Abstract
Background:
Infectious zoonotic viral respiratory diseases have dramatically emerged and reemerged globally, with high socioeconomic and public health impacts. The 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 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 3000 respiratory specimens (nasopharyngeal swabs) were screened by real-time reverse transcription polymerase chain reaction (RT-PCR) 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 case fatality rate showed significant differences in vitamin D, ABO system, 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.

Key words: Animal reservoir, Case fatality rate, Libya, SARS-CoV2, Zoonoses