Racial Health Disparity and COVID-19

Abstract

The infection by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and resultant coronavirus diseases-19 (COVID-19) disproportionally affects minorities, especially African Americans (AA) compared to the Caucasian population. The AA population is disproportionally affected by COVID-19, in part, because they have high prevalence of underlying conditions such as obesity, diabetes, and hypertension, which are known to exacerbate not only kidney diseases, but also COVID-19. Further, a decreased adherence to COVID-19 guidelines among tobacco smokers could result in increased infection, inflammation, reduced immune response, and lungs damage, leading to more severe form of COVID-19. As a result of high prevalence of underlying conditions that cause kidney diseases in the AA population coupled with tobacco smoking make the AA population vulnerable to severe form of both COVID-19 and kidney diseases. In this review, we describe how tobacco smoking interact with SARS-CoV-2 and exacerbates SARS-CoV-2-induced kidney diseases including renal failure, especially in the AA population. We also explore the role of extracellular vesicles (EVs) in COVID-19 patients who smoke tobacco. EVs, which play important role in tobacco-mediated pathogenesis in infectious diseases, have also shown to be important in COVID-19 pathogenesis and organ injuries including kidney. Further, we explore the potential role of EVs in biomarker discovery and therapeutics, which may help to develop early diagnosis and treatment of tobacco-induced renal injury in COVID-19 patients, respectively. Graphical Abstract

The impact of COVID-19 on income and employment and willingness to become vaccinated among African Americans enrolled in a smoking cessation randomized trial

“… [4] Emerging data on the impact of COVID on population subgroups finds that smokers have increased infection, inflammation, reduced immune response, and lung damage, leading to more severe forms of COVID-19. [3] Also, AAs with tobacco use disorder have an increased risk for COVID-19 and its adverse outcomes compared to white smokers. [5] …”

“… [1] , [2] Potential underlying reasons for racial disparities in impacts of the pandemic include social vulnerability, indicated by higher concentrations of minority groups in lower-wage employment, essential jobs where social distancing is difficult or impossible, and high-density housing. [2] Additionally, African Americans (AAs) have higher rates of comorbidities such as diabetes, obesity, and hypertension, [3] and face inequalities in accessing healthcare. [1] , [2]…”

“…The high prevalence of pre-existing comorbid health conditions makes AAs who smoke especially vulnerable to severe forms of COVID-19. [3] Recent studies have established that smoking increases the risk for hospitalization by 80% and doubles the risk of mortality from COVID-19. [4] Others have found that AAs who smoke have a higher risk for contracting COVID-19 as well as a poorer prognosis compared to Caucasian smokers.…”

The Neuroimmune Pharmacology of SARS-CoV-2

“…COVID-19 severely affected disadvantaged/vulnerable populations, not only with racial disparity including African Americans (AA), but also populations who used different substances or drugs. In this special issue, authors reviewed the potential cause of underlying conditions such as hypertension and diabetes and subsequent COVID-19, which disproportionally affected minorities and tobacco smokers, and their impact on renal failure (Kumar et al 2021b ). The AA population is disproportionally affected by COVID-19, in part, because they have high prevalence of underlying conditions such as obesity, diabetes, and hypertension, which are known to exacerbate COVID-19.…”

“…Then, there are two brief reports: “Cannabis/Cannabinoids for Treating COVID-19 Associated Neuropsychiatric Complications” (Khalsa et al 2021 ) and “SARS-CoV-2 spike protein disrupts blood–brain barrier integrity via RhoA activation” (DeOre et al 2021 ). Next comes the issue’s review paper, “Racial Health Disparity and COVID-19” (Kumar et al 2021b ) followed by three original research articles. One of these primary research papers examines a potential treatment approach using the herbal product, “Eugenol, a component of holy basil (Tulsi) and common spice clove, and reporting that this herbal product inhibits the interaction between SARS-CoV-2 spike S1 and ACE2 to induce therapeutic responses” (Paidi et al 2021 ).…”