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. 2025 Feb;15(2):885-892.
doi: 10.5455/OVJ.2025.v15.i2.37. Epub 2025 Feb 28.

Case fatality rate of zoonotic SARS.CoV2 and associated risk factors in the Libyan population

Hafsa A Alemam  1 , Abdusalam Sharef Mahmoud  2 , Mouna A Abdunnabi  2 , Ahlam Masaud Ellafi  3 , Abdurrezagh A Elfahem  4 , Khaled M Ibrahim  5 , Salah Edin El Meshri  4 , Adam Elzghied  5   6
Affiliations

Case fatality rate of zoonotic SARS.CoV2 and associated risk factors in the Libyan population

Hafsa A Alemam et al. Open Vet J. 2025 Feb.

Abstract

Background: Infectious zoonotic viral respiratory diseases have dramatically emerged and reemerged globally, with high socioeconomic and public health impacts. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak was first reported in China as a transmissible disease among animals and humans with great universal public concern. Later, it slipped across the world as a pandemic with a high significant case fatality rate (CFR).

Aim: This study was conducted to estimate the CFR and potentially associated risk factors among animals and the Libyan population.

Methods: This retrospective cohort study assessed the CFR of coronavirus disease 2019 (COVID-19) and investigated the potentially associated risk factors (socio-demographic data, animal reservoir, household characteristics, and health status) among the Libyan population from July 2020 to January 2021. A total of 3,000 respiratory specimens (nasopharyngeal swabs) were screened by real-time reverse transcription polymerase chain reaction to detect SARS-CoV-2. Descriptive analyses, frequency, and percentage were measured for numerical data and numbers, and rate for qualitative data. The level of the association among variables at the significance level (p < 0.05) was investigated using SPSS version 22.

Results: The present study reported a variable degree of association with the investigated risk factors included in this study: sociodemographic data, household characteristics, and health status. The overall CFR showed significant differences in vitamin D, Blood group system (ABO), health status, and comorbidity.

Conclusion: The CFR seems to have been underestimated; however, our result reported a relatively high CFR in Libya, at least in the surveyed region (targeted population). The risk factors measured in this study potentially significantly influenced the CFR. Among these potential risk factors were animal welfare, vitamin D levels, the ABO system, lymphocyte count (level), and healthy status. In contrast, the results showed that other risk factors were not significantly associated with the CFR. The results highlighted the potential risk of fatalities in the country. A large set of prospective studies is required to enhance our understanding of the CFR associated with zoonotic COVID-19 in Libya.

Keywords: Animal reservoir; Case fatality rate; Libya; SARS-CoV2; Zoonoses.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1.
Fig. 1.. COVID-19 hypothesis based on keeping and non-keeping animals.
Fig. 2.
Fig. 2.. CFR according to Vitamin D values.
Fig. 3.
Fig. 3.. CFR based on the ABO system.
Fig. 4.
Fig. 4.. CFR according to comorbidity.
Fig. 5.
Fig. 5.. CFR according to occupation.
Fig. 6.
Fig. 6.. CFR according to COVID-19 clinical form.
See this image and copyright information in PMC

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