Why are COVID-19 effects less severe in Sub-Saharan Africa? Moving more and sitting less may be a primary reason

Wachira, Lucy-Joy M.; Arena, Ross; Sallis, James F.; Lambert, Estelle V.; Ong'wen, Otieno Martin; Laddu, Deepika; Onywera, Vincent; Oyeyemi, Adewale L.

doi:10.1016/j.pcad.2022.04.012

Cited by 8 publications

(5 citation statements)

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“…Most of the influenza and SARS-CoV-2 cases in this study were mild infections. Some authors have suggested reasons for the relatively low rates of severe disease with SARS-CoV-2 infection in Africa, including a high proportion of young people, tropical climate, high physical activity and more time spent outdoors [20]. The data from this study do not support any of these hypotheses, but as our population was predominantly young, this may explain the low rates of SARS-CoV-2 in our study.…”

Section: Discussioncontrasting

confidence: 75%

The Detection of Influenza Virus Before and During the COVID‐19 Pandemic in Cameroon

Monamele,

Tsafack,

Bilounga

et al. 2024

Influenza Resp Viruses

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BackgroundInfluenza and severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) are both respiratory viruses with similar clinical manifestations and modes of transmission. This study describes influenza data before and during the coronavirus disease pandemic (COVID‐19) in Cameroon and SARS‐CoV‐2 data during the pandemic period.MethodsThe study ran from 2017 to 2022, and data were divided into two periods: before (2017–2019) and during (2020–2022) the COVID‐19 pandemic. Nasopharyngeal samples collected from persons with respiratory illness were tested for influenza using the Centers for Disease Control and Prevention (CDC) typing and subtyping assays. During the COVID‐19 pandemic, the respiratory specimens were simultaneously tested for SARS‐CoV‐2 using the DaAn gene protocol or the Abbott real‐time SARS‐CoV‐2 assay. The WHO average curve method was used to compare influenza virus seasonality before and during the pandemic.ResultsA total of 6246 samples were tested. Influenza virus detection rates were significantly higher in the pre‐pandemic period compared to the pandemic period (30.8% vs. 15.5%; p < 0.001). Meanwhile, the SARS‐CoV‐2 detection rate was 2.5%. A change in the seasonality of influenza viruses was observed from a bi‐annual peak before the pandemic to no clear seasonal pattern during the pandemic. The age groups 2–4 and 5–14 years were significantly associated with higher influenza positivity rates in both pre‐pandemic and pandemic periods. For SARS‐CoV‐2, all age groups above 15 years were the most affected population.ConclusionThe COVID‐19 pandemic had a significant impact on the seasonal influenza by changing the seasonality of the virus and reducing its detection rates.

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Section: Discussioncontrasting

confidence: 75%

The Detection of Influenza Virus Before and During the COVID‐19 Pandemic in Cameroon

Monamele,

Tsafack,

Bilounga

et al. 2024

Influenza Resp Viruses

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“…This wealth of evidence suggests that the COVID-19 pandemic was less severe in Africa compared to Europe and Asia. Wachira [62,63]. These studies explored the low COVID-19 pandemic burden in Africa and suggested that it may be explained by the demographic pyramid, the existence of pre-existing conditions, trained immunity, socio-economic factors, and genetics.…”

Section: Inclusion and Exclusion Criteria For Selected Snpsmentioning

confidence: 99%

Genetic Variants within SARS-CoV-2 Human Receptor Genes May Contribute to Variable Disease Outcomes in Different Ethnicities

Adimulam

Arumugam

Gokul

et al. 2023

IJMS

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The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has evolved into a global pandemic, with an alarming infectivity and mortality rate. Studies have examined genetic effects on SARS-CoV-2 disease susceptibility and severity within Eurasian populations. These studies identified contrasting effects on the severity of disease between African populations. Genetic factors can explain some of the diversity observed within SARS-CoV-2 disease susceptibility and severity. Single nucleotide polymorphisms (SNPs) within the SARS-CoV-2 receptor genes have demonstrated detrimental and protective effects across ethnic groups. For example, the TT genotype of rs2285666 (Angiotensin-converting enzyme 2 (ACE2)) is associated with the severity of SARS-CoV-2 disease, which is found at higher frequency within Asian individuals compared to African and European individuals. In this study, we examined four SARS-CoV-2 receptors, ACE2, Transmembrane serine protease 2 (TMPRSS2), Neuropilin-1 (NRP1), and Basigin (CD147). A total of 42 SNPs located within the four receptors were reviewed: ACE2 (12), TMPRSS2 (10), BSG (CD147) (5), and NRP1 (15). These SNPs may be determining factors for the decreased disease severity observed within African individuals. Furthermore, we highlight the absence of genetic studies within the African population and emphasize the importance of further research. This review provides a comprehensive summary of specific variants within the SARS-CoV-2 receptor genes, which can offer a better understanding of the pathology of the SARS-CoV-2 pandemic and identify novel potential therapeutic targets.

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“…One postulated reason for these better-than expected outcomes is the higher prevalence of a physically active lifestyle in this part of the world. 34 Additional research is required in this area.…”

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confidence: 99%

Mapping One Million COVID-19 Deaths and Unhealthy Lifestyle Behaviors in the United States: Recognizing the Syndemic Pattern and Taking Action

Arena¹,

Pronk²,

Laddu³

et al. 2022

The American Journal of Medicine

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Why are COVID-19 effects less severe in Sub-Saharan Africa? Moving more and sitting less may be a primary reason

Cited by 8 publications

References 50 publications

The Detection of Influenza Virus Before and During the COVID‐19 Pandemic in Cameroon

The Detection of Influenza Virus Before and During the COVID‐19 Pandemic in Cameroon

Genetic Variants within SARS-CoV-2 Human Receptor Genes May Contribute to Variable Disease Outcomes in Different Ethnicities

Mapping One Million COVID-19 Deaths and Unhealthy Lifestyle Behaviors in the United States: Recognizing the Syndemic Pattern and Taking Action

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