Keywords : COVID-19,,

Intrauterine vertical transmission of COVID-19 during pregnancy: A systematic review

Jasim Al Asadi; Sadiq M Mousa

The Medical Journal of Basrah University, 2021, Volume 39, Issue 1, Pages 7-20
DOI: 10.33762/mjbu.2021.128851.1045

Background: COVID-19 infection in pregnancy raised concerns about the risk of intrauterine vertical transmission of the SARS-CoV-2 from mother to fetus.
Objectives: to review the current evidence on the possibility of intrauterine vertical transmission potential among COVID-19 infected pregnant mothers.
Methods: Eligible studies published from December 2019 until August 1, 2020, were searched for from PubMed, PubMed Central, Google scholar, medRxiv, and bioRxiv collection databases using MeSH-compliant keywords including COVID-19, pregnancy, intrauterine vertical transmission, Coronavirus 2019, SARS-CoV-2, 2019-nCoV, and maternal-fetal transmission.
Results: The initial search yielded 152 articles. After elimination of duplicates, review, commentaries, and articles from media, 78 articles were deemed relevant and comprised neonatal outcome data for 1231 neonates whose mothers were infected with COVID-19. Of these 78 articles, 24 articles that fulfilled the inclusion criteria were eventually selected for analysis yielding 517 neonates from 514 pregnancies (3 sets of twins). Most of the women (64.4%) were delivered by cesarean section. Vaginal delivery was reported in 31.7%, and in 20 women (3.9%), the mode of delivery was not reported. Of the total 517 neonates reported in the 24 analyzed articles, 51 neonates (9.9%; 95% CI, 7.4-12.8) were tested by positive by at least one of the investigation tools, and 38 neonates (7.3%; 95% CI, 5.3-9.9) were found positive for SARS-CoV-2 by RT-PCR nasopharyngeal swab.
Conclusions: The risk of intrauterine vertical transmission of SARS-CoV-2 in late pregnancy is possible but rare. However, the potential risk of vertical transmission in early pregnancy is not yet assessed.

National Health Systems Response to COVID-19 Outbreak, Iraq an Example

Alaa Hussein Abed; Dhurgham A. Abdulwahid; Haider A. Jassim

The Medical Journal of Basrah University, 2021, Volume 39, Issue 1, Pages 1-6
DOI: 10.33762/mjbu.2021.130218.1071

This article describes chronologically the development of COVID-epidemic in Iraq, mainly Basra Province, and the response of the national and provincial health system response to control this crisis. It points some strengths and weaknesses of this response. In addition, it mentions some of the opportunities that need to get benefit from, including following an evidence-based approach in epidemic control management. Some of the international assessments' results showed that the performance of Iraqi health system come at the tail of the sorted list of international health systems. This necessitates conducting a scientific systematic evaluation to the national performance to precisely quantify structural and process strengths and weaknesses.

The Pandemic of COVID-19 in Eastern Mediterranean Region: Selected Outcome Parameters

Omran Habib; Dhurgham A Abdul-Wahid; Nabil Salim Khudair; Nihad Qasim Mohammed; Riyadh A Al-Hilfi

The Medical Journal of Basrah University, 2020, Volume 38, Issue 2, Pages 15-24
DOI: 10.33762/mjbu.2020.128305.1036

Background: Despite the passage of eight months since the start of COVID-19 pandemic, it still represents a major public health problem at global, regional and national levels.
Objective: To present comparative outcome indicators and time trends for the pandemic among countries in the Eastern Mediterranean Region and to discuss possible determinants behind such trends.
Methods: We used data on all newly reported cases of COVID-19 infection from the start of the pandemic in each EMR country till the middle of August, 2020. Two sources of data were used: the World Health Organization Website (Corona World meters) and a private website reporting cases world countries. Numbers were directly abstracted from these sources and Excel programme functions were used to make graphic presentations.
Results: As on August 5,2020 countries of the Eastern Mediterranean Region varied substantially in scale of the incidence rate per million population (from highest of 38939.1 in Qatar to lowest of 54.2 in Syria), the case fatality (closed case fatality ratio) ranged from Lowest of 0.2% in Qatar to the highest of 37.0% in Yemen. Cause-specific mortality rate ranged from 1.1 to 212.5 per million population in Jordan and Iran respectively. Testing policy was the main determinants of reported cases. None of the countries has reached a stage of clear exit based on scientific evidence despite the decline in the scale of cases in most countries.
Conclusion: Most of The countries are experiencing a pattern of accelerated pandemic and are heading towards declining trend.

Incidence and Characterization of Skin Lesions Among Hospitalized Patients with COVID-19 infection: An Observational Cohort Study from Iraq

Zahraa Jasim; Khalili Al Hamdi; Samer Dhaher; Zainab Hadi; Hayder Aledan; Muhammed Ahmed; Ziyad Tariq

The Medical Journal of Basrah University, 2020, Volume 38, Issue 2, Pages 46-54
DOI: 10.33762/mjbu.2020.128833.1044

Background and objectives: A wide arrays of skin lesions occurred in the setting of COVID-19 infection. We aimed to estimate the incidence and types of skin lesions among hospitalized patients with COVID-19 infection.
Methods: We conducted an observational cohort study on 369 hospitalized patients with COVID-19 infection at Basra Teaching Hospital for 3 months. We studied the incidence and types of skin lesions.
Results: Among 369 hospitalized patients, skin lesions were developed in 5%. Of those who developed skin lesions, 33% were asymptomatic. Patients who developed skin lesions were younger (mean age of 40 ± 19.6 SD) and female (83.3%). The most frequent type of skin lesion was maculopapular 44.3% which occurred exclusively in the medical ward and half of them in asymptomatic patients. For pustular lesions, all were female, diabetic, in the ICU, in symptomatic patients with the highest levels of serum C-reactive proteins. Pseudo-chilblain lesions were reported only in younger female and half of patients were asymptomatic. Urticarial lesions were reported in the younger patients, two-thirds were symptomatic and in the ICU. Purpuric lesions were reported in the older patient who developed acute kidney injury. Extremities were the most common distribution of skin lesions in 38.8%. The mean latency period for development of skin lesions was 8.6 ± 9.1, the shortest for urticarial lesions and the longest for purpuric lesions.
Conclusions: Different types of skin lesions were reported in patients with COVID-19 and may be the sole manifestations of the disease.