Infectious Disease Genetics, National Institute of Biomedical Genomics, Kalyani, India.
Am J Hum Biol. 2021 Nov;33(6):e23504. doi: 10.1002/ajhb.23504. Epub 2020 Sep 23.
SARS-CoV-2, the causative agent of COVID-19 pandemic caught the world unawares by its sudden onset in early 2020. Memories of the 1918 Spanish Flu were rekindled raising extreme fear for the virus, but in essence, it was the host and not the virus, which was deciding the outcome of the infection. Age, gender, and preexisting conditions played critical roles in shaping COVID-19 outcome. People of lower socioeconomic strata were disproportionately affected in industrialized countries such as the United States. India, a developing country with more than 1.3 billion population, a large proportion of it being underprivileged and with substandard public health provider infrastructure, feared for the worst outcome given the sheer size and density of its population. Six months into the pandemic, a comparison of COVID-19 morbidity and mortality data between India, the United States, and several European countries, reveal interesting trends. While most developed countries show curves expected for a fast-spreading respiratory virus, India seems to have a slower trajectory. As a consequence, India may have gained on two fronts: the spread of the infection is unusually prolonged, thus leading to a curve that is "naturally flattened"; concomitantly the mortality rate, which is a reflection of the severity of the disease has been relatively low. I hypothesize that trained innate immunity, a new concept in immunology, may be the phenomenon behind this. Biocultural, socioecological, and socioeconomic determinants seem to be influencing the outcome of COVID-19 in different regions/countries of the world.
SARS-CoV-2，即导致 COVID-19 大流行的病原体，于 2020 年初突然爆发，令全世界猝不及防。人们回想起 1918 年的西班牙流感，由此产生了对该病毒的极度恐惧，但实际上，决定感染结果的是宿主，而不是病毒。年龄、性别和既往疾病在塑造 COVID-19 结局方面起着关键作用。在像美国这样的工业化国家中，社会经济地位较低的人群受到了不成比例的影响。印度是一个拥有超过 13 亿人口的发展中国家，其中很大一部分人处于贫困状态，公共卫生服务基础设施也不达标，因此人们对其庞大的人口规模和人口密度感到担忧，害怕出现最坏的结果。在大流行六个月后，对印度、美国和几个欧洲国家 COVID-19 发病率和死亡率数据进行比较，揭示了一些有趣的趋势。虽然大多数发达国家的曲线都符合快速传播的呼吸道病毒的预期，但印度的曲线似乎较为平缓。因此，印度可能在两个方面取得了进展：感染的传播异常延长，从而导致曲线“自然变平”；同时，死亡率，即疾病严重程度的反映，相对较低。我假设，经过训练的先天免疫，这是免疫学中的一个新概念，可能是造成这种情况的原因。生物文化、社会生态和社会经济决定因素似乎在影响着全球不同地区/国家 COVID-19 的结局。
