Early COVID-19 Management Experience in Iraq: A 40-Day Single Center Study Analysis

This document presents a comprehensive analysis of a study conducted at Baghdad's Medical City Teaching Hospital (MCTH) during the initial phase of the COVID-19 pandemic. It outlines key demographic insights, clinical classifications, treatment protocols, and outcomes observed during the first 40 days of the crisis. The findings provide valuable contributions to understanding pandemic management strategies in Iraq and their alignment with global trends.

Study Overview and Demographics

A groundbreaking study conducted at Baghdad's Medical City Teaching Hospital (MCTH) has provided valuable insights into Iraq's early response to the COVID-19 pandemic. The research, spanning the first 40 days of the crisis, offers crucial data on treatment protocols and patient outcomes during the critical initial phase of the pandemic.

The study examined 469 suspected cases, identifying 79 RT-PCR positive patients who were admitted for treatment. Key demographic findings include:

• Mean patient age: 47.18 ± 18 years
• Gender distribution: 74.68% male (59 patients) and 25.31% female (20 patients)
• Most affected age group: 40-50 years
• Higher prevalence among males (3:1 ratio)

Study Overview and Demographics

A groundbreaking study conducted at Baghdad's Medical City Teaching Hospital (MCTH) has provided valuable insights into Iraq's early response to the COVID-19 pandemic. The research, spanning the first 40 days of the crisis, offers crucial data on treatment protocols and patient outcomes during the critical initial phase of the pandemic.

The study examined 469 suspected cases, identifying 79 RT-PCR positive patients who were admitted for treatment. Key demographic findings include:

• Mean patient age: 47.18 ± 18 years
• Gender distribution: 74.68% male (59 patients) and 25.31% female (20 patients)
• Most affected age group: 40-50 years
• Higher prevalence among males (3:1 ratio)

Clinical Classification and Treatment Protocol

Patients were categorized into four severity levels:

• Mild: 48.10% (38 patients)
• Moderate: 16.45% (13 patients)
• Severe: 18.98% (15 patients)
• Critical: 16.45% (13 patients)

The hospital implemented a tiered treatment protocol based on disease severity:

1. Mild cases received conservative treatment without specific medication
2. Moderate cases were treated with Oseltamivir and Hydroxychloroquine
3. Severe cases received additional Lopinavir-Ritonavir
4. Critical cases were administered Ribavirin along with the previous medications

Treatment Outcomes

The study reported encouraging results:

• Complete recovery: 51.89% (41 patients)
• Clinical recovery (symptom-free): 84.9%
• Overall mortality: 12.65% (10 patients)
• Early mortality (within 24 hours): 7.5% (6 patients)
• Later mortality (after 24 hours): 5.06% (4 patients)

Among non-recovered patients (48.1%):

• 44.73% became symptom-free but maintained positive RT-PCR results
• Only 5.26% remained symptomatic after five days of treatment

Significant Findings

1. The case fatality rate (CFR) showed improvement over time:
   • Initial three weeks: 7.5%
   • Subsequent three weeks: 5.06%
   These figures aligned with international trends.
2. The younger mean age of patients compared to European data was attributed to Iraq's predominantly younger population demographics.
3. The treatment protocol demonstrated effectiveness with:
   • High clinical recovery rate (84.9%)
   • Low rate of persistent symptoms (2%)
   • Promising complete recovery rate (51.89%)

Conclusions

The study demonstrates that Iraq's early response to COVID-19, particularly at MCTH, was largely successful. The implemented treatment protocol showed promising results, with recovery rates comparable to international standards. The initially higher mortality rates improved significantly after the first three weeks, following patterns observed in other countries.

The research highlights the importance of early intervention and structured treatment protocols in managing pandemic situations. It also underscores the value of systematic data collection and analysis during the initial phases of a health crisis, providing valuable insights for future pandemic responses.

Significance

This study represents one of the first comprehensive analyses of COVID-19 management in Iraq, offering valuable insights into the effectiveness of early treatment protocols and hospital management strategies during the initial phase of the pandemic. The findings contribute to the global understanding of COVID-19 treatment approaches and outcomes in different healthcare settings and populations.