Outcomes of COVID-19: Disparities by ethnicity

Ali, Hamad; Alshukry, Abdullah; Marafie, Sulaiman K.; AlRukhayes, Monera; Ali, Yaseen; Abbas, Mohammad Bu; Al-Taweel, Abdullah; Bukhamseen, Yousef; Dashti, M H; Alshammari, Abdullah; Abu-Farha, Mohammad; Abubakr, Jehad; Al-Mulla, Fahd

doi:10.1016/j.meegid.2020.104639

Cited by 29 publications

(33 citation statements)

References 6 publications

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“…Toxic metal pollutants in high dense areas can cause mitochondrial stress, increasing the vulnerability in psychiatric patients who already have mitochondrial dysfunction due to psychiatric illness, namely schizophrenia, bipolar disorder, and major depressive disorder, and who become infected and develop COVID-19 illness[ 17 , 108 ]. In Kuwait, a multi-ethnic country, South East Asians mostly live in highly populated dense areas where overcrowding and pollutants lead to higher exposure to COVID-19 illness[ 2 ]. This higher exposure can increase transmission of COVID-19, possibly leading to worsened mental health outcomes due to the potentiating effects of mitochondrial stress.…”

Section: Disparities Between Urban and Rural Environmentsmentioning

confidence: 99%

“…Amid the coronavirus disease 2019 (COVID-19) pandemic, vulnerable populations are the most affected medically, resulting in limited access to care and worsened health outcomes, including death[ 1 ]. Identified vulnerable populations include children with developmental disabilities, mature adults, pregnant women, sexual and gender minorities, and Black, Indigenous and People of Color communities[ 2 - 6 ]. Health outcomes differ in vulnerable populations than the general public since there is a disproportionate exposure to risk factors that cause disease[ 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Global health disparities in vulnerable populations of psychiatric patients during the COVID-19 pandemic

Diaz¹,

Baweja²,

Bonatakis³

et al. 2021

WJP

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The coronavirus disease 2019 pandemic affects psychiatric patients disproportionately compared to the general population. In this narrative review, we examine the impact of the pandemic on significant global health disparities affecting vulnerable populations of psychiatric patients: People of diverse ethnic background and color, children with disabilities, sexual and gender minorities, pregnant women, mature adults, and those patients living in urban and rural communities. The identified disparities cause worsened mental health outcomes placing psychiatric patients at higher risk for depression, anxiety and posttraumatic stress disorder symptoms. Those psychiatric patients who are ethnic minorities display barriers to care, including collective trauma and structural racism. Sexual and gender minorities with mental illness face discrimination and limited access to treatment. Pregnant women with psychiatric diagnoses show higher exposure to domestic violence. Children with disabilities face a higher risk of worsening behavior. Mature adults with psychiatric problems show depression due to social isolation. Psychiatric patients who live in urban communities face pollutants and overcrowding compared to those living in rural communities, which face limited access to telehealth services. We suggest that social programs that decrease discrimination, enhance communal resilience, and help overcome systemic barriers of care should be developed to decrease global health disparities in vulnerable population.

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Section: Disparities Between Urban and Rural Environmentsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Global health disparities in vulnerable populations of psychiatric patients during the COVID-19 pandemic

Diaz¹,

Baweja²,

Bonatakis³

et al. 2021

WJP

View full text Add to dashboard Cite

show abstract

“…The global pandemic COVID-19 caused by SARS-CoV-2 virus is lifethreatening and has become a significant concern to humanity. Notably, the severity of this disease is highly variable in different populations across the world [1,2]. Since the outbreak, several studies have reported specific factors including age, gender, and pre-existing health conditions that could have contributed to the increased severity of the disease [3,4,5,6].…”

Section: Introductionmentioning

confidence: 99%

ACE2 and FURIN variants are potential predictors of SARS-CoV-2 outcome: A time to implement precision medicine against COVID-19

Al-Mulla¹,

Mohammad²,

Madhoun³

et al. 2021

Heliyon

Self Cite

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The severity of the new COVID-19 pandemic caused by the SARS-CoV-2 virus is strikingly variable in different global populations. SARS-CoV-2 uses ACE2 as a cell receptor, TMPRSS2 protease, and FURIN peptidase to invade human cells. Here, we investigated 1,378 whole-exome sequences of individuals from the Middle Eastern populations (Kuwait, Qatar, and Iran) to explore natural variations in the ACE2, TMPRSS2, and FURIN genes. We identified two activating variants (K26R and N720D) in the ACE2 gene that are more common in Europeans than in the Middle Eastern, East Asian, and African populations. We postulate that K26R can activate ACE2 and facilitate binding to S-protein RBD while N720D enhances TMPRSS2 cutting and, ultimately, viral entry. We also detected deleterious variants in FURIN that are frequent in the Middle Eastern but not in the European populations. This study highlights specific genetic variations in the ACE2 and FURIN genes that may explain SARS-CoV-2 clinical disparity. We showed structural evidence of the functionality of these activating variants that increase the SARS-CoV-2 aggressiveness. Finally, our data illustrate a significant correlation between ACE2 variants identified in people from Middle Eastern origins that can be further explored to explain the variation in COVID-19 infection and mortality rates globally.

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“…Whereas pediatric cases show a milder clinical course [ 11 ], a worse prognosis has been associated with older age and being male. Emerging evidence also indicates that preexisting medical conditions, including hypertension, cardiovascular disease, chronic kidney disease, chronic obstructive pulmonary disease, solid organ transplantation, and diabetes, can increase the risk of poor COVID-19 prognosis [ 2 , 12 , 13 , 14 , 15 , 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics and outcomes of COVID-19 patients with diabetes mellitus in Kuwait

Alshukry

Abbas

Ali

et al. 2021

Heliyon

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Background COVID-19 has a highly variable clinical presentation, ranging from asymptomatic to severe respiratory symptoms and death. Diabetes seems to be one of the main comorbidities contributing to a worse COVID-19 outcome. Objective In here we analyze the clinical characteristics and outcomes of diabetic COVID-19 patients Kuwait. Methods In this single-center, retrospective study of 417 consecutive COVID-19 patients, we analyze and compare disease severity, outcome, associated complications, and clinical laboratory findings between diabetic and non-diabetic COVID-19 patients. Results COVID-19 patients with diabetes had more ICU admission than non-diabetic COVID-19 patients (42.4% vs. 7.7%, p < 0.001). Diabetic COVID-19 patients also recorded higher mortality in comparison to non-diabetic COVID-19 patients (34.7% vs. 3.7%, p < 0.001). Diabetic COVID-19 patients had significantly higher prevalence of comorbidities, such as hypertension. Laboratory investigations also highlighted notably higher levels of C-reactive protein in diabetic COVID019 patients and lower estimated glomerular filtration rate. They also showed a higher incidence of complications. logistic regression analysis showed that every 1 mmol/L increase in fasting blood glucose in COVID-19 patients is associated with 1.52 (95% CI: 1.34–1.72, p < 0.001) times the odds of dying from COVID-19. Conclusion Diabetes is a major contributor to worsening outcomes in COVID-19 patients. Understanding the pathophysiology underlining these findings could provide insight into better management and improved outcome of such cases.

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Outcomes of COVID-19: Disparities by ethnicity

Cited by 29 publications

References 6 publications

Global health disparities in vulnerable populations of psychiatric patients during the COVID-19 pandemic

Global health disparities in vulnerable populations of psychiatric patients during the COVID-19 pandemic

ACE2 and FURIN variants are potential predictors of SARS-CoV-2 outcome: A time to implement precision medicine against COVID-19

Clinical characteristics and outcomes of COVID-19 patients with diabetes mellitus in Kuwait

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