The epidemiological and clinical details of COVID19 pandemic in Libya are well characterized in this study. Up to July 31 th a total of 3695 were reported which accounted of 6.2/10000 of population. The mean age was 53 years old, with a male to female ratio of 2.1:1. Of these patients, 74 (1.3%) were died. The largest number were reported in the Western and Southern regions which accounted for 1732 (47.8%) and 418 (11.5%) respectively. Though it was less in the Eastern 729 (20.1%) and Meddle 418 (11.5%) regions . Our data showed that COVID-19 infects men more than women; these findings are in concordance with other studies reported from China and Iran [25,26]. Although, there is no obvious reason for such gender variability speculation has been raised regarding the hormonal and genetic variation or even to social culture particularly in Middle-east and African countries. However, other studies have shown , similar susceptibility to SARS-CoV-2 between males and females .
Taking the patients’ age into consideration, children ( <15 years) accounted only for 2.4 and those aged 20-50 years accounted for (4-9.5.%) although those aged over 60 years represents the largest number of infected cases which accounted for 10-24 %. This is clearly evident that COVID-19 among Libyan correspondence to a higher age. In fact most deaths in infected individuals occurred in Italy, Spain and France occurred in old people suffering from severe conditions particularly in the early phases of the epidemics. However, a recent study carried on the Libyan population demography shows that over 65 % of the Libyan population are aged less than 60 years old.
Based on our data the majority of the reported cases were mild 2327 (64.3%)and moderate 1101 (30.4%). Although only 102 (2.8%) were Sever and 91 (2.5%) Critical. The association between illness severity and age was evident in this study. It was shown that illness severity aggravated with age. Although the infected and deceased patients were significantly older than the patients who survived COVID-19, ages were comparable between males and females in both the deceased and the patients who survived. Furthermore , this study has showed that males tend to experience more serious cases of COVID-19 than females according to the clinical classification of severity including Mild, Moderate, Severe, and Critical. This is in agreement with other studies carried by Li etal, and Jian-Min etal . who showed that men’s cases tended to be more serious than women’s[19,30] . Therefore, gender may be considered as a risk factor for higher severity and mortality in patients with COVID-19, independent of age and susceptibility.
In this study we evaluated the spatial and temporal patterns of the COVID-19 pandemic in Libya within the first 16 Epi-weeks of the epidemic. In the early stage of the COVID-19 outbreak , few sporadic cases were reported in first six Epi-weeks in Tripoli at the Western region. By the end of the 8 th epi-week, the cases spread to cities neighboring Tripoli such as Musrta and Zawia ; the first-order neighboring cities showed a particularly increased number of confirmed cases. Since then, the number of weekly confirmed COVID-19 cases exponentially increased across the country from the 9 th to 16th epi-week. During the entire, study period, the prevalence of COVID-19 in Libyan regions showed striking variations. The epidemic was much higher and important in Western and Southern regions though it was less in Meddle and Eastern regions. This is more likely to depend on the different timing of the onset of the outbreak in each regions [31,32].
it is clearly evident in this study that the dynamics of the epidemic in Libya followed a geographical differentiation, with a strong West to South gradient, although no region was free of cases and deaths at the end of August. In all regions, both morbidity and mortality curves tended to depart from linear lines up and no sign of flattening with time, thus highlighting critical situation of the epidemic. Similar trends were observed early stages of spread COVID‐19 in Italy. Spain and France. Hence then specific strategies should be implemented to contain the soared of the pandemic [33,34].
Despite that the study gave a detailed information regarding the Epidemiology of COVID-19 in Libya. The reported data suffer from many uncertainties and limitations. These may include. First, the confirmed cases of COVID-19 might not reflect the actual number of persons infected by COVID-19 as many cases were a symptomatic and some went untested further to the limited testing resources in the country. Second the study did not highlights the impact of the ongoing armed conflict on spread of COVID-19 in Libya which defiantly hinder the accurate number of cases in certain cities. Third, the study, did not cover certain groups such as immigrants displaced population and injured people who are prone at higher risk of COVID-19 [35-37].