ABSTRACT
Background The annual Ashura pilgrimage is a mass Islamic gathering during which millions of worshippers converge in the city of Karbala in Iraq. We report on the incidence of the coronavirus disease 2019 (COVID-19) in Omani pilgrims returning from Karbala in the month of Muharram (August) 2021 during the COVID-19 pandemic. Methodology This is a retrospective study using an electronic, self-completed, and Arab-language survey, composed of 17 questions, that was distributed to all pilgrims returning from Karbala. Participation was voluntary, and consent with confidentiality was obtained. Data on the demographics including sex, COVID-19 vaccination record, type of vaccine, duration of stay, compliance with wearing a face mask, using hand sanitization, and polymerase chain reaction (PCR) results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus before the departure from Oman, upon the return to Oman, and on the eighth post-quarantine day were collected. The responses were collected from the period between August 28, 2021, and September 25, 2022. Statistical association and analysis were performed using the Statistical Package for Social Sciences (SPSS) software (IBM SPSS Statistics, Armonk, NY). Results Out of 250 pilgrims, 139 responded to the survey. Fifty-two participants (37.4%) were males, and 87 (63.6%) were females. None of the pilgrims had positive SARS-CoV-2 PCR results before their departure from Oman. Only four pilgrims (2.9%) were detected positive on PCR by the end of a compulsory quarantine on the eighth day after arrival to Oman. No hospital admissions were recorded. The vast majority of the pilgrims were vaccinated with two doses of COVID-19 vaccination, while some few pilgrims were not vaccinated at all. Most of the pilgrims were also compliant with mask wearing, and just over half the pilgrims were compliant with hand sanitization. No significant statistical association was found between contracting SARS-CoV-2 virus infection and taking SARS-CoV-2 vaccination, the number of vaccination doses, having had COVID-19 before, wearing a mask, or compliance with hand sanitization. Conclusion The incidence of COVID-19 cases among pilgrims returning from Iraq during the COVID-19 pandemic was low. No significant difference was noted between pilgrims vaccinated and compliant with the protective measures and those who were not vaccinated or compliant. Herd immunity could be a possible explanation for the low incidence of COVID-19 infection. Larger studies are needed to investigate the incidence of COVID-19 in Ashura pilgrims.