Objective/Background: While there is no universal agreement on the benefits of convalescent plasma (CP) in the treatment of COVID-19 infection, very little is known about whether CP affects the association between chronic diseases and mortality. It is known that chronic diseases are associated with worse outcomes, but it is not clear whether the transfusion of CP impacts this association. This study aims to evaluate this impact considering that few studies have discussed the treatment of COVID-19 patients with CP. Methods: A cross-sectional study was conducted among COVID-19 patients treated with CP at the main hospital for treatment and isolation of COVID-19 in Anbar/Iraq during the period of May to August 2020. A questionnaire on socio-demographic characteristics, smoking, and contact with COVID-19 was conducted. The presence of comorbidity, especially hypertension, heart failure, coronary artery disease, diabetes mellitus, chronic pulmonary diseases, asthma, and the hospital outcome (discharged home alive or cure/death) were included. The Chi-square test (or Fisher's exact test) was used to measure the association between comorbidity with the outcome. Logistic regression was used to assess the main predictors for cure (discharged home alive) and death outcome. Results: The mean age of the subjects was (53.05 ± 15.16), with a higher death rate among the older age group, especially those over 60-year with non-survivors at age of 65 or more. There was a statistically significant association between the presence of comorbidity and the mortality rate (P < 0.001). Subjects with chronic disease had a 5 times higher risk for death due to COVID-19 in comparison to those without the chronic disease (OR = 5.8, C.I. = 2.01-16.96, P = 0.001), hypertension showed the highest predictor (C.I = 1.43- 22.29, p = 0.013). Smoking and gender were not associated with mortality. Conclusion: The present study found a high mortality rate among COVID-19 patients treated with CP, specially for those with age over 60, or with comorbidities.

Background: The socio-clinical characteristics have been considered an important variable associated with COVID-19 and a predictor of morbidity and mortality. Convalescent plasma therapy (CPT) was one of the modalities used worldwide for COVID-19 treatment. In Iraq, there is a paucity of studies evaluating the socio-clinical variables of patients with severe COVID-19 treated with CPT. Objectives: This study aims to describe the socio-clinical characteristics of patients with severe COVID-19 treated with and without CPT in one of the main COVID-19 treatment centers in Iraq. Materials and Methods: A descriptive cross-sectional study was conducted between May 15 and August 14, 2020, at the main COVID-19 treatment center in Anbar Governorate, west of Iraq. Out of 529 hospitalized patients, a total of 438 with severe disease were enrolled in the study. Results: The participants’ mean age was 49.9±13.8 years. The majority of the subjects were males, aged ≥40 years, residing in urban areas. 65.2% of the patients had at least one comorbidity, and 6.4% were smokers. Hypertension and diabetes mellitus represented the two commonest comorbid conditions. All patients have required oxygen therapy; 41.1% were performed with continuous positive airway pressure. Male patients aged ≥60, and patients with comorbidities received CPT at a higher frequency. Conclusion: This study corroborates the findings from other studies that certain socio-clinical characteristics had an association with hospitalization related to severe COVID-19. Convalescent plasma was administered in more than one-fifth of the COVID-19 hospitalized patients in Anbar during the early pandemic phase.

Background: Multiple myeloma (MM) is a clonal proliferation of malignant plasma cells that results in the production of a monoclonal paraprotein with a light or heavy chain that is seen in the urine and/or serum. The ultimate goal of the MM therapy is the achievement of complete response (CR). The aim of this study is to evaluate the efficacy of the commonly used therapeutic protocols of MM utilized at the National Center of Hematology in Baghdad, Iraq. Materials and Methods: Fifty-two patients with MM were enrolled consecutively for a cross-sectional study between July 2015 and May 2022 at one of Iraq’s major hematology institutions, the National Center of Hematology, Mustansiriyah University. The enrolled patients were evaluated for the overall response rate (ORR), which constitutes CR, very good partial response, and partial response, in comparison to non-response (NR), which constitutes stable disease and progressive disease. Responses to the main MM triple therapeutic regimens used in Iraq, VCD, VRD, and VTD, were evaluated. These regimens are composed of cyclophosphamide (C), bortezomib (V), thalidomide (T), lenalidomide (R), and dexamethasone (D). According to its availability, subsequent autologous stem cell transplantation (ASCT) was performed for some patients. Results: Of the 52 enrolled patients, 50 (96.2%) were assessed at a median follow-up time of 60.5 months. The mean ± SD age of the enrolled patients was 61.5 ± 11.0 years, and the male-to-female ratio was 3:2. However, two patients (3.8%) died before the end of the follow-up. The most common features the patients presented with were bone pain and/or backache in 67.3% of the patients, followed by lower limb weakness and mass (1.9% each). The radiological changes include osteolytic lesions in 34.6% and vertebral wedging in 15.4% of the patients. The most frequent laboratory findings were anemia (69.2%), with hemoglobin levels of 10.0 ± 1.5g/dL, detection of IgG-kappa paraprotein (51.9 %), and high levels of serum calcium in 23.1% (11.7 ± 1.1mg/dL) and serum creatinine in 21.2% (3.3 ± 1.5mg/dL) of the patients. ORR was 88.5%, while NR was reported in 11.5% of the patients. The outcomes were stratified according to the treatment used. It was found that ORR showed statistically significant differences and the VRD group demonstrated the best (P < 000.1). Twenty-one (40.4%) patients underwent subsequent ASCT, and the ORR showed non-significant differences compared to that when patients did not undergo transplantation (P > 0.05). Conclusions: In this study, VRD was the most effective protocol with a better ORR. In addition, the age of the patients presenting with MM in Iraq was less than in western countries. Also, most of the patients were presented with bone lesions, and IgG was the predominant type of myeloma paraproteins.

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Objectives/Background: Since the outbreak of COVID-19, healthcare professionals suggested a wide range of recommendations in the fields of diagnosis, treatment, and prevention. Laboratory biomarkers are considered one of the crucial diagnostic tools for COVID-19, assessing its severity and progress predictor. Owing to the lack of consensus regarding changes in biomarkers and their correlations, researchers are encouraged to detect more interesting findings. A few studies were conducted in Iraq considering this aspect. This study aimed to investigate certain biomarkers in patients with severe COVID-19 and their relations to mortality outcomes. Also, this study aimed to identify the correlation between these markers in severe disease. Patients and Methods: A cross-sectional study was conducted at the Fallujah Teaching Hospital, west of Iraq, which included all admittance with severe COVID-19 between September 20, 2021, and February 30, 2022. A questionnaire was designed to collect socio-clinical characteristics and in-hospital outcomes (recovery/death). Procalcitonin (PCT) and certain biomarkers were analyzed, based on that outcome, and correlations between these markers were assessed. Results: For 75 patients who were enrolled in this study, the mean age was 62.3 ± 14.3 years, of which females constituted 62%. The most preponderance age was ≥60 years with a statistically significant higher rate of death (37.3%) when compared to other ages (P = 0.007), while other socio-clinical characteristics revealed nonsignificant differences. High PCT levels were found in 34.7% of the enrolled patients, while neutrophilia, lymphopenia, and elevated levels of troponin, ferritin, and C-reactive protein (CRP) were the prominent abnormal biomarker findings. However, only ferritin and troponin mean levels revealed significant differences in relation to the outcomes (P = 0.019 and 0.010, respectively). A moderate positive correlation was found between PCT and interleukin-6 (IL-6) (r = 0.586, P = 0.005), and also PCT correlates positively with CRP (r = 0.49, P = 0.005) and troponin (r = 0.41, P = 0.001). Additionally, there were significant positive correlations of troponin with IL-6 (r = 0.41, P = 0.005) and PCT (r = 0.37, P = 0.001). Also, IL-6 correlates positively with troponin (r = 0.62, P = 0.005). Conclusions: We found an elevated level of PCT in almost three-quarters of patients with severe COVID-19, with a non-significant difference with the specific recovery/death outcomes. In addition, high troponin levels, neutrophilia, and lymphopenia regardless of the outcome were found. Also, there were valuable correlations between certain biomarkers in patients with COVID-19.