Analysis of COVID-19 Outbreak in Iraq from the Perspective of Doctors Working in Iraqi Hospitals

Background: The COVID-19 is an enveloped RNA enveloped beta coronavirus. In Iraq there were more than 700 cases officially reported for the period from February 24th 2020 to April 1st 2020 and the case fatality rate was 7.1%. This study aims to determine the most common clinical characteristics of patients who are confirmed as COVID-19 positive in Iraq, as well as to understand the underlying causes which make Iraq have one of the highest case-fatality rates in the world. Methods: A total of 128 doctors working in Iraqi hospitals participated in this study through answering a questionnaire that has been prepared for this purpose. The questionnaire included a set of questions related to the symptoms of the disease, hospital procedures, the level of these procedures and major obstacles. A total of 108 patients who were diagnosed with COVID-19 enrolled in this study to understand the clinical characteristics of COVID-19 in Iraq. Result: The most common symptoms of COVID-19 in Iraq were: fever (seen in 85.2% of patients), cough (55.6%), shortness of breath (31.5%), fatigue (27.8%), headache (7.4%), diarrhea (1.9%), and (9.3%) were asymptomatic. Initial chest X-rays were abnormal in (63%) and lymphopenia was seen in (72.2%). Most of the doctors (76.2%) complained from the unclear guidelines regarding COVID-19 screening and (17.7%) of suspected cases were not tested for COVID-19. Conclusion: The high fatality rate which seen in Iraq is related to the low level of awareness and late presentation of the patients, in addition to the limited number of the COVID-19 screening tests, unclear guidelines regarding the patients who should be enrolled for the COVID-19 testing, and finally, many of the suspected cases which were reported by doctors were not provided with the necessary tests to confirm the diagnosis. All these together contribute to high fatality rate.