SARS-CoV-2 Omicron Variant Genomic and Phylogenetic Analysis in Iraqi Kurdistan Region.

Omicron variants have been classified as Variants of Concern (VOC) by the World Health Organization (WHO) ever since they first emerged as a result of a significant mutation in this variant, which showed to have an impact on transmissibility and virulence of the virus, as evidenced by the ongoing modifications in the SARS-CoV-2 virus. As a global pandemic, the Omicron variant also spread among the Kurdish population. This study aimed to analyze different strains from different cities of the Kurdistan region of Iraq to show the risk of infection and the impact of the various mutations on immune responses and vaccination. A total of 175 nasopharyngeal/oropharyngeal specimens were collected at West Erbil Emergency Hospital and confirmed for SARS-CoV-2 infection by RT-PCR. The genomes of the samples were sequenced using the Illumina COVID-Seq Method. The genome analysis was established based on previously published data in the GISAID database and compared to previously detected mutations in the Omicron variants, and that they belong to the BA.1 lineage and include most variations determined in other studies related to transmissibility, high infectivity and immune escape. Most of the mutations were found in the RBD (receptor binding domain), the region related to the escape from humoral immunity. Remarkably, these point mutations (G339D, S371L, S373P, S375F, T547K, D614G, H655Y, N679K and N969K) were also determined in this study, which were unique, and their impact should be addressed more. Overall, the Omicron variants were more contagious than other variants. However, the mortality rate was low, and most infectious cases were asymptomatic. The next step should address the potential of Omicron variants to develop the next-generation COVID-19 vaccine.

Assessment of the implementation of preventive measures by Iraqis people to reduce the spread of coviD-19 pandemic.

BACKGROUND AND AIM: The new outbreak "Coronavirus disease 2019 (COVID-19)" happened in china is caused by severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2). Consequently, it spreads across the globe and is affecting wellbeing frameworks and the global economy. This pandemic disease places a heavy burden on governments in general, so individuals must adhere to WHO's instructions to limit its spread. The current study was applied to find out the extent of commitment among the Iraqi people to the standards of prevention measures against the coronavirus. MATERIALS AND METHODS: A cross sectional study was conducted with 1153 respondents widely in all governorates of Iraq to identify the commitment of the Iraqis to the preventive measures against COVID-19 in Iraq. This study covered the Iraqis in three main regions (Southern, middle, and Northern) for data collection. It was conducted between the 17th and 25th of March 2020, and Iraqis were administered with a structured questionnaire comprising of three domains. RESULTS: The results showed that the majority of the respondents (52%) were female, and most of them (42.3%) were observed between the age group of 31-40 years. About 82% of the respondents were residents of urban areas. CONCLUSION: This study reveals the excellent implementation of preventive measures by the population. It is observed that the application of prevention standards in the countryside is less than in the city.

EVALUATION OF HUMAN ABO BLOOD GROUPS AND BLOOD COMPONENTS AMONG IRAQI PATIENTS INFECTED WITH CORONAVIRUS DISEASE 2019 (COVID-19).

OBJECTIVE: The aim: To evaluate the differences in blood groups, gender and type of Rh factor, as well as the levels of hemoglobin, white blood cells and platelets among patients infected with COVID-19. PATIENTS AND METHODS: Materials and methods: A cross-sectional study was performed on 202 patients diagnosed with sever COVID-19 infection who were admitted to the Al-Shefaa center in Al- Hakeem hospital in Al-Najef city.Haematological investigations involved the types of blood groups, Rh factors, haemoglobin (Hb), white blood cells (WBCs), and platelets. In addition, the demographic features including age, gender and presence of any prescribed medications before or at the time of the study were also included. RESULTS: Results: This study indicated that COVID-19 infected patients with type A blood group are at higher risk of hospitalization than other blood groups, and the majority of these patients were Rh positive. Additionally, WBCs counts indicated that the majority of patients had increased risk of getting infections which demonstrated lower WBC counts than normal. Platelet and Hb levels were normal for the majority of patients. CONCLUSION: Conclusions: The findings of this study may help in the diagnosis of the pandemic infection with COVID-19, and prediction of the incidence of some complications caused by COVID-19. Further researches are warranted to confirm our findings.

Assessment of COVID-19 vaccination among healthcare workers in Iraq; adverse effects and hesitancy.

Several messenger ribonucleic acid (mRNA) and inactivated COVID-19 vaccines are available to the global population as of 2022. The acceptance of the COVID-19 vaccine will play a key role in combating the worldwide pandemic. Public confidence in this vaccine is largely based on its safety and effectiveness. This study was designed to provide independent evidence of the adverse effects associated with COVID-19 vaccines among healthcare workers in Iraq and to identify the attitudes of healthcare workers who rejected the vaccination. We conducted a cross-sectional study to collect data on the adverse effects of the Pfizer, AstraZeneca, and Sinopharm vaccines. Data were collected between October 2021 and February 2022. A total of 2,202 participants were enrolled in the study: (89.97%) received injections of the COVID-19 vaccines and (10.03%) were hesitant to receive the vaccination. Participants received either the Pfizer vaccine (62.9%), AstraZeneca vaccine (23.5%) or Sinopharm vaccine (13.6%). Most adverse effects were significantly less prevalent in the second dose than in the first dose. Notably, the adverse effects associated with the Pfizer vaccine were significantly more prevalent in females than in males. Following the first dose, the participants experienced more adverse effects with the AstraZeneca vaccine. Following the second dose, more adverse effects were associated with the Pfizer vaccine. Interestingly, the prevalence of COVID-19 infection in participants who received two doses of the Pfizer vaccine was significantly reduced compared to those who received two doses of either the AstraZeneca or Sinopharm vaccines. According to vaccine-hesitated participants, insufficient knowledge (29.9%), expeditious development (27.6%) and lack of trust in the vaccines (27.1%) were the three major reasons for refusing the vaccines. The results of our study indicated that these adverse effects do not present a significant problem and should not prevent successful control of the COVID-19 pandemic.

Association between ABO blood groups and the risk of infection with SARS-CoV-2 in Iraq.

OBJECTIVE: The primary goals of this research were to analyze the relationship between ABO blood types and the severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and investigate the effect of vaccination in Iraq. METHODS: Data and outcomes were gathered from the medical records of 200 patients. Patients were categorized by blood group and vaccination status in the analysis. RESULTS: In total, 200 hospitalized patients (125 men and 75 women) with confirmed SARS-CoV-2 infection and blood group (ABO) and clinical data were enrolled. Of the 200 patients, 155 (77.5%) were vaccinated against SARS-CoV-2. The results illustrated that 25 patients died, which might have been attributable to a lack of vaccination or older age. Our analysis revealed that blood group O individuals were much less likely to be infected by SARS-CoV-2 than non-O subjects, whereas blood group A individuals carried a higher risk of infection. CONCLUSIONS: Our findings illustrated that immunization significantly reduces COVID-19 risk across all age groups, but there has been an increase in the number of cases because of decreased vaccine efficacy in older patients and persons with comorbidities. However, 45% vaccination coverage lowered the outbreak's peak.

COVID-19 Death Rates in Iran and Iraq: Possible Relations Between Iraq's Pre-COVID-19 Mass Gatherings and Its Low Death Rate.

In recent years, COVD-19 has made millions of death worldwide. When reviewing the death rate, we encountered a very notable difference in death rate of Iran and Iraq, which are two neighboring countries. Investigating the COVID-19 risk factors, parameters, such as ethnicity and vaccination, do not appear not to be affecting our observation. We also could not find important differences in mortality rate being under-reported in the two countries. In this letter, we tried to discuss the possible effect of Iraq pre-COVID-19 mass gatherings on the death rate. The authors would like to highlight the effect of immune system on COVID-19.

COVID-19 infection among dentists in Iraqi Kurdistan Region.

INTRODUCTION: COVID-19 incidence was relatively high among dentists in Iraq, reflecting the high number of cases in the community. Therefore, possible epidemiological features of COVID-19 infection were investigated among dentists in Iraqi Kurdistan Region. METHODOLOGY: A cross-sectional study has been conducted among dentists using a structured questionnaire. The questionnaire included demographic and working characteristics, self-reported COVID-19 history, and prevention practices toward SARS-CoV-2 during the pandemic. An online questionnaire was developed and spread with a snowball method among dentists. RESULTS: We analyzed the responses of 83 participants (31 women and 52 men, mean age 33.8 ± 6.8 years). They had a mean of 10.6 ± 6.5 years of work experience and 20.2 ± 12.6 hours of weekly working time. In total, 46 (55.4%) of the participants reported COVID-19 infection. Only 29 (34.9%) participants always followed the hygiene rules. The most common personal precautions were mask-wearing (98.8%) and hand hygiene as a part of institutional protective precaution (51.8%). Of the infected dentists, 24 (52.2%) did not know the source of infection. Of the remaining 16 (34.8%) were infected from family and/or friends circle, and five (10.9%) from patients. Eleven of them (23.9%) reported transmitting the infection to at least one person. In the multivariate analyses, working in Sulaymaniyah Province (p = 0.031) and working only in a public hospital (p = 0.029) were significant risk factors for COVID-19 infection. CONCLUSIONS: The high risk of COVID-19 infection among dentists in the Iraqi Kurdistan Region relates to their family and friends rather than their occupation.

Sequencing and mutations analysis of the first recorded SARS-CoV-2 Omicron variant during the fourth wave of pandemic in Iraq.

Despite vaccine development and vaccination programs underway around the globe, the coronavirus disease 2019 (COVID-19) pandemic has not been controlled as the SARS-CoV-2 virus is evolving and new variants are emerging. This study was conducted to sequence and molecularly characterize the representing samples from the early fourth SARS-CoV-2 wave in Iraq. Here, we have performed next-generation sequencing of whole-genome sequencing of two representing samples from the country's early beginning of the fourth pandemic wave. The samples were sequenced using Illumina Miseq system, and the reference sequences were retrieved from GISAID database. Phylogenetic analysis was performed through Mega software. This study provides an initial sequence analysis and molecular characterization of the first Omicron variant cases recorded in the country. Our analysis revealed many mutations on the spike glycoprotein, especially on the receptor binding domain, with potential impact on immune escape and infectivity. The study findings suggest considering the highly mutated immunogenic epitope of the Omicron variant as a reference for developing a new vaccine for combating the ongoing pandemic.

Strict social distancing measures helped early control of SARS-CoV-2 spread in Duhok city, Iraq.

The aim of this letter is to discuss the pandemic management measures, including social distancing and community containment, taken in Duhok city in Northern Iraq, where a few patients were infected with COVID-19. During the first three months of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, 15 patients were diagnosed with SARS-CoV-2 in Duhok city. All the patients were asymptomatic and were discharged to their home within 10 ± 3.2 days after throat swabs indicated a negative SARS-CoV-2 Real Time Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) test. The social distancing and lockdown measures taken by the city were implemented in three stages. In the first stage, all educational institutions including schools, colleges and universities were closed. In the second stage, all gatherings were banned. Finally, state-imposed community-wide containment was declared. The social distancing measures helped control infections in the city. Gradual reopening is recommended to avoid the spread of infection.

Cross-sectional study of Middle East respiratory syndrome coronavirus in humans and dromedary camels in Diyala, Iraq.

BACKGROUND: Middle East respiratory syndrome (MERS) is a zoonotic viral disease transmitted from dromedaries to humans. To date, more than 1500 cases of MERS have been reported and 80% of all cases have occurred in the Kingdom of Saudi Arabia (KSA). This cross-sectional study was carried out to figure out the rate of infection among humans and dromedary camels and to explore the risk factors. METHODS: This study was conducted in Diyala Province, Iraq for the period from August 2017 to October 2018. Human subjects included 90 participants; 34 (37.8%) were females and 56 (62.2%) were males. Additionally, 90 dromedary camels were also included, 50 (55.6%) males and 40 (44.4%) females. Serum samples from subjects were collected and tested for the presence of anti-MERS-coronavirus (CoV) immunoglobulin g (IgG). RESULTS: The results revealed that 46 (51.1%) of human subjects were positive for anti-MERS-CoV IgG, (95% confidence interval (CI) for the prevalence rate 40.9-61.3) with a mean titer of anti-MERS-CoV IgG antibodies (Ab) of 81.2 U/mL. The anti-MERS-CoV IgG positivity rate was insignificantly higher, but the mean of anti-MERS-CoV IgG titer was significantly higher among females (p = 0.12 and p < 0.004, respectively). Furthermore, the anti-MERS-CoV IgG positivity rate and Ab titer were significantly higher among those people who visited KSA for Hajj or Umrah (p < 0.001 and p < 0.001, respectively). In camels, 81 (90.0%) were positive for anti-MERS-CoV IgG, (95% CI for the prevalence rate 82.5-94.9), with a mean titer of 99.8 U/mL. DISCUSSION: The MERS-CoV infection rate was high among both Iraqi humans and dromedary camels. Further confirmatory studies are needed, and setting up of national precaution program is essential.

Prevalence of SARS -CoV-2 IgG/IgM antibodies among patients in Zakho City, Kurdistan, Iraq.

INTRODUCTION: In 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the agent of Coronavirus Disease 2019 (COVID-19), spread all over the world. This global pandemic spread rapidly to more than 195 countries and caused over 200 million infections with a mortality rate of 2%. This study aimed to detect seropositivity against the SARS-CoV-2 virus among outpatients, symptomatic and asymptomatic individuals. METHODOLOGY: A total of 489 individuals of age 5-70 years (mean 38.0 ± 17 SD) were enrolled for a cross-sectional study. They were tested for presence of SARS-CoV-2 IgM/IgG antibodies in serum samples using Enzyme-linked Immunofluorescent Assay (ALFA). RESULTS: A higher seroprevalence was recorded for IgM among females (34.96%) than males (28.83%). In the case of IgG, and IgG + IgM, both males and females had similar values. A significant correlation was identified between seropositivity and age; higher seropositivity (IgG, IgM, and IgG + IgM) was recorded in age groups 51-60 and ≥ 61 years, relative to the younger age groups. No significant correlation was found between symptomatic and asymptomatic individuals. No significant correlation was detected between seropositivity and RT-PCR positive and negative cases. CONCLUSIONS: COVID-19 is spreading rapidly and there is a high percentage of asymptomatic carriers. The sensitivity of RT-PCR tests is not uniform and may not be able to detect all cases. On the other hand, serology can be used for large scale testing to detect the real extent to which the disease has spread.

Misdiagnosis of COVID-19 infection before molecular confirmation in Sulaimaniyah City, Iraq.

BACKGROUND: During the last 2 years, in the Kurdistan Region, Northern Iraq, there were thousands of COVID-19 cases that have not been reported officially, but diagnosed and confirmed by private laboratories and private hospitals, or clinicians based on typical clinical signs, as well as few people using home self-test after appearing of some flu-like clinical symptoms. Thus, this study aims to assess the misdiagnosis and mismanagement of cases before COVID-19 confirmation. METHODS: This study enrolled 100 consecutive patients who visited an outpatient clinic of Shar Hospital that had symptoms highly suspicious of COVID-19 infection while misdiagnosed previously to have other types of disease. Detailed questionnaires were filled for all studied patients, including age, gender, main presenting symptoms, and duration of these symptoms with the following questions: who made the false diagnosis, depending on which diagnostic test the false diagnosis was made, which medication was used for the false diagnosis, who prescribed those medications, and how long those medications were used. They were investigated by RT-PCR on their nasopharyngeal swab for confirmation. RESULTS: Most of the false diagnoses were typhoid (63%), influenza (14%), pneumonia (9%), gastroenteritis (5%), common cold (4%), brucellosis (4%), and meningitis (1%). Regarding the false diagnosis of cases, 92% were made by non-physician healthcare workers, and only 8% were made by physicians. All false diagnoses with typhoid, gastroenteritis, and common cold were made by non-physician healthcare workers, together with about half of the diagnosis of pneumonia and brucellosis, with statistically significant results (P < 0.001). CONCLUSIONS: We realized that some patients had been misdiagnosed before the COVID-19 infection confirmation. Their health conditions improved drastically after correct diagnosis and treatment, and this research is considered the first research to be conducted in Iraq in this regard.

Visual health and prevalence of dry eye syndrome among university students in Iraq and Jordan.

Dry eye syndrome (DES), is a multifactorial disease that affects the ocular surface and contributes to the ocular symptoms. The COVID-19 pandemic influenced the general population and university students' health in different ways. The pandemic forced many people including university students around the world to use virtual platforms on their digital devices, such as computers and smartphones, to work from a distance. This study aimed to explore the visual health and prevalence of dry eye syndrome among university students in Iraq and Jordan. This was a cross-sectional study that was conducted in Iraq and Jordan using online questionnaire tool for the duration between November 2021 and January 2022. University students in Jordan and Iraq were invited to participate in this study and formed the study population. No restrictions on study level or field of study were applied. A previously developed and validated questionnaire tools were used in this study (National Eye Institute Visual Functioning Questionnaire - 25 (VFQ-25) and the Women's Health Study Questionnaire (WHS), which was developed by Schaumberg et al.). A total of 1,431 university students were involved in this study (1,018 students from Iraq, 71.1%). Around one third the study participants (29.0%) reported that have been diagnosed by a clinician as having dry eye syndrome. Around15.3% of the total study participants reported that they feel their eyes are dry (not wet enough) and 17.3% reported that they feel their eyes are irritated. Based on Women's Health Study Questionnaire (WHS) criteria, a total of 479 participants (33.4%) are symptomatically diagnosed with DES. Students aged 27-29 years, those at their fifth year of study, and those who wear contact lenses are at higher risk of developing DYS compared to others. Dry eye syndrome is common health problem among university students. Further studies are required to identify other risk factors associated with DES. Future research should focus on identifying strategies that could help reduce the risk of developing DES as a result of the inevitability of long-term use of digital devices among many categories of society, including university students.

The vaccination coverage rate in under-5 children in Nasiriyah, Iraq before and during the COVID-19 pandemic.

OBJECTIVES: This study compared the vaccination coverage rate (VCR) in children under 5 years old in Nasiriyah, Iraq before and during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: This cross-sectional study was conducted in the city of Nasiriyah in southeastern Iraq, with data collected from 79 primary healthcare facilities. This study evaluated the VCR in 3 periods (2018, 2019, and 2020) using multi-level random sampling. Pertinent data were extracted from the vaccination records of 598 children for Bacillus Calmette-Guérin (BCG); pentavalent 1, 2, and 3; measles; and activated oral poliovirus vaccine 1 and 2. Missing data were completed by telephone calls to participants' parents. Logistic regression was applied to compare and estimate the odds ratios (ORs) with 95% confidence intervals (CIs) for the association between VCR and related factors. RESULTS: The data showed the greatest decline in the studied vaccines in 2020. Among the vaccines studied, BCG had the highest rate in all 3 periods (100% VCR) and measles had the lowest rate (83.7%), reaching 63.6% in 2020 (p<0.001). The highest OR among all types of vaccine were found for the pentavalent-3 vaccine among city dwellers and those born in 2020 (OR, 2.67; 95% CI, 1.39 to 5.10 and OR, 2.34; 95% CI, 1.28 to 4.28, respectively). CONCLUSIONS: The VCR for children decreased during the COVID-19 pandemic in Iraq, and new health policies are needed to increase the coverage rate. Improving the knowledge and attitudes of parents, as well as removing barriers or risk factors, can also be effective in improving the VCR.

COVID-19 vaccine breakthrough infection among fully vaccinated healthcare workers in Duhok governorate, Iraqi Kurdistan: A retrospective cohort study.

The aims of this study were: to determine the incidence of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection among vaccinated healthcare workers (HCWs), assess risk factors associated with the vaccine breakthrough (BT), and compare the effectiveness of vaccine manufacturers against SARS-CoV-2 variant of concern among HCWs in Duhok governorate. It is a multicenter retrospective cohort study, which enrolled 944 HCWs through March 2022. COVID-19 vaccinated HCWs aging 18 and above were included. A random sampling process was performed by asking the participants to fill out a standardized questionnaire by means of interviews or participant-completed surveys. Fully vaccinated HCWs with positive polymerase chain reaction tests were considered to have vaccine BT infection. Two hundred and eighty-four (30.1%) out of 944 vaccinated HCWs had SARS-CoV-2 infection postvaccination, of whom 241 (84.9%) were fully vaccinated, concluding that the incidence of BT infection is 25.5%. There were 422 (44.7%) males and 522 (55.3%) females. Most vaccine BT infections had developed in SARS-CoV-2 Omicron variant (53.5%). The majority of BT infections were mild to moderate (95.5%). Occupation, namely dentist was a significant risk factor, with a p value of 0.001. HCWs with a history of SARS-CoV-2 infection prevaccination were more prone to a vaccine BT infection (p value =0.002). Pfizer vaccine manufacturers revealed the highest effectiveness against BT infection (p value =0.0001). Paramedics showed a significant association with the disease severity (p value =0.02). The three available vaccine manufacturers in the Duhok governorate are effective against COVID-19 BT infections. Dentists and paramedics were significantly associated with poor COVID-19 outcomes.

Menstrual changes following COVID-19 infection: A cross-sectional study from Jordan and Iraq.

PURPOSE: COVID-19 infection is normally followed by several post-COVID effects. This study aimed to investigate to evaluate menstrual changes in females following COVID-19 infection, and to evaluate female perception about the effect of COVID-19 on their menstrual cycles. METHODS: During this cross-sectional survey-based study, a convenience sample of 483 women from Jordan and from Iraq, who had infected with COVID-19 were invited to fill-out the study questionnaire. RESULTS: The study was conducted on the females, with a median age 31 years old. Results showed that 47.2% of them (n = 228) suffered from a change in the number of days between two consecutive periods, as well as from a change in the amount of blood loss. Also, more than 50% of them believed that COVID-19 infection may cause changes in the amount of blood loss during the cycle (n = 375, 56.9%), and changes in the number of days between the two consecutive periods (n = 362, 54.2%). Regression analysis showed that participants with higher educational level (bachelor or higher) (Beta = -0.114, P = 0.011), and those living in Iraq (Beta = -0.166, P<0.001) believed that COVID-19 has lower tendency to cause menstrual changes. In addition, non-married females (Beta = 0.109, P = 0.017), and those who are current smokers (Beta = 0.091, P = 0.048) believed that COVID-19 has higher tendency to cause menstrual changes. CONCLUSION: his study revealed that COVID-19 infection could affect the menstrual cycle for the females. Further prospective studies should be done to confirm these findings and evaluate how long these menstrual irregularities lasted.

Trends in COVID-19: Incidence, mortality, and case fatality in Iraq.

OBJECTIVES: To detect the epidemiological trend of coronavirus disease-19 (COVID-19) in Iraq, the distribution of cases by age, gender, and governorates, and to assess its burden on the health system by estimating morbidity and mortality rates. METHODS: This biometric study was carried out in 2021. The distribution, incidence, mortality, and case fatality rates in a 17-month period was sketched in a biometric design. A semi-structured questionnaire was distributed to a number of decision makers in the Ministry of Health regarding health system challenges that have been faced during this pandemic. RESULTS: More than half (55.1%) of the cases were among males, and 67.5% were in the age group 30-60 years. Mortality was also predominant among males (62.7%), and 50.0% of the deaths were in the age group >50 years. The predominant age group for both genders was 30-60 years. Case fatality rate was 1.2%; again higher among males (1.3% versus 1.1%). CONCLUSION: The trend of COVID-19 in Iraq showed 2 peaks, August-October 2020 and March-July 2021, with males being more affected by morbidity, mortality, and fatality. The main challenge faced by the Iraqi health system was the rapid increase of COVID-19 cases with limited bed capacity and medical equipment.

Molecular and computational analysis of spike protein of newly emerged omicron variant in comparison to the delta variant of SARS-CoV-2 in Iraq.

BACKGROUND: The Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) has had a major impact on world health over the last 2 years. The emergence of SARS-CoV-2 variants, particularly concerning variants, may affect the virus's pathogenicity, transmissibility, and vaccines potency. Both delta and the omicron variants have been designated by WHO as variants of concern. METHODS AND RESULTS: In this study, molecular techniques such as qPCR, conventional PCR, and sequencing were used to identify the first SARS-CoV-2 omicron variant that circulated in Iraq in January 2022. Bioinformatics and computational tools like phylogenetic analysis, predicted physical and chemical properties, stability, and molecular docking of the spike protein were used to compare the omicron with the delta variants. We found the receptor binding domain (RBD) and spike protein in omicron contain a greater number of hydrophobic amino acids compared to delta variant. We discovered a disorder-order conversion in RBD regions of the omicron variant, and this change may be important in terms of the effect of disordered residues/regions on spike protein stability and interaction with human angiotensin converting enzyme 2 (ACE2). Docking studies show that the omicron variant requires less energy to engage with ACE2, contributing to its higher binding affinity with human ACE2, consistent with more contagious transmission. CONCLUSION: This is the first molecular study of the circulated omicron and delta variants in Iraq, showing that the omicron variant in Iraq had a higher affinity for ACE2 than the delta variant, which may lead to higher transmissibility.

Evaluation of IgM and IgG in COVID-19 Recovered Patients in Iraq.

Severe acute respiratory syndrome coronavirus-2 is a major threat to health care worldwide with high morbidity and mortality. Therefore, understanding the role of immune mechanisms and humoral response is vital in this disease. The present study aimed to investigate the relationship between Immunoglobulins (IgM, IgG) in COVID-19 recovered patients with age, gender, and severity of the disease. The duration of effect of antibody levels and protection against re-infection has also been evaluated in the patients. Three groups participated in this study; group 1: 0-14 days after recovery, group 2: 2 months after recovery, group 3: 3 months after recovery, group 4: 4-6 months after recovery, group 5: more than 6 months. The nasopharyngeal swab was used to confirm recovery by Real-Time Polymerase Chain Reaction (RT-PCR) technique. IgM and IgG antibody levels were evaluated using Enzyme-Linked Immuno Fluorescent Assay (ELIFA) technique. The results indicated that the IgM levels increased for one month during the seven days after infection and then decreased in most patients (P≤0.05). The mean of IgG in group 1 increased compared to those of other studied groups. A significant decrease was observed in group 2 compared to group 1, as well as in group 3 compared to groups 1, and 2. Also, a significant difference existed between group 4 compared to groups 1, 2, and 3. Finally, significant differences were noticed between group 5 compared to groups 1, 2, 3, and 4 (P≤0.05). No significant differences were observed in antibodies level between male, and female COVID-19 recovered patients in groups 1, 2, 3, 4, and 5 (P≤0.05). Finally, highly significant differences in IgG levels between mild, moderate, and severe subgroups in groups 1 and 2. The present study demonstrated that IgM and IgG against SARS-CoV-2 appeared in the early stages of the disease and decreased after 1 month and failed to maintain high levels during the 6-month observation.

Assessment of some Physiological Biomarkers in COVID-19 Patients in Thi-Qar, Iraq.

It is believed that many biomarkers and factors could be linked to the prognosis of coronavirus disease 2019 (COVID-19). Therefore, this study aimed to evaluate the association of lactate dehydrogenase (LDH), D-Dimer, vitamin D, and ferritin statuses with the prognosis of COVID-19; moreover, it was attempted to investigate its prevalence according to age, employment status, body mass index (BMI), and place of residency in a population sample of hospitalized patients in Thi-Qar, Iraq. This study evaluated 200 COVID-19 patients and 100 controls. The BMI of all individuals was calculated, and such demographic characteristics as age, gender, place of residency, and occupational status were collected from all participants. Blood samples were taken and used to estimate D-Dimer, LDH, vitamin D, ferritin, oxygen, and pulse rate. The mean age of the patients approached the fifth decade, and 72% of the cases were more than 40 years of age. In addition, 60% of the patients were living in the countryside, and 52% of the participants were employed, compared to only 8% of the cases who were students. The BMI of the patients was obtained at 31.44±10.2 kg/m2; accordingly, 47% and 40% of the cases were obese and overweight, respectively, compared to only 12% of the patients who had normal weight (P˂0.05). There were significantly lower vitamin D levels in the patients; however, the concentrations of LDH, serum ferritin, and D-Dimer were significantly higher in the patients, compared to the control group (P˂0.05). Not only age and body weight but also employment status and place of residency maybe also the important risk factors for COVID-19 distribution. LDH, D-dimer, vitamin D, and ferritin statuses could be used as good biomarkers for this disease and its severity.