1
Novel coronavirus (COVID-19) Outbreak in Iraq: The First Wave and Future
Scenario
Adil R. Sarhan, Mohammed H. Flaih, Thaer A. Hussein and Khwam R. Hussein
Department of Medical Laboratory Techniques, Nasiriyah Technical Institute, Southern Technical University, Nasiriyah 64001, Iraq
*Corresponding author. Tel: +9647805167722; E-mail: [email protected]
Abstract
The first patient with COVID-19 was reported in Iraq on 24 February 2020 for the Iranian
student came from Iran. As of 24 May 2020, the confirmed cases of COVID-19 infections
reached 4469, with 160 deaths and 2738 patients were recovered from the infection. Significant
public health strategies have been implemented by the authorities to contain the outbreak
nationwide. Nevertheless however, the number of cases is still rising dramatically. Here, we aim
to describe a comprehensive and epidemiological study of all cases diagnosed in Iraq by 24 May
2020. Most of the cases were recorded in Baghdad followed by Basra and Najaf. About 45% of
the patients were female (with 31% deaths of the total cases) and 55% were male (with 68%
deaths of the total cases). Most cases are between the ages of (20-59) years old, and (30-39)
years are the most affected range (19%) Approximately (8%) of cases are children under 10
years old. Iraq has shown a cure rate lower than those reported by Iran, Turkey and Jordan; and
higher than Saudi Arabia and Kuwait. Healthcare workers represented about (5%) of the total
confirmed cases. These findings enable us to understand COVID-19 epidemiology and
prevalence in Iraq that can alert the our community to the risk of this novel coronavirus and
serve as a baseline for future studies.
Keywords: COVID-19 , epidemiology, case fatality rate, Pandemic, Iraq
. CC-BY-NC-ND 4.0 International licenseIt is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)
The copyright holder for this preprint this version posted June 26, 2020. ; https://doi.org/10.1101/2020.06.23.20138370doi: medRxiv preprint
NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice.
https://doi.org/10.1101/2020.06.23.20138370http://creativecommons.org/licenses/by-nc-nd/4.0/
2
Introduction
Coronavirus is one of the major viruses which primarily affecting the respiratory system in
human (1). However, Coronaviruses have been also diagnosed in animals and can cause a range
of severe diseases such as gastroenteritis and pneumonia (2,3). Previous coronavirus outbreaks
have been reported, including severe acute respiratory syndrome (SARS-CoV) and Middle East
respiratory syndrome (MERS-CoV), which is described as a significant public health threat (4).
In 2002, coronavirus infections (SARS-CoVs) spread in Guangdong, south China, causing high
fever, breathlessness and pneumonia, and rapidly spread to various regions around the world.
The infection has spread in 26 countries, resulting about 8096 cases and 774 deaths (5,6).
Whereas MERS-CoV was first detected in Saudi Arabia in 2012. The disease has mild
respiratory symptoms that can lead to acute respiratory syndrome and death. 2494 cases were
infected by the virus, of which 858 died in more than 25 countries (7–9). On December 2019,
Atypical unkown pneumonia was first recorded in Wuhan city, Hubei province. Patients have
showed high fever (more than 38 C°), dry cough, malaise, and breath difficulties. The infection
has been linked to the seafood market of Wuhan, China and named COVID-19 (10–12). It spread
rapidly to other Far East Asian nations, then to the Middle East and Europe. In severe cases the
disease causes pneumonia, septic shock, metabolic acidosis and bleeding (13). The incubation
period has been estimated from 5 - 14 days and may vary from patient to patient according to age
and infection history (14).
Several studies have revealed that COVID-19 can be transmitted between humans via nasal
droplets and direct contact in both symptomatic and asymptomatic patients (15–17). No vaccine
or effective medication currently available to prevent or cure COVID-19 infections; however,
some preventive health measures can help to resolve primary complications in patients (18). On
16 March 2020, the disease affected more than 150 countries and territories around the world.
Over the past few months there has been a significant increase in COVID-19 cases. In Iraq, the
first confirmed case of COVID-19 has been reported in Najaf province for the Iranian student
came from Iran on 24 February 2020, followed by 4 cases from one family in Kirkuk province
on 25 February, they have also a travel history to Iran. An additional case was recorded on 27
February in Baghdad, for a patient who recently visited Iran. (19). 74 confirmed cases and 8
fatalities have been reported across Iraq as of 12 March 2020 (20). The confirmed cases jumped
to 1415 on 16 April 2020, with 78 fatalities were recorded (21). By 24 May 2020, the confirmed
cases of COVID-19 reached 4469 and reported 160 deaths, while 2738 patients recovered from
the infection (22). Here, we aim to describe a comprehensive, epidemiological study of all cases
. CC-BY-NC-ND 4.0 International licenseIt is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)
The copyright holder for this preprint this version posted June 26, 2020. ; https://doi.org/10.1101/2020.06.23.20138370doi: medRxiv preprint
https://doi.org/10.1101/2020.06.23.20138370http://creativecommons.org/licenses/by-nc-nd/4.0/
3
diagnosed in Iraq by 24 May 2020. We hope our study will alert the community to the risk of
this novel coronavirus, in order to prevent a second wave of the virus infections.
Methods
This study was an exploratory and descriptive analysis of all COVID-19 confirmed cases,
diagnosed in Iraq as of 24 May 2020. We obtained epidemiological and demographic data for all
COVID-19 cases that were reported from 24 February 2020 to 24 May 2020 by the Iraqi
Ministry of Health, Directorate of Public Health. Sex-disaggregated data about COVID-19 was
obtained from Global Health 50/50. We collected data for global COVID-19 cases from
ProMED, WHO, and CDC reports.
Case fatality rates (CFR) were calculated as the total number of deaths (td) divided by the total
number of cases (tc), represented as a percentage (23,24).
��� � ��
�� 100
While the incidence rates (IR) were calculated as the total number of COVID-19 confirmed
cases (tc) divided by the population (p) of each province times 100,000 (25).
�� � ��
100,000
This study was evaluated according to the reporting guidelines for Strengthening the Reporting
of Observational Studies in Epidemiology (STROBE) (26).
Results
Demographics and the distribution of COVID-19
Overall, 4469 cases were confirmed with COVID�19 infection and showed a substantial
cumulative rise since the first case was confirmed on 24 Feb 2020 until 24 May 2020. (Figure
1A and B). In comparison, Anbar, Ninewa, Diwaniya and Sala-Aldin have reported the lowest
number of COVID�19 confirmed cases. The most cases were registered in Baghdad (2233
cases) followed by Basra (747 cases) and Najaf (318 cases) (Figure 1A). In contrast to other
. CC-BY-NC-ND 4.0 International licenseIt is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)
The copyright holder for this preprint this version posted June 26, 2020. ; https://doi.org/10.1101/2020.06.23.20138370doi: medRxiv preprint
https://doi.org/10.1101/2020.06.23.20138370http://creativecommons.org/licenses/by-nc-nd/4.0/
4
cities, the fatalities of COVID-19 infection in Baghdad was high (97 deaths), followed by Basra
(18 deaths) and Kerbala with 8 deaths (Figure 1C). On the other hand, Erbil (Kurdistan region,
north Iraq) registered only one death for 242 confirmed cases. In addition, Figure 1D shows the
breakdown of confirmed cases and deaths by gender across all cities. Approximately 45% of
patients were female and 55% were male. While the death rates were 68% for males and 31% for
females.
COVID-19 cases and indicators by province and age
Data revealed that most cases are between the ages of 20-59, with those aged 30-39 years being
the most affected range (19 %). Such age groups are the ones that are most likely to have a high
chance of participation in different sectors of work (Figure 2A). Data have also shown that
around 8% of overall confirmed cases are children under 10 years old (Figure 2A). As can be
seen from the Figure 2A, there is a clear trend of increasing in the fatality rate with ages between
60-80 years old reaching the max in patients with above 80 years old (24%).
The provinces are widely varied in their incidence and case fatality rates (CFR) (Figure 2B). The
incidence rate, which is the number of new cases in the population over a given period, has been
calculated in all provinces. A higher incidence rate can be seen in Baghdad (26.09) followed by
Basra with (24.39) and Najaf with (20.52) (Figure 2B). The high incidence rate in those large
cities could be explained by the high number of confirmed cases. Although Anbar, Ninewa and
Sala-Aldin demonstrated the lowest incidence rates ranging between (0.27-0.77). On the other
hand, despite these findings on incidence rates, the case fatality rates were higher in Diyala
(11%) and Babylon (10%), followed by Diwaniya (7%) (Figure 2B).
Among the confirmed cases of COVID�19, cure rates have shown a promising trend in some
cities (Figure 3). For example, Najaf showed (94%) cure rate of the 318 confirmed cases. Erbil
and Missan showed a cure rate of (87%). Despite this, Baghdad represented the lowest cure rate
with (42%).
Healthcare workers
By 24 May 2020, a total of 207 healthcare workers had been infected with COVID-19 (Figure
4). Represented about (5%) of the total confirmed cases in Iraq. The most interesting aspect of
this data is that around (80%) of these infections were located in Baghdad, Najaf, Basra and
. CC-BY-NC-ND 4.0 International licenseIt is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)
The copyright holder for this preprint this version posted June 26, 2020. ; https://doi.org/10.1101/2020.06.23.20138370doi: medRxiv preprint
https://doi.org/10.1101/2020.06.23.20138370http://creativecommons.org/licenses/by-nc-nd/4.0/
5
Sulaymaniya. The majority of the infected health workers were nursing staff (60%), followed by
physicians (30%) (Figure 4). These two groups have a greater chance of being in contact with
infected patients.
COVID-19 cure and fatality rate in Iraq and neighboring countries
Iraq has shown a (61%) cure rate lower than those reported by Iran, Turkey and Jordan (Figure
5A). This figure is, however, higher than the reported cure rate for other neighboring countries.
On the other hand, Iraq's fatality rate was (4%) lower than Iran, which is indicated the high rate
of fatality (5%). Saudi Arabia, by contrast, showed the lowest fatality rate (0.5%) (Figure 5B).
Discussion
The recent COVID-19 is a continuing pandemic that creates confusion and panic around the
world. According to the genomic studies, the virus is considered to originate from infected bats,
and can be transmitted to humans and animals, as well as to humans (27). It was found to have a
positive-sensed, single-strand beta-coronavirus RNA virus similar to Bat Coronavirus (BatCoV
RaTG13) with 88% identity (27,28). By 24 May 2020, an astounding 5,230,755 confirmed
COVID-19 cases were reported worldwide, with 339,588 fatalities.
In Iraq, as of 24 May, 4469 COVID�19 confirmed cases, 160 deaths and 2738 patients who
have recovered from the virus and discharged from hospitals. In the last few weeks, the number
of confirmed cases has risen by more than 70%, from 1677 cases on 24 April to 4469 on 24 May
2020. Unfortunately, while we were writing this manuscript, the number of confirmed cases
increased dramatically from 4469 on 24 May to 15,414 on 10 June with 426 deaths. One possible
explanation for this increase could be that during this period (24 May-10 June) people celebrated
Eid Al-Fitr after fasting in the holly Ramadan, which exhibited many gatherings for all family
members and friends. Another possible explanation is that authorities has generally relaxed
enforcement of the stringent curfews and movement restrictions which have been in place for the
past several weeks. Partial lockdowns are currently in force in order to limit the spreading of the
virus. It’s worth notice that the total cumulative number of COVID-19 cases increasing
significantly, so this is could be a sign that a country will faces a second wave of virus
infections. Furthermore, the number of confirmed cases varies across provinces. The highest
. CC-BY-NC-ND 4.0 International licenseIt is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)
The copyright holder for this preprint this version posted June 26, 2020. ; https://doi.org/10.1101/2020.06.23.20138370doi: medRxiv preprint
https://doi.org/10.1101/2020.06.23.20138370http://creativecommons.org/licenses/by-nc-nd/4.0/
6
number of cases were recorded in Baghdad and Basra compared to other cities due to the fact
that these provinces have a large population with many factories and shopping malls that could
not follow the instructions of the health authorities to contain the spread of the virus. The current
study also found 54% of confirmed cases were males, and 45% were females (male: female ratio
= 1.2:1). In addition, the fatality rates were higher in male (68%) than female (31%). These data
seem to be consistent with other studies which found that men with COVID-19 infection are
more likely to have serious consequences and death (29,30). Differences between males and
females in getting infection with COVID-19 remain unclear. Countries like Italy, Scotland,
Switzerland, Sweden and Belgium have reported a higher percentage of cases among women
according to Global Health 50/50 (31). While the rates of infection among men appear to be
much higher in Iran, Costa Rica, Thailand, Greece, Pakistan and Mexico.
In our study, data showed all ages are susceptible to infected with COVID-19 and the highest
range was between 30-39 years old. Consistent with other studies (32–34), this research found
that fatality rates were higher in patients with ≥60 years old. COVID-19 negative outcomes tend
to be related to comorbidity including diabetes, obesity, cardiovascular and lung diseases. These
factors may account for high death rates in older patients. Despite this, the majority of provinces,
apart from Baghdad, showed promising cure rates.
As our healthcare workers continue to fight COVID-19, they get infected with the virus. The
authorities start to be concerned that this could make a significant contribution to increasing the
number of cases among healthcare workers and could then transmit the virus to their families and
loved ones. Overall, 207 Healthcare workers were tested positive for COVID-19 representing
(5%) of the total confirmed cases in Iraq. What stands out in the data is that (78%) of these cases
were in Baghdad, Najaf and Basra. Cure and fatality rates have shown variation when comparing
Iraq with neighboring countries. Iran reported the highest rates of cure and fatality at the same
time. This inconsistency may be due to the fact that each country has different management
protocols, case reporting and the number of tests carried out on each day. Some countries may
not report mild cases if they do not need treatment or if they have been treated at home. There
are some limitations to this study. First, We were unable to evaluate the clinical characteristics of
confirmed cases since these data were not accessible at the moment of analysis. Second, we did
not have any information as to whether or not these patients, especially elderly patients, have
comorbidities. A further study with more focus on the comorbidities and the severity of COVID-
19 in elderly is therefore suggested. Taken together, these findings contribute to our
understanding of the epidemiology and prevalence of COVID-19 in Iraq, in several ways, which
may be useful and provide a basis for future studies.
. CC-BY-NC-ND 4.0 International licenseIt is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)
The copyright holder for this preprint this version posted June 26, 2020. ; https://doi.org/10.1101/2020.06.23.20138370doi: medRxiv preprint
https://doi.org/10.1101/2020.06.23.20138370http://creativecommons.org/licenses/by-nc-nd/4.0/
7
Figure legends
Figure 1: Demographics and the distribution of COVID-19. A. The number of all confirmed
cases reported for all provinces in Iraq and represented as color-coded heatmap. B. Cumulative
cases that have been reported between 24 Feb 2020 and 24 May 2020. C. Direct comparison
between the total number of all cases with the total number of deaths in all provinces. D. Cases
and deaths by gender across all cities.
Figure 2: COVID-19 cases and indicators by province and age. A. The number of cases and
the fatality rates across ages. B. Represents the incidence and case fatality rates in all provinces.
Figure 3: Confirmed COVID�19 cases and cure. Comparison among the number of cases in
all provinces with the number of cure.
Figure 4: Healthcare workers who were infected with COVID-19. COVID-19 infections
among healthcare workers and were classified according to gender and job role.
Figure 5: COVID-19 cure and fatality rate in Iraq and neighboring countries. A. The cure
rate in Iraq and neighboring countries. B. The fatality rate in Iraq and neighboring countries.
References 1. Chen Y, Liu Q, Guo D. Emerging coronaviruses: Genome structure, replication, and
pathogenesis. J Med Virol (2020) 92:418–423. doi:10.1002/jmv.25681
2. Hoek L, Pyrc K, Jebbink MF, Vermeulen-oost W, Berkhout RJM, Wolthers KC, Dillen PMEW, Kaandorp J, Spaargaren J, Berkhout B. Identification of a new human coronavirus. Nat Med (2004) 10:368–373. doi:10.1038/nm1024
3. Gralinski LE, Menachery VD. Return of the coronavirus: 2019-nCoV. Viruses (2020) 12: doi:10.3390/v12020135
4. Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease ( COVID-19 ) outbreak. J Autoimmun (2020)1–4. doi:10.1016/j.jaut.2020.102433
. CC-BY-NC-ND 4.0 International licenseIt is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)
The copyright holder for this preprint this version posted June 26, 2020. ; https://doi.org/10.1101/2020.06.23.20138370doi: medRxiv preprint
https://doi.org/10.1101/2020.06.23.20138370http://creativecommons.org/licenses/by-nc-nd/4.0/
8
5. WHO | Summary of probable SARS cases with onset of illness from 1 November 2002 to 31 July 2003. WHO (2015)
6. SARS (severe acute respiratory syndrome) - NHS. Available at: https://www.nhs.uk/conditions/sars/ [Accessed June 7, 2020]
7. Padron-regalado E. Vaccines for SARS-CoV-2�: Lessons from Other Coronavirus Strains. Infect Dis Ther (2020) 9:255–274. doi:10.1007/s40121-020-00300-x
8. Contini C, Nuzzo M, Barp N, Bonazza A, Giorgio R, Tognon M, Rubino S. The novel zoonotic COVID-19 pandemic�: An expected global health concern. J Infect Dev Ctries (2020) 14:254–264. doi:10.3855/jidc.12671
9. Zaki AM, Van Boheemen S, Bestebroer TM, Osterhaus ADME, Fouchier RAM. Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia. N Engl J Med (2012) 367:1814–1820. doi:10.1056/NEJMoa1211721
10. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, Zhao X, Huang B, Shi W, Lu R, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med (2020) 382:727–733. doi:10.1056/NEJMoa2001017
11. Wu F, Zhao S, Yu B, Chen YM, Wang W, Song ZG, Hu Y, Tao ZW, Tian JH, Pei YY, et al. A new coronavirus associated with human respiratory disease in China. Nature (2020) 579:265–269. doi:10.1038/s41586-020-2008-3
12. Naming the coronavirus disease (COVID-19) and the virus that causes it. Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it [Accessed June 8, 2020]
13. Helmy YA, Fawzy M, Elaswad A, Sobieh A, Kenney SP, Shehata AA. The COVID-19 Pandemic�: A Comprehensive Review of Taxonomy , Genetics , Epidemiology , Diagnosis , Treatment , and Control. J Clin Med (2020) 9:1–29.
14. Xiao Z, Xie X, Guo W, Luo Z, Liao J, Wen F, Zhou Q, Han L, Zheng T. Examining the incubation period distributions of COVID-19 on Chinese patients with different travel histories. J Infect Dev Ctries (2020) 14:323–327. doi:10.3855/jidc.12718
15. Lauer SA, Grantz KH, Bi Q, Jones FK, Zheng Q, Meredith HR, Azman AS, Reich NG, Lessler J. The incubation period of coronavirus disease 2019 (CoVID-19) from publicly reported confirmed cases: Estimation and application. Ann Intern Med (2020) 172:577–582. doi:10.7326/M20-0504
16. Xiao Z, Xie X, Guo W, Luo Z, Liao J, Wen F, Zhou Q, Han L, Zheng T. Examining the incubation period distributions of COVID-19 on Chinese patients with different travel histories. J Infect Dev Ctries (2020) 14:323–327. doi:10.3855/jidc.12718
17. Chan JFW, Yuan S, Kok KH, To KKW, Chu H, Yang J, Xing F, Liu J, Yip CCY, Poon RWS, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet (2020) 395:514–523. doi:10.1016/S0140-6736(20)30154-9
18. Khedmat L. New Coronavirus (2019-nCoV): An Insight Toward Preventive Actions and Natural Medicine. IJTMGH (2020) 8:44–45. doi:10.34172/ijtmgh.2020.07
19. OCHA. IRAQ�: COVID-19. (2020).
. CC-BY-NC-ND 4.0 International licenseIt is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)
The copyright holder for this preprint this version posted June 26, 2020. ; https://doi.org/10.1101/2020.06.23.20138370doi: medRxiv preprint
https://doi.org/10.1101/2020.06.23.20138370http://creativecommons.org/licenses/by-nc-nd/4.0/
9
20. OCHA. IRAQ�: COVID-19. (2020).
21. OCHA. IRAQ�: COVID-19. (2020).
22. OCHA. IRAQ�: COVID-19. (2020).
23. Spychalski P, Błażyńska-Spychalska A, Kobiela J. Estimating case fatality rates of COVID-19. Lancet Infect Dis (2020) doi:10.1016/S1473-3099(20)30246-2
24. Feigin VL, Lawes CMM, Bennett DA, Anderson CS. Stroke epidemiology: A review of population-based studies of incidence, prevalence, and case-fatality in the late 20th century. Lancet Neurol (2003) 2:43–53. doi:10.1016/S1474-4422(03)00266-7
25. Vandenbroucke JP, Pearce N. Incidence rates in dynamic populations. Int J Epidemiol (2012) 41:1472–1479. doi:10.1093/ije/dys142
26. Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. Ann Intern Med (2007) 147:573–577. doi:10.7326/0003-4819-147-8-200710160-00010
27. Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, Wang W, Song H, Huang B, Zhu N, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet (2020) 395:565–574. doi:10.1016/S0140-6736(20)30251-8
28. Tan W, Zhao X, Ma X, Wang W, Niu P, Xu W, F. Gao G, Wu G. A Novel Coronavirus Genome Identified in a Cluster of Pneumonia Cases — Wuhan, China 2019−2020. China CDC Wkly (2020) 2:61–62. doi:10.46234/ccdcw2020.017
29. Jin J-M, Bai P, He W, Liu S, Wu F, Liu X-F, Han D-M, Yang J-K. Higher severity and mortality in male patients with COVID-19 independent of age and susceptibility. medRxiv (2020)2020.02.23.20026864. doi:10.1101/2020.02.23.20026864
30. Jin J-M, Bai P, He W, Wu F, Liu X-F, Han D-M, Liu S, Yang J-K. Gender Differences in Patients With COVID-19: Focus on Severity and Mortality. Front Public Heal (2020) 8:152. doi:10.3389/fpubh.2020.00152
31. COVID-19 sex-disaggregated data tracker – Global Health 50/50. Available at: https://globalhealth5050.org/covid19/sex-disaggregated-data-tracker/ [Accessed June 12, 2020]
32. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qiu Y, Wang J, Liu Y, Wei Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet (2020) 395:507–513. doi:10.1016/S0140-6736(20)30211-7
33. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, Wang B, Xiang H, Cheng Z, Xiong Y, et al. Clinical Characteristics of 138 Hospitalized Patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA - J Am Med Assoc (2020) 323:1061–1069. doi:10.1001/jama.2020.1585
34. Zhang J jin, Dong X, Cao Y yuan, Yuan Y dong, Yang Y bin, Yan Y qin, Akdis CA, Gao Y dong. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy Eur J Allergy Clin Immunol (2020) doi:10.1111/all.14238
. CC-BY-NC-ND 4.0 International licenseIt is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)
The copyright holder for this preprint this version posted June 26, 2020. ; https://doi.org/10.1101/2020.06.23.20138370doi: medRxiv preprint
https://doi.org/10.1101/2020.06.23.20138370http://creativecommons.org/licenses/by-nc-nd/4.0/
Muthanna
Missan
Kerbala
Diwaniya
Dahuk
Wassit
Najaf
Sala-Aldin
Kirkuk
Diyala
Anbar
Erbil
Babylon
Thi-Qar
Sulaymaniya
Basra
Ninewa
Baghdad
5
2233
Number of confirmed cases
Mutha
nna
Miss
an
Kerba
la
Diwa
niya
Dahu
k
Was
sitNa
jaf
Sala-
Aldin
Kirku
kDi
yala
Anba
rEr
bil
Baby
lon
Thi-Q
ar
Sulay
maniy
aBa
sra
Nine
wa
Bagh
dad
0
500
1000
1500
2000
2500
0
50
100
150
Num
ber o
f con
firm
ed c
ases
(bar
s)
Num
ber of confirmed deaths
(curve)
Province
A
B
C
Feb 2
4
Mar 2
4
Apr 2
4
May 2
40
1000
2000
3000
4000
5000
Months
Pat
ient
s
Cumulative cases
D
Bagh
dad-
Rusa
faBa
sra
Bagh
dad-
Karkh
Bagh
dad-M
edica
l City
Najaf
Erbil
Sulay
maniy
a
Kerba
la
Mutha
nna
Thi-Q
ar
kirku
k
Was
sit
Miss
an
Baby
lonDi
yala
Dahu
k
Diwa
niya
Nine
wa
Sala-
Aldin
Anba
r0
200
400
600
800
Province
Num
ber
of c
onfir
med
cas
es
Cases by gender
45.50%Female54.50%
Male
Total =4448Total = 160
68.75%Male
31.25%Female
Cases by fatality
Figure 1
. CC-BY-NC-ND 4.0 International licenseIt is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)
The copyright holder for this preprint this version posted June 26, 2020. ; https://doi.org/10.1101/2020.06.23.20138370doi: medRxiv preprint
https://doi.org/10.1101/2020.06.23.20138370http://creativecommons.org/licenses/by-nc-nd/4.0/
< 10
10-19
20-29
30-39
40-49
50-59
60-69
70-79
>= 80
0
5
10
15
20
0
10
20
30
Con
firm
ed c
ases
(%)
(bar
s)Fatality R
ate (%)
(curve)
Age (Years)
Mutha
nna
Miss
an
Kerba
la
Diwa
niya
Dahu
k
Was
sitNa
jaf
Sala-
Aldin
Kirku
k
Diya
laAn
bar
Erbil
Baby
lon
Thi-Q
ar
Sulay
maniy
aBa
sra
Nine
wa
Bagh
dad
0
10
20
30
0
5
10
15
Inci
denc
e R
ate/
100
,000
(bar
s)C
ase Fatality Rate (%
)(curve)
Province
A
B
Figure 2
. CC-BY-NC-ND 4.0 International licenseIt is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)
The copyright holder for this preprint this version posted June 26, 2020. ; https://doi.org/10.1101/2020.06.23.20138370doi: medRxiv preprint
https://doi.org/10.1101/2020.06.23.20138370http://creativecommons.org/licenses/by-nc-nd/4.0/
Mutha
nna
Miss
an
Kerb
ala
Diwa
niya
Dahu
k
Was
sitNa
jaf
Sala-
Aldin
Kirku
k
Diya
laAn
bar
Erbil
Baby
lon
Thi-Q
ar
Sulay
maniy
aBa
sra
Nine
wa
Bagh
dad
0
500
1000
1500
2000
2500
Province
Patients
Confirmed casesCure
Figure 3
. CC-BY-NC-ND 4.0 International licenseIt is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)
The copyright holder for this preprint this version posted June 26, 2020. ; https://doi.org/10.1101/2020.06.23.20138370doi: medRxiv preprint
https://doi.org/10.1101/2020.06.23.20138370http://creativecommons.org/licenses/by-nc-nd/4.0/
Baghdad
Najaf
Basra
Sulaymania
Karbala
Thi-qar
kirkuk
Babylon
Anbar
Diwaniya
Wasit
Diyala
Erbil
Number of confirmed cases
Pro
vinc
e
Female
Male
50 30 10 10 30 50 70 90 110 130 150
Cases by job role
Total = 207
60.39%Nursing
29.95%Doctor
1.45%Pharmacist
3.38%Service employee
0.97%Ambulance driver
2.42%Dentist
1.45%Laboratory specialist
Figure 4
. CC-BY-NC-ND 4.0 International licenseIt is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)
The copyright holder for this preprint this version posted June 26, 2020. ; https://doi.org/10.1101/2020.06.23.20138370doi: medRxiv preprint
https://doi.org/10.1101/2020.06.23.20138370http://creativecommons.org/licenses/by-nc-nd/4.0/
Syria
SaudiArabia
Iraq
Jordan
Turkey
Iran29%
78%
CureRate
Kuwait
Syria
SaudiArabia
Iraq
Jordan
Turkey
Iran0.54%
5.47%
FatalityRate
Kuwait
A B
Figure 5
. CC-BY-NC-ND 4.0 International licenseIt is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)
The copyright holder for this preprint this version posted June 26, 2020. ; https://doi.org/10.1101/2020.06.23.20138370doi: medRxiv preprint
https://doi.org/10.1101/2020.06.23.20138370http://creativecommons.org/licenses/by-nc-nd/4.0/