COVID-19 has caused significant morbidity and mortality around the world. However, it has been noticed that case-fatality rates have been significantly higher in Europe and North America compared to the Asia, Middle East and Africa. This could be due to several factors which include average age of the population, testing and tracing facilities, social distancing measures and difference in immunogenic response to SARS-COV-2. In this report, we have discussed the factors which may affect a population to develop herd immunity against COVID-19. We have hypothesized here that frequent prior exposure to other coronaviruses in Asian population might impart partial immunity to COVID-19. This may be the reason for significant lower number of case fatalities seen in this region compared to the west. We, therefore, propose molecular immunological studies to correlate prior exposure to coronaviruses with disease severity. This will help us to develop therapeutic targets to treat severe infection with COVID-19.
Citation: Ahmed Yaqinuddin, Ayesha Rahman Ambia, Tasnim Atef Elgazzar. Case fatalities due to COVID-19: Why there is a difference between the East and West?[J]. AIMS Allergy and Immunology, 2021, 5(1): 56-63. doi: 10.3934/Allergy.2021005
COVID-19 has caused significant morbidity and mortality around the world. However, it has been noticed that case-fatality rates have been significantly higher in Europe and North America compared to the Asia, Middle East and Africa. This could be due to several factors which include average age of the population, testing and tracing facilities, social distancing measures and difference in immunogenic response to SARS-COV-2. In this report, we have discussed the factors which may affect a population to develop herd immunity against COVID-19. We have hypothesized here that frequent prior exposure to other coronaviruses in Asian population might impart partial immunity to COVID-19. This may be the reason for significant lower number of case fatalities seen in this region compared to the west. We, therefore, propose molecular immunological studies to correlate prior exposure to coronaviruses with disease severity. This will help us to develop therapeutic targets to treat severe infection with COVID-19.
[1] | Delamater PL, Street EJ, Leslie TF, et al. (2019) Complexity of the basic reproduction number (R0). Emerg Infect Dis 25: 1-4. doi: 10.3201/eid2501.171901 |
[2] | Randolph HE, Barreiro LB (2020) Herd immunity: understanding COVID-19. Immunity 52: 737-741. doi: 10.1016/j.immuni.2020.04.012 |
[3] | Sarmadi M, Marufi N, Moghaddam VK (2020) Association of COVID-19 global distribution and environmental and demographic factors: An updated three-month study. Environ Res 188: 109748. doi: 10.1016/j.envres.2020.109748 |
[4] | Jin Y, Yang H, Ji W, et al. (2020) Virology, epidemiology, pathogenesis, and control of COVID-19. Viruses 12: 372. doi: 10.3390/v12040372 |
[5] | Tu H, Tu S, Gao S, et al. (2020) Current epidemiological and clinical features of COVID-19; a global perspective from China. J Infect 81: 1-9. doi: 10.1016/j.jinf.2020.04.011 |
[6] | Shi Y, Wang G, Cai XP, et al. (2020) An overview of COVID-19. J Zhejiang Univ Sci B 21: 343-360. doi: 10.1631/jzus.B2000083 |
[7] | Algaissi AA, Alharbi NK, Hassanain M, et al. (2020) Preparedness and response to COVID-19 in Saudi Arabia: Building on MERS experience. J Infect Public Health 13: 834-838. doi: 10.1016/j.jiph.2020.04.016 |
[8] | COVID CDC, Team R (2020) Geographic differences in COVID-19 cases, deaths, and incidence—United States, February 12–April 7, 2020. MMWR Morb Mortal Wkly Rep 69: 465-471. doi: 10.15585/mmwr.mm6915e4 |
[9] | Dhama K, Khan S, Tiwari R, et al. (2020) Coronavirus disease 2019-COVID-19. Clin Microbiol Rev 33: e00028-20. doi: 10.1128/CMR.00028-20 |
[10] | Amariles P, Granados J, Ceballos M, et al. (2021) COVID-19 in Colombia endpoints. Are we different, like Europe? Res Social Adm Pharm 17: 2036-2039. doi: 10.1016/j.sapharm.2020.03.013 |
[11] | Shokoohi M, Osooli M, Stranges S (2020) COVID-19 pandemic: What can the West learn from the East? Int J Health Policy Manag 9: 436. |
[12] | Coccia M (2020) Factors determining the diffusion of COVID-19 and suggested strategy to prevent future accelerated viral infectivity similar to COVID. Sci Total Environ 729: 138474. doi: 10.1016/j.scitotenv.2020.138474 |
[13] | Chersich MF, Gray G, Fairlie L, et al. (2020) COVID-19 in Africa: care and protection for frontline healthcare workers. Glob Health 16: 46. doi: 10.1186/s12992-020-00574-3 |
[14] | Rosenthal PJ, Breman JG, Djimde AA, et al. (2020) COVID-19: Shining the light on Africa. Am J Trop Med Hyg 102: 1145-1148. doi: 10.4269/ajtmh.20-0380 |
[15] | Alwahaibi N, Al-Maskari M, Al-Dhahli B, et al. (2020) A review of the prevalence of COVID-19 in the Arab world. J Infect Dev Ctries 14: 1238-1245. doi: 10.3855/jidc.13270 |
[16] | Khanna RC, Cicinelli MV, Gilbert SS, et al. (2020) COVID-19 pandemic: Lessons learned and future directions. Indian J Ophthalmol 68: 703-710. doi: 10.4103/ijo.IJO_843_20 |
[17] | Smith DR (2019) Herd Immunity. Vet Clin North Am Food Anim Pract 35: 593-604. doi: 10.1016/j.cvfa.2019.07.001 |
[18] | Fine P, Eames K, Heymann DL (2011) “Herd immunity”: a rough guide. Clin Infect Dis 52: 911-916. doi: 10.1093/cid/cir007 |
[19] | Meyer B, Drosten C, Muller MA (2014) Serological assays for emerging coronaviruses: challenges and pitfalls. Virus Res 194: 175-183. doi: 10.1016/j.virusres.2014.03.018 |
[20] | Hu Z, Song C, Xu C, et al. (2020) Clinical characteristics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing, China. Sci China Life Sci 63: 706-711. doi: 10.1007/s11427-020-1661-4 |
[21] | Lipsitch M, Grad YH, Sette A, et al. (2020) Cross-reactive memory T cells and herd immunity to SARS-CoV-2. Nat Rev Immunol 20: 709-713. doi: 10.1038/s41577-020-00460-4 |
[22] | Grifoni A, Weiskopf D, Ramirez SI, et al. (2020) Targets of T cell responses to SARS-CoV-2 coronavirus in humans with COVID-19 disease and unexposed individuals. Cell 181: 1489-1501. doi: 10.1016/j.cell.2020.05.015 |
[23] | Sekine T, Perez-Potti A, Rivera-Ballesteros O, et al. (2020) Robust T cell immunity in convalescent individuals with asymptomatic or mild COVID-19. Cell 183: 158-168. doi: 10.1016/j.cell.2020.08.017 |
[24] | Shrock E, Fujimura E, Kula T, et al. (2020) Viral epitope profiling of COVID-19 patients reveals cross-reactivity and correlates of severity. Science 370: eabd4250. doi: 10.1126/science.abd4250 |
[25] | Fontanet A, Cauchemez S (2020) COVID-19 herd immunity: where are we? Nat Rev Immunol 20: 583-584. doi: 10.1038/s41577-020-00451-5 |
[26] | Yaqinuddin A (2020) Cross-immunity between respiratory coronaviruses may limit COVID-19 fatalities. Med Hypotheses 144: 110049. doi: 10.1016/j.mehy.2020.110049 |
[27] | Britton T, Ball F, Trapman P (2020) A mathematical model reveals the influence of population heterogeneity on herd immunity to SARS-CoV-2. Science 369: 846-849. doi: 10.1126/science.abc6810 |
[28] | Gomes MGM, Corder RM, King JG, et al. (2020) Individual variation in susceptibility or exposure to SARS-CoV-2 lowers the herd immunity threshold. medRxiv In press. |