Department of Medicine, College of Medicine, University of Sulaimani, Sulaimani New, Street 29, Zone 207, Sulaymaniyah, 46001, Republic of Iraq.
Department of Physiology, College of Medicine, University of Sulaimani, Sulaimani New, Street 29, Zone 207, Sulaymaniyah, 46001, Republic of Iraq.
Eur J Med Res. 2022 Jun 3;27(1):84. doi: 10.1186/s40001-022-00704-0.
During the last 2 years, in the Kurdistan Region, Northern Iraq, there were thousands of COVID-19 cases that have not been reported officially, but diagnosed and confirmed by private laboratories and private hospitals, or clinicians based on typical clinical signs, as well as few people using home self-test after appearing of some flu-like clinical symptoms. Thus, this study aims to assess the misdiagnosis and mismanagement of cases before COVID-19 confirmation.
This study enrolled 100 consecutive patients who visited an outpatient clinic of Shar Hospital that had symptoms highly suspicious of COVID-19 infection while misdiagnosed previously to have other types of disease. Detailed questionnaires were filled for all studied patients, including age, gender, main presenting symptoms, and duration of these symptoms with the following questions: who made the false diagnosis, depending on which diagnostic test the false diagnosis was made, which medication was used for the false diagnosis, who prescribed those medications, and how long those medications were used. They were investigated by RT-PCR on their nasopharyngeal swab for confirmation.
Most of the false diagnoses were typhoid (63%), influenza (14%), pneumonia (9%), gastroenteritis (5%), common cold (4%), brucellosis (4%), and meningitis (1%). Regarding the false diagnosis of cases, 92% were made by non-physician healthcare workers, and only 8% were made by physicians. All false diagnoses with typhoid, gastroenteritis, and common cold were made by non-physician healthcare workers, together with about half of the diagnosis of pneumonia and brucellosis, with statistically significant results (P < 0.001).
We realized that some patients had been misdiagnosed before the COVID-19 infection confirmation. Their health conditions improved drastically after correct diagnosis and treatment, and this research is considered the first research to be conducted in Iraq in this regard.
在过去的 2 年里，在伊拉克库尔德斯坦北部地区，有数千例 COVID-19 病例未经官方报告，但已被私人实验室和私人医院或临床医生根据典型临床症状诊断和确认，还有少数人在出现一些类似流感的临床症状后使用家庭自检。因此，本研究旨在评估 COVID-19 确诊前病例的误诊和管理不当。
本研究纳入了 100 例连续就诊于 Shar 医院门诊的患者，这些患者之前被误诊为其他类型疾病，症状高度疑似 COVID-19 感染。对所有研究患者进行详细的问卷调查，包括年龄、性别、主要表现症状以及这些症状的持续时间，并提出以下问题：谁做出了错误诊断，错误诊断依据的是哪种诊断测试，错误诊断使用了哪种药物，谁开了这些药物，以及这些药物使用了多长时间。对所有患者的鼻咽拭子进行 RT-PCR 检测以确认。
大多数错误诊断为伤寒（63%）、流感（14%）、肺炎（9%）、肠胃炎（5%）、普通感冒（4%）、布氏杆菌病（4%）和脑膜炎（1%）。关于病例的错误诊断，92%是由非医务人员做出的，只有 8%是由医生做出的。所有伤寒、肠胃炎和普通感冒的误诊都是由非医务人员做出的，与肺炎和布氏杆菌病的一半左右误诊有统计学意义（P<0.001）。
我们意识到，在 COVID-19 感染确诊之前，一些患者被误诊了。在正确诊断和治疗后，他们的健康状况明显改善，这项研究被认为是伊拉克在这方面进行的首次研究。
