Coronavirus Disease 2019 (<scp>COVID</scp>‐19): Potential implications for weak health systems and conflict zones in the Middle East and North Africa region

Da’ar, Omar B.; Haji, Mohamed; Jradi, Hoda

doi:10.1002/hpm.2982

Cited by 24 publications

(16 citation statements)

References 21 publications

(23 reference statements)

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“…Special attention to COVID-19 infections is needed in the countries of the MENA region, where political and economic factors might lead to devastating effects on the countries affected by the current pandemic ( Karamouzian and Madani, 2020 ; Sawaya et al., 2020 ). Particular attention should be paid to countries like Yemen, Syria and Libya, where the ongoing instabilities can result in underreporting of COVID-19 cases and heavy burden on their health-care systems ( Da'ar et al., 2020 ; Daw, 2020 ; Karamouzian and Madani, 2020 ; Sawaya et al., 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Temporal increase in D614G mutation of SARS-CoV-2 in the Middle East and North Africa

Sallam¹,

Ababneh²,

Dababseh³

et al. 2021

Heliyon

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Background: Phylogeny construction can help to reveal evolutionary relatedness among molecular sequences. The spike (S) gene of SARS-CoV-2 is the subject of an immune selective pressure which increases the variability in such region. This study aimed to identify mutations in the S gene among SARS-CoV-2 sequences collected in the Middle East and North Africa (MENA), focusing on the D614G mutation, that has a presumed fitness advantage. Another aim was to analyze the S gene sequences phylogenetically. Methods: The SARS-CoV-2 S gene sequences collected in the MENA were retrieved from the GISAID public database, together with its metadata. Mutation analysis was conducted in Molecular Evolutionary Genetics Analysis software. Phylogenetic analysis was done using maximum likelihood (ML) and Bayesian methods. Result: A total of 553 MENA sequences were analyzed and the most frequent S gene mutations included: D614G ¼ 435, Q677H ¼ 8, and V6F ¼ 5. A significant increase in the proportion of D614G was noticed from (63.0%) in February 2020, to (98.5%) in June 2020 (p < 0.001). Two large phylogenetic clusters were identified via ML analysis, which showed an evidence of inter-country mixing of sequences, which dated back to February 8, 2020 and March 15, 2020 (median estimates). The mean evolutionary rate for SARS-CoV-2 was about 6.5 Â 10 À3 substitutions/site/year based on large clusters' Bayesian analyses. Conclusions: The D614G mutation appeared to be taking over the COVID-19 infections in the MENA. Bayesian analysis suggested that SARS-CoV-2 might have been circulating in MENA earlier than previously reported.

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Section: Introductionmentioning

confidence: 99%

Temporal increase in D614G mutation of SARS-CoV-2 in the Middle East and North Africa

Sallam¹,

Ababneh²,

Dababseh³

et al. 2021

Heliyon

View full text Add to dashboard Cite

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“…The challenge of COVID-19 is very high globally due to a lack of proven treatment and the complexity of its transmission [16][17][18][19][20]. However, the impact is more catastrophic for low and middle-income countries because of very poor health care system, high illiteracy and low awareness of the disease and its prevention, lack of skilled health personnel, scarce Intensive Care Unit, a limited number of mechanical ventilators, and prevalence of co-morbidities/infection along with malnutrition [15,[20][21][22].…”

Section: Introductionmentioning

confidence: 99%

Postoperative mortality among surgical patients with COVID-19: a systematic review and meta-analysis

2020

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Background The coronavirus disease 2019 (COVID-19) pandemic puts perioperative providers and staff at risk of viral exposure to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) during aerosol-generating procedures, particularly in asymptomatic carriers.However, the perioperative risk for adverse outcomes in SARS-CoV-2 infected patients remain uncertain and the topic of debate. The current study was designed to determine the postoperative mortality in COVID-19 patients based on a systematic review and meta-analysis of the global published peer-reviewed literature. Methods A comprehensive search was conducted in PubMed/Medline; Science direct and LILACS from December 29, 2019, to August15, 2020, without language restriction. All observational studies reporting the prevalence of mortality were included while case reports and reviews were excluded. The data from each study were extracted with two independent authors with a customized format excel sheet and the disagreements were resolved by the third author. The methodological quality of included studies was evaluated using a standardized critical appraisal Tool adapted from the Joanna Briggs Institute. Results A total of 715 articles were identified from different databases and 45 articles were selected for evaluation after the successive screening. Twenty-three articles with 2947 participants were included. The meta-analysis revealed a very high global rate of postoperative mortality among COVID-19 patients of 20% (95% CI: 15 to 26) and a postoperative ICU admission rate of 15% (95% confidence interval (CI):10 to 21). Conclusion The unexpected high postoperative mortality rate in SARS-CoV-2 infected patients of 20% in the global literature mandates further scrutiny in assuring appropriate surgical indications and perioperative surgical safety measures in this vulnerable cohort of patients. Registration This systematic review and meta-analysis was registered in Prospero’s international prospective register of systematic reviews (CRD42020203362) on August 10, 2020.

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“…Special attention to COVID-19 infections is needed in the countries of the MENA region, where political and economic factors might lead to devastating effects on the countries affected by the current pandemic (Karamouzian and Madani, 2020;Sawaya et al, 2020). Particular attention should be paid to countries like Yemen, Syria and Libya, where the ongoing instabilities can result in underreporting of COVID-19 cases and heavy burden on their health-care systems (Da'ar et al, 2020;Daw, 2020;Karamouzian and Madani, 2020;Sawaya et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Temporal Increase in D614G Mutation of SARS-CoV-2 in the Middle East and North Africa: Phylogenetic and Mutation Analysis Study

Sallam¹,

Ababneh

Dababseh³

et al. 2020

Preprint

View full text Add to dashboard Cite

Phylogeny construction can help to reveal evolutionary relatedness among molecular sequences. The spike (S) gene of SARS-CoV-2 is the subject of an immune selective pressure which increases the variability in such region. This study aimed to identify mutations in the S gene among SARS-CoV-2 sequences collected in the Middle East and North Africa (MENA), focusing on the D614G mutation, that has a presumed fitness advantage. Another aim was to analyze the S gene sequences phylogenetically. The SARS-CoV-2 S gene sequences collected in the MENA were retrieved from the GISAID public database, together with its metadata. Mutation analysis was conducted in Molecular Evolutionary Genetics Analysis software. Phylogenetic analysis was done using maximum likelihood (ML) and Bayesian methods. A total of 553 MENA sequences were analyzed and the most frequent S gene mutations included: D614G=435, Q677H=8, and V6F=5. A significant increase in the proportion of D614G was noticed from (63.0%) in February 2020, to (98.5%) in June 2020 (p<0.001). Two large phylogenetic clusters were identified via ML analysis, which showed an evidence of inter-country mixing of sequences, which dated back to February 8, 2020 and March 15, 2020 (median estimates). The mean evolutionary rate for SARS-CoV-2 was about 6.5 × 10-3 substitutions/site/year based on large clusters’ Bayesian analyses. The D614G mutation appeared to be taking over the COVID-19 infections in the MENA. Bayesian analysis suggested that SARS-CoV-2 might have been circulating in MENA earlier than previously reported.

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Coronavirus Disease 2019 (COVID‐19): Potential implications for weak health systems and conflict zones in the Middle East and North Africa region

Cited by 24 publications

References 21 publications

Temporal increase in D614G mutation of SARS-CoV-2 in the Middle East and North Africa

Temporal increase in D614G mutation of SARS-CoV-2 in the Middle East and North Africa

Postoperative mortality among surgical patients with COVID-19: a systematic review and meta-analysis

Temporal Increase in D614G Mutation of SARS-CoV-2 in the Middle East and North Africa: Phylogenetic and Mutation Analysis Study

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