Low COVID-19 impact in Africa: The multifactorial Nexus

Abstract

Africa has defied predictions of being the worst hit by the novel coronavirus disease (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, which has devastated Europe, the Americas, and some Asian countries. However, with a current second and third wave of the COVID-19 pandemic across other continents, pertinent​ questions have arisen regarding the lower disease severity and seemingly better outcomes in most African countries. Several factors have been proposed as discussed in this review including, underreporting, quick lockdown measures, effective public health intervention, younger population structure, cross-immunity and experience from fighting previous epidemics, such as the Ebola virus outbreak, previous infections or vaccinations, genetic predisposition, and tropical climate. We have discussed the implications of these factors on the magnitude of the outbreak and the better-than-expected outcomes observed in Africa. In addition, other potential factors like vitamin-D deficiency and chronic non-communicable diseases could predispose non-African regions to severe COVID-19 outcome. Therefore, this review further advocates for research to understand the precise mechanisms responsible for the pandemic’s relatively mild impact in Africa and proposed recommendations to prevent an infection surge.

Haematological Profile and ACE2 Levels of COVID-19 Patients in a Metropolis in Ghana

“…It is worthy of note that more than a third of the participants who were SARS-CoV-2 positive were at least 51 years old. Consistent with other studies, we have shown that older individuals are more susceptible to COVID-19 [29,[36][37][38][39]. A reason for such a susceptibility in these older age groups may be attributed to the increased expression in respiratory tissues of the angiotensin-converting enzyme 2 receptor (ACE2R) [7,8].…”

TYK2, IFITM3, IFNAR2 and OAS3 single-nucleotide polymorphisms among severe COVID-19 ICU patients in Morocco

“…However, it should be noted that other factors could explain the disparities between our results and those of previously cited studies, such as interactions with other polymorphisms or the influence of other risk and protective factors within each population. 26 , 27 Indeed, our results showed a significant correlation between age and the severity of COVID-19 ( p < .001), with severe cases having a median age of 51 years. Additionally, a peak was observed in the age group between 61 and 65 years in the ICU hospitalization group.…”

“…Therefore, our findings regarding the lack of association of these polymorphisms in our cohort could explain the low impact of the COVID-19 pandemic and the lower severity of SARS-CoV-2 infected patients in Morocco compared with Europe, America and Asia. 26 …”

Addressing Inequality in the COVID-19 Pandemic in Africa: A Snapshot from Clinical Symptoms to Vaccine Distribution

“…It comprises 54 independent nations, many of which are referred to as fragile states [2,3]. Original predictions indicated that Africa would be disproportionately affected by COVID-19 [4], also in view of the difficulty of implementing effective measures of social distancing [5]. The first case of COVID-19 was reported in Egypt on 14 February 2020 [6].…”

“…However, despite the overall lower number of individuals that were reported to have developed severe symptoms [4], COVID-19 in Africa is still a threat. The precarious situation, characterized by a variety of infectious diseases, malnutrition, and limited access to healthcare, has worsened since the pandemic occurred [27,28].…”