Compounding Health Risks and Increased Vulnerability to SARS-CoV-2 for Racial and Ethnic Minorities and Low Socioeconomic Status Individuals in the United States

Em, Myers

doi:10.20944/preprints202004.0234.v1

Cited by 17 publications

(19 citation statements)

References 114 publications

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“…In view of the reported in vitro functional relevance of FCS [16], it is postulated here that the polybasic FCS does need to be cleaved by furin protease, leading to a different action mechanism of SARS-CoV-2 from its siblings, where its S1 and S2 subunits (while still strongly bonded together) undergoes a major structural rearrangement before or after viral cell entry. Nevertheless, in the midst of this COVID-19 pandemic [32] with more than 5.5 million (as of Thu Jun 25 09:39:402020) confirmed cases globally, this short article puts forward a set of analysis that the net structural consequence of FCS here is the insertion of a furin cleavage site into the S protein of SARS-CoV-2, and is thus of only limited structural biophysical relevance here. Finally, along with [9], the structural biophysical analysis here makes even more unlikelier a purposeful-manipulationbased hypothesis of the origin of SARS-CoV-2.…”

Section: Discussionmentioning

confidence: 99%

Delving deep into the structural aspects of a furin cleavage site inserted into the spike protein of SARS-CoV-2: A structural biophysical perspective

2020

Biophysical Chemistry

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One notable feature of the SARS-CoV-2 genome, the spike (S) protein of SARS-CoV-2 has a polybasic furin cleavage site (FCS) at its S1-S2 boundary through the insertion of 12 nucleotides encoding four amino acid residues PRRA. Quite intriguingly, this polybasic FCS is absent in coronaviruses of the same clade as SARS-CoV-2. Thus, with currently available experimental structural data for S protein, this short article presents a set of comprehensive structural characterization of the insertion of FCS into S protein, and argues against a hypothesis of the origin of SARS-CoV-2 from purposeful manipulation: (1), the inserted FCS is spatially located at a random coil loop region, mostly distantly solvent-exposed (instead of deeply buried), with no structural proximity to the other part of the S protein; (2), the insertion of FCS itself does not alter, neither stabilize nor destabilize , the three-dimensional structure of S; (3), the net result here is the insertion of a furin cleavage site into S protein, whose S1 and S2 subunits will still be strongly electrostatically bonded together from a structural and biophysical point of view, even if the polybasic FCS is actually cleaved by furin protease before or after viral cell entry.

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Section: Discussionmentioning

confidence: 99%

Delving deep into the structural aspects of a furin cleavage site inserted into the spike protein of SARS-CoV-2: A structural biophysical perspective

2020

Biophysical Chemistry

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“…In England and Wales, males in the least deprived areas have a death rate of 77.6 per 100,000 (44.3 per 100,00 for females) rising to 172 per 100,000 in the most deprived areas (97 per 100,000 for females) [21]. The disease has also been seen to hit those from nonwhite ethnicity harder [22,23]. Of the 10,075 patients who have been through intensive care in England, Wales and Northern Ireland by the 16 July 2020 4,654 were White ethnicity males and 2,411 were nonwhite ethnicity males [1,999 White ethnicity females, 1,004 non-White ethnicity females], which represents a higher proportion than seen within the overall demographics for the countries [24].…”

Section: Men's Risk Of Sars-cov2mentioning

confidence: 99%

“…There is a strong link between poverty and the high levels of mortality in nonwhite ethnicities, representing 62% of all male patients in intensive care living in the lowest two quintiles of deprivation (as compared to 44.7% for White ethnicity) [24]. In an analysis into the clinical risk factors against demographic profiles for the first 5,683 deaths in England, the risk posed by deprivation and by race was not explained by higher rates of ill-health or other clinical risk factors, suggesting that it was more related to local social and environmental issues [25], such as living in crowded areas, poorer housing, a lack of accessible health care, and be employed in more risky settings [22,26,27,28]. There are also higher levels of co-morbidity associated with the severe forms of the disease, such as cardiovascular disease, diabetes, and obesity in men of nonwhite ethnicity [23,29,30].…”

Section: Men's Risk Of Sars-cov2mentioning

confidence: 99%

Men and COVID-19: the aftermath

White

2020

Postgraduate Medicine

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The global pandemic as a result of the SARS-CoV2 virus has seen over 16 m people infected and over 650,000 deaths, with men at double the risk of both developing the severe form of the disease and mortality. There are both biological (sex) and socio-cultural (gender) factors, compounded by socioeconomic factors and ethnicity, that impact on the aftermath of what has occurred over the short time that this novel coronavirus has been circulating the world. The potential lifelong morbidity as a result of the infection and as a consequence of highly invasive critical care treatment needs to be factored into the rehabilitation of survivors. There are also many men whose lives will have been severely affected both physically and emotionally by the pandemic without ever contracting the disease, with the widespread disruption to normal existence and its impact on their social world and the economy. The implications of the closure of many healthcare services over the initial lockdown will also have both a shorter-and longer-term impact on other diseases due to missed early diagnosis and disrupted treatment regimes. Getting effective public health messages out to the population is critical and this current pandemic is demonstrating that there needs to be a more focused view on men's health behavior. Without effective public support for preventative action, the more likely the disease will continue its path unabated. This review explores the wider ramifications of the disease both for those men who have survived the disease and those that have been affected by the wider social effects of the pandemic. The pandemic should be a wake-up call for all involved in the planning and delivery of health and social care for the greater attention to the central role of sex and gender.

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“…Ethnicity and socioeconomic position strongly influence health outcomes for both infectious and noncommunicable diseases. Previous pandemics have often disproportionately impacted ethnic minorities and socioeconomically disadvantaged populations [5,6]. Early evidence suggests that the same may be occurring in the current SARS-CoV-2 pandemic but empirical research remains highly limited [7].…”

Section: Introductionmentioning

confidence: 99%

Ethnic and socioeconomic differences in SARS-CoV-2 infection: prospective cohort study using UK Biobank

Niedzwiedz

O’Donnell

Jani

et al. 2020

BMC Med

371

349

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Background: Understanding of the role of ethnicity and socioeconomic position in the risk of developing SARS-CoV-2 infection is limited. We investigated this in the UK Biobank study. Methods: The UK Biobank study recruited 40-70-year-olds in 2006-2010 from the general population, collecting information about self-defined ethnicity and socioeconomic variables (including area-level socioeconomic deprivation and educational attainment). SARS-CoV-2 test results from Public Health England were linked to baseline UK Biobank data. Poisson regression with robust standard errors was used to assess risk ratios (RRs) between the exposures and dichotomous variables for being tested, having a positive test and testing positive in hospital. We also investigated whether ethnicity and socioeconomic position were associated with having a positive test amongst those tested. We adjusted for covariates including age, sex, social variables (including healthcare work and household size), behavioural risk factors and baseline health. Results: Amongst 392,116 participants in England, 2658 had been tested for SARS-CoV-2 and 948 tested positive (726 in hospital) between 16 March and 3 May 2020. Black and south Asian groups were more likely to test positive (RR 3.35 (95% CI 2.48-4.53) and RR 2.42 (95% CI 1.75-3.36) respectively), with Pakistani ethnicity at highest risk within the south Asian group (RR 3.24 (95% CI 1.73-6.07)). These ethnic groups were more likely to be hospital cases compared to the white British. Adjustment for baseline health and behavioural risk factors led to little change, with only modest attenuation when accounting for socioeconomic variables. Socioeconomic deprivation and having no qualifications were consistently associated with a higher risk of confirmed infection (RR 2.19 for most deprived quartile vs least (95% CI 1.80-2.66) and RR 2.00 for no qualifications vs degree (95% CI 1.66-2.42)). Conclusions: Some minority ethnic groups have a higher risk of confirmed SARS-CoV-2 infection in the UK Biobank study, which was not accounted for by differences in socioeconomic conditions, baseline self-reported health or behavioural risk factors. An urgent response to addressing these elevated risks is required.

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Compounding Health Risks and Increased Vulnerability to SARS-CoV-2 for Racial and Ethnic Minorities and Low Socioeconomic Status Individuals in the United States

Cited by 17 publications

References 114 publications

Delving deep into the structural aspects of a furin cleavage site inserted into the spike protein of SARS-CoV-2: A structural biophysical perspective

Delving deep into the structural aspects of a furin cleavage site inserted into the spike protein of SARS-CoV-2: A structural biophysical perspective

Men and COVID-19: the aftermath

Ethnic and socioeconomic differences in SARS-CoV-2 infection: prospective cohort study using UK Biobank

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