adolescents aged 14–19 years were enrolled in a cross‐sectional study. Capillary blood was used to measure glycated hemoglobin and lipids. Prediabetes and dyslipidemia were determined according to international guidelines. Associations and statistical interactions (body mass index‐for‐age × sex) were evaluated using multivariable logistic regression models. Results Data from a total of 1584 adolescents (826 female participants) were analyzed in the current report. Obesity (38.6% vs. 24.4%) and dyslipidemia (54.2% vs. 36.7%) were more prevalent in male than female participants; however, prediabetes prevalence did not differ between male and female participants (34.8% vs. 33.8%). The association between obesity and prediabetes differed according to sex (Pinteraction = 0.046), with obesity showing a stronger association among female participants (adjusted odds ratios [aOR]: 3.24; 95% confidence interval [CI]: 2.25, 4.66) compared with male participants (aOR: 1.64; 95% CI: 1.12, 2.39). However, obesity showed a stronger association with dyslipidemia among male participants (aOR: 2.74; 95% CI: 1.93, 3.90) compared with female participants (aOR: 1.49; 95% CI: 1.04, 2.13; Pinteraction = 0.016). Conclusion Obesity demonstrated sex‐specific associations with cardiometabolic conditions in adolescents, showing a stronger association with prediabetes in females but with dyslipidemia in males.

Obesity and prediabetes are common among adolescents; however, it is unclear whether they jointly influence lipid levels. Hence, this study sought to assess whether obesity and prediabetes independently or jointly influence lipid levels among adolescents. A cross-sectional study enrolled school students aged 14-19 years (n = 1584). Body mass index (BMI)-for-age z-scores were estimated, and glycated hemoglobin A1c (HbA1c) and lipid profile were measured in capillary blood. Prediabetes was defined as 5.7≤ HbA1c% ≤6.4. Geometric means of lipids were calculated, and linear regression was used to estimate the ratio of geometric means (RoGM) and their 95% confidence intervals (CI). All analyses were stratified by sex. Of the total study participants, 52.1% (826/1584) were females and the majority were aged between 14.0 (5th percentile) and 18.0 (95th percentile) years. Based on BMI-for-age categories, 356 (22.5%) and 494 (31.2%) participants were classified as overweight and obese, respectively. Moreover, 34.3% (543/1584) of the study participants met the prediabetes definition. Compared to those with normal BMI and no prediabetes (reference category), participants classified as obese and having prediabetes had elevated levels of total cholesterol (TC; RoGM=1.09, 95% CI: 1.06-1.13), low-density lipoprotein cholesterol (LDL-C; 1.21, 1.13-1.29), non-high-density lipoprotein cholesterol (non-HDL-C; 1.20, 1.14-1.26), and triglycerides (TG; 1.18, 1.09-1.27) and reduced HDL-C (0.91, 0.88-0.95) levels. Independent of prediabetes, obesity was associated with all the investigated lipids. Prediabetes alone was associated with reduced levels of LDL-C and increased levels of HDL-C only among females. Obesity independently and in combination with prediabetes demonstrated unfavorable effects on lipids among male and female adolescents, whereas prediabetes independently influenced LDL-C and HDL-C favorably only among females.

Background. Epidemiologic studies have reported associations of sibship size and position of the child in the sibship with multiple health outcomes, including adiposity and diabetes. However, little is known about sibling effects on lipids. Hence, this study sought to evaluate associations of the number of total, older, and younger siblings with lipid profile among adolescents. Methods. In a cross-sectional study among high school students aged 14 to 19 years, lipid levels were measured in capillary blood. Parents reported the number of siblings (total, older, and younger). Geometric means of lipids were calculated, and linear regression was used to estimate the ratio of geometric means (RoGM) and 95% confidence intervals (CI). Analyses were sex stratified. Results. Of the total study sample (n = 1,584), 758 (47.9%) were boys and 826 (52.1%) were girls, with median age of 16.0 years. Total cholesterol (TC) was lower by 8% (adjusted-RoGM = 0.92, 95% CI: 0.88–0.96) among boys with ≥3 older siblings compared to those with no older siblings. Similarly, boys with ≥3 younger sibling compared to those with no younger siblings had reduced TC by 7% (adjusted-RoGM = 0.93, 0.87–0.99). Moreover, an increased number of total siblings (≥4 vs. 0/1: adjusted-RoGM = 0.80, 0.67–97) and older siblings (≥3 vs. 0: adjusted-RoGM = 0.90, 0.82–0.98) were associated with reduced low-density lipoprotein cholesterol (LDL-C) among boys. Similarly, lower levels of triglycerides (TG) were seen among boys with ≥3 older siblings compared to those with no older siblings (adjusted-RoGM = 0.87, 0.78–0.96). A higher number of younger siblings was associated with increased high-density lipoprotein cholesterol (HDL-C) among boys (≥3 vs. 0: adjusted-RoGM = 1.08, 1.01–1.17). Sibship characteristics were not associated with lipids among girls. Conclusions. Increased number of total, older, and younger siblings were associated with favorable lipid profiles among adolescent boys, but not girls. Mechanisms underlying these associations need further investigations.

Detrimental effects of secondhand smoke (SHS) exposure are well established; however, data on SHS exposure among adolescents in Kuwait are lacking. Hence, this study sought to estimate the prevalence of household SHS exposure among two samples of adolescents in Kuwait and assess its variation by socioeconomic status and parental education level. Data from two large school-based cross-sectional studies were analyzed. Adolescents attending public middle (n=3864; aged 11-14 years) and high (n=1959; aged 14-19 years) schools throughout Kuwait were enrolled in 2016-2017, and parental self-reported household SHS exposure was ascertained. Associations were assessed using Poisson regression with robust variance estimation, and adjusted prevalence ratios (APRs) and 95% confidence intervals (CIs) were estimated. Overall, 45.8% (1755/3836; 95% CI: 44.2-47.3%) of the enrolled middle school students and 51.6% (998/1936; 95% CI: 49.3-53.8%) of the enrolled high school students were exposed to household SHS. Among middle and high school students, the prevalence of household SHS exposure increased as maternal/paternal education level and family income decreased. Among middle school students, paternal educational attainment of middle school or less compared to bachelor's degree or higher was associated with 1.60 times (95% CI: 1.44-1.79) higher household SHS exposure. Similarly, in the sample of middle school students, the prevalence of household SHS exposure significantly increased from 35.8% among children from families reporting the highest household income to 50.5% among children from families with the lowest reported household income (p-trend<0.001). Household SHS exposure is substantially high among adolescents in Kuwait. Enrolled adolescents from families with low socioeconomic status or with low parental education level have the highest household SHS exposure. These findings highlight the need for national comprehensive tobacco control policies and increasing parental awareness of the impact of SHS exposure on children.