Covid-19 Virus Variants and Gender Distribution over the Common Four Waves of the Outbreak

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Marwan Khalil Qader et al.


Background: Coronavirus disease-19 (COVID-19), produced by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic, giving rise to a serious health threat globally.

Aims: The aims of the current study were to investigate the distribution of the viral variants that caused the epidemic and to determine the rate of infection in a gender-based approach.

Methods: The current study is a retrospective cohort study which involved 999 cases of covid-19 infection recovered from passengers crossing Ibrahem Al khalel border, Zakho, Kurdistan region, Iraq. Sample collection started at 15th March until 15th October 2020. All patients admitted in march 2020 were considered to be in the first wave, all those whose admission date started at January 2021in the second wave. The admission of July 2021 was considered as the third wave of the pandemic in this region, and the patients admitted in February 2022 assigned to the fourth wave of the epidemic. The infection was confirmed by RT-PCR after obtaining swab samples from the upper respiratory tract (nasopharyngeal/oropharyngeal exudate). Multiple virus variants were investigated in the present work by utilizing variant-specific primers and the resultant viral strains were assigned to the waves of infection. During the current study, four waves of COVID-19 were reported.

Results: The minimum percentage (11.01 %) of the participants were affected during the first wave while the higher percentage (47.65 %) was for those who experienced the disease during the fourth wave; moreover, 12.71 % and 28.63 % were reported for the participant who have been through the second and the third waves, respectively. The results also revealed that females were more affected by the disease (52.65 %) compared to the males (47.35 %). The results showed that six virus variants dominated the four waves of viral spread. The alpha (B1.1.7) and the alpha (B1.1.7.2) variants were reported in the four waves of the disease, three more variants namely beta (B.1.351), delta (B.1.617.2), and delta (B.1.617.3) were reported in the second, third, and fourth waves of the pandemic; while omicron BA.2 (B.1.1.529.2) variant was reported in the fourth wave exclusively. There was statistically significant association between gender and the wave of infection (p<0.001).

Conclusions: In conclusion, the infection had differential pattern of distribution by gender and the presence of multiple variants in a single wave referred to the rapidly changing nature of the virus.

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