Covid-19 kills more black people: Genetics, or something else at play?

Evidence that race and ethnicity might play a role in the infection and mortality patterns of Covid-19 is piling up, but South African doctors are cautious to draw direct links, and there are suggestions of a rather simple correlation.

Scientific studies into patterns seen in South Africa, the UK, and the USA have suggested that certain race groups had increased risk of severe Covid-19 illness and death. Studies have looked at social and environmental factors but also that of genetic make-up and susceptibility to comorbidities.

In the US it was found the people considered Black and Hispanic and those from lower socio-economic status are more likely to die of COVID-19.

According to NGO group Oxfam’s recent report, ‘The Inequality Virus’, the novel coronavirus followed patterns consistent with existing inequalities of wealth, gender, and race and has further exposed them.

Critical care specialist and consultant surgeon at Groote Schuur Hospital Dr David Thomson is highly sceptical of the proposition that certain ethnic groups may have a higher risk of dying of Covd-19, and says there is some overlap in patients with comorbid diseases such as diabetes. Having worked for over a year with Covid-19 patients, Thomson argues that he has seen various patterns emerge when it came to Covid-19 mortality, including age and the time when the patient is brought to the hospital.

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A December 2020 review published in The Lancet calls for greater attention to be given to the question of Covid-19 risks and ethnicity. Researchers analysed the data of 18,728,893 patients from 50 studies, 26 of which were peer-reviewed. There were 42 from the US and 8 from the UK.

The review concluded that individuals from Black and Asian ethnicity had a higher risk of COVID-19 infection compared to white individuals. Asians may also be at higher risk of critical care admission and death.

Spokesperson for the South African Medical Association (SAMA) Dr Angelique Coetzee, says in her experience she has not seen a correlation between race and mortality and illness with Covid-19, but qualifies that it may depend on the area of each hospital and what other socio-economic factors are at play. Being overweight and diabetic is the biggest risk factor for mortality, he says, followed by other health issues such as hypertention which do have higher incidence rates in black communities.

Evidence mounting for racially split patterns

Scientists began to collect data on the impact of Covid-19 on minority ehtnicities in Western countries from early on in the pandemic last year, and a general consensus could only be made around the socio-economic factors affecting black and other minority ethnicities. The Oxford Journal of Health also recently published a study which concluded that though there exists a greater risk of severe COVID-19 in Black, Asian and Minority Ethnic (BAME) populations, this phenomenon cannot be explained by environmental nor biological factors.

The study looked at cardiometabolic, socioeconomic, and behavioural factors, as well as presence of 25(OH)-vitamin D in 1326 cases from the UK Biobank.

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Researchers found an over-representation of men and BAME ethnicities in the COVID-19 positive group. Factors which underlie ethnic differences in COVID-19, the study concludes, may not be easily captured. They called for further investigation of alternative biological and genetic susceptibilities as well as more comprehensive assessment of the complex economic, social and behavioural differences.

More evidence emerged from acros the globe and in August last year, South African scientists began suggesting a correlation between race and higher risks of contracting and dying from Covid-19.

The National Institute of Communicable Diseases announcing late last year that people of the ‘black African’ and “coloured’ racial groups had a higher risk of dying in hospital of Covid-19 than those in the ‘white’ grouping.

Simnikiweh@citizen.co.za