[HTML][HTML] COVID19 and increased mortality in African Americans: socioeconomic differences or does the renin angiotensin system also contribute?

M Doumas, D Patoulias, A Katsimardou… - Journal of human …, 2020 - nature.com
M Doumas, D Patoulias, A Katsimardou, K Stavropoulos, K Imprialos, A Karagiannis
Journal of human hypertension, 2020nature.com
The dawn of the new decade is marked by the emergence of the novel coronavirus SARS-
CoV-2, whose spread has resulted in the COVID-19 pandemic, having already affected
millions of individuals and resulted in hundreds of thousands of deaths worldwide [1, 2].
While the pandemic situation is constantly evolving, alarming signals have arisen during the
past few weeks from the United States of America, which now represents the world's most
affected country, as disproportionally higher infection and mortality rates in African …
The dawn of the new decade is marked by the emergence of the novel coronavirus SARS-CoV-2, whose spread has resulted in the COVID-19 pandemic, having already affected millions of individuals and resulted in hundreds of thousands of deaths worldwide [1, 2]. While the pandemic situation is constantly evolving, alarming signals have arisen during the past few weeks from the United States of America, which now represents the world’s most affected country, as disproportionally higher infection and mortality rates in African–Americans compared to other races were reported in some states [3, 4]. After these initial reports that raised public awareness, most states gradually started sharing data regarding confirmed cases and deaths by race. Most of them have reported higher infection rates in African–Americans, although data regarding confirmed COVID-19 cases by race are largely incomplete [5]. Furthermore, based on current estimates, it is calculated that overall African–Americans suffer from a 2.4 and 2.2 times higher mortality rate when compared to Whites and Asians or Latinos, respectively [6, 7]. The first thing that needs to be addressed is whether this phenomenon is actual or COVID-19 was spread in states with a relatively higher African–American population. Available data suggest that the mortality rate is indeed higher, even when adjusted for the African–American population in each state in most cases. In Illinois, for instance, 14% of the population which is African–Americans accounts for 36% of confirmed COVID-19 deaths. Similarly, in Michigan 43% of deaths concerned African–Americans who represent 14% of the state’s population [7]. However, more data is eagerly needed on this topic: first of all from every state, and second for specific counties as well, since the population is not evenly divided by race within each state. The higher mortality rate in African–Americans raises questions about the underlying mechanisms behind these racial disparities. Several known mechanisms might be implicated, including increased comorbidities, inequalities in healthcare access, and socioeconomic factors. However, we propose that another mechanism might be also implicated: the renin-angiotensin system.
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