Iran as the Center of challenges in the Middle East for the Outbreak of COVID-19 Delta Variant

Context: During the past three decades, the Middle East has experienced three major viral epidemics. Coronavirus disease 2019 (COVID-19) is a pulmonary disease which has been first reported in China in the early third decade of the 21st century and quickly infected people in Asia, the Middle East, and the entire world. This pandemic is life-threatening and has caused widespread financial losses; however, the exact extent of the damage is still unclear. Evidence Acquisition: This review study aimed to present the latest on the COVID-19 symptoms, pathogenicity, host immune responses, etiology and epidemiology, transmission routes in the Middle Eastern countries, especially Iran, and the role this country plays in the spread of the disease. The search was conducted using Google scholar, PubMed, Scopus, and ISI Web of Science to identify relevant studies published from 2019 to 2021. Results: Many countries do not have sufficient equipment to prevent, identify, and treat the disease and still have major challenges in controlling this deadly virus. In Iran, a Middle Eastern country, people faced widespread disease and deaths due to the lack of facilities caused by heavy economic and political sanctions. These challenges affect not only Iran but also many neighboring countries. Over time, mutations in the SARS-CoV-2 virus led to the emergence of various variants of the virus, such as Alpha (B.1.1.7), Beta (B.1.351), Gamma (B.1.1.28.1), and Delta (B.1.617.2). Conclusion: Different variants of SARS-CoV-2 virus pose a substantial menace to public health due to their high transmissibility and ability to escape the immune system. Recently, concerns have increased about the risk of hospitalization and the high spread rate of the COVID-19 delta variant.