vv 016 Citation: Nasef A, Taguri AE (2020) Tracking of Covid-19 in Libya. Stud Stem Cells Res Ther 6(1): 016-0017. DOI: https://dx.doi.org/10.17352/sscrt.000016 https://dx.doi.org/10.17352/sscrt DOI: 2641-3000 ISSN: LIFE SCIENCES GROUP Introduction We read with interest the article entitled “Preliminary epidemiological analysis of suspected cases of corona infection in Libya” published by Dr. Daw MA, 2020. The author acknowledged the declaration of Coronavirus Disease 2019 (COVID-19) pandemic and the difficulties in application of WHO and CDC measures in conflict areas such as Libya. Epidemiological, clinical and laboratory data We noticed that the article was submitted on 16 March and was published online on 20 March. This was eight days earlier than the official declaration of the first case of COVID-19 in Libya. The author did not report about the required legally mandatory notification of the cases to the local health authorities. This is of a great concern, due to the nature of infection and the fragility of the Libyan HealthCare systems. There was no information about the time of conducting the research, its place, and eventual admission of the patients to intensive care units. There were no comments about respiratory symptoms especially respiratory rate and/ or dyspnea. Laboratory investigation did not include hypoxia assessment and blood gas results were not reported even for the two patients who died. Total number of patients were eight, but in reporting about the radiological findings, six patients (75%) had bilateral pneumonia and three patients (38%) had unilateral pneumonia, which make a total of nine different presentations. We were wondering whether in reality there were findings of unilateral pneumonia in two patients (25%) and multiple mottling in three patients (38%). The author reported negative results for screening of respiratory viruses. There was no mention of the types of respiratory infections that were looked for. This is of paramount importance as some of the resources required might not be available, and many diseases such as Influenza A and B viruses, respiratory syncytial virus, parainfluenza virus, adenovirus, or COVID like viruses such as Sever Acute Respiratory Syndrome (SARS), or Middle East Respiratory Syndrome (MERS) could present with similar range of clinical pictures. In addition, the diagnosis of these patients was not confirmed by the recommended Polymerase Chain reaction (RT-qPCR) or other accepted tests. Moreover, it is known now that C-reactive Protein (CRP) and Angiotensin II levels among others are markedly elevated and are linearly associated to viral load, acute lung injury and prognosis. Unfortunately, these testes either were not performed or were not reported by the author. The author reported the death of two patients out of the eight patients (25%). This is particularly a high case fatality rate from COVID-19 in comparison to reported figures on other parts of the world. This is of particular concern as, no data was mentioned about associated comorbidities, but the laboratory investigations reported that six patients were diabetics and six were anemic. The number of cases in this study is small, and no conclusive mortality rate can be withdrawn in the time being. As two patients (25%) passed away, it would be worthy to know if they were patients with ground glass opacity, as it is usually found in the second week of COVID-19 infection. It is not clear whether these suspected cases were informed about their possible diagnosis and eventual consent for this publication. Patient’s isolation seems to be practiced according to scoring criteria based on travel history, clinical finding and circumstantial radiological and laboratory investigation. The author mentioned that the patients were treated according to international standards. Looking back to referenced protocol of treatment, it includes anti-viral drugs and alpha interferons inhalation with use of steroids and gamma immunoglobulins in certain indications. It’s not clear why they adopt this treatment protocol as investigations did Letter to Editor Tracking of COVID-19 in Libya Aisha Nasef* and Adel El Taguri 1 Authority of Natural Science Research and Technology, Medical Specialty Council, Libya 2 Department of community Medicine, University of Tripoli, Libya Received: 10 April, 2020 Accepted: 26 May, 2020 Published: 27 May, 2020 *Corresponding author: Aisha Nasef, Authority of Natural Science Research and technology, Medical Specialty Council, Libya, E-mail: Keywords: Corona; COVID-19; Libya; Epidemiological https://www.peertechz.com