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Unmarried men at higher death risk from Covid-19

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Being a man, having a lower income, a lower level of education, not being married, and being born in low-or middle-income countries — these are factors that relate to an elevated risk of dying from Covid-19, warn researchers.

“We can show that there are independent effects of various separate risk factors that have been brought up in debates and news about Covid-19,” said study author Sven Drefahl from Stockholm University in Sweden.

“All of these factors are accordingly individually associated with a strongly elevated risk of dying from Covid-19,” Drefahl added.

The study is based on data from the Swedish National Board of Health and Welfare on all registered deaths from Covid-19 in Sweden for adults aged 20 and older.

In a study, published in the journal Nature Communications, Drefahl explained that those born abroad generally have lower mortality than people born in Sweden.

This also applies when the research took income and level of education into account.

The elevated risk of dying from Covid-19 for this group remains after the researchers controlled for circumstances, such as income and level of education.

The study shows that being a man, having a lower income and lower level of education also result in a strongly elevated risk of dying from Covid-19. As to these aspects, this also agrees with the patterns for mortality from other diseases.

The findings showed that men had more than twice as high a risk of dying from Covid-19 than women.

Unmarried men and women (including those never married, widows/widowers and the divorced) had a 1.5-2 times as high risk of dying from Covid-19 as those who were married.

According to the researchers, men generally have higher mortality at comparable ages, which is considered to be due to a combination of biology and lifestyle.

“The fact that people with little education or a low income have higher mortality may largely be due to lifestyle factors, including finances — how much one can afford to prioritise one’s health,” said study author Gunnar Andersson

“Similarly, we can explain the elevated mortality from Covid-19 for these groups,” Andersson added.

A number of earlier studies have also shown that single and unmarried people have higher mortality from various diseases, the research team noted.

Corona

Call for Covid-19 studies to focus on mucosal immunity

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Researchers have stressed that more Covid-19 studies should be devoted to how immunity to coronavirus emerges in the mucous membranes of the nose and mouth.

Anyone who has undergone a nasal swab or saliva test for Covid-19 knows that the virus is most easily detected in the nose and mouth, the study, published in the journal Frontiers in Immunology, reported.

Noting that the mucosal immune system is the immune system’s largest component, the researchers expressed concern that it hasn’t been a focus of much of the research on Covid-19 to date.

“We think it is a serious omission to ignore the mucosal immune response to SARS-CoV-2, given its initial sites of infection,” said study author Michael W Russell from the University at Buffalo in the US.

“Clearly the response of the systemic immunoglobulin G antibody (the most abundant circulating antibody) is important — we do not deny that — but on its own it is insufficient,” Russell added.

Russell noted that naturally, the initial focus of research on the disease was on cases of severe disease when the virus descends into the lower respiratory tract, especially the lungs, where the cellular immune responses exacerbate the inflammation rather than fight the infection.

But since the upper respiratory tract, including the nose, tonsils and adenoids are the initial point of infection for the SARS-CoV-2 virus, the immune responses that are triggered there are of special interest.

“Given that many infected people remain asymptomatic, and that a large number of those who develop symptoms suffer only mild to moderate disease, this suggests that something, somewhere, does a fairly good job of controlling the virus,” said Russell.

“Could it be that this is due to early mucosal immune responses that succeed in containing and eliminating the infection before it becomes serious? We will not know unless these questions are addressed,” he asked.

The paper recommends that studies are needed to determine the nature of mucosal secretory immunoglobulin A (SIgA) antibody responses over the course of infection, including asymptomatic or pre-symptomatic infection, and mild and moderate cases of Covid-19 disease.

In addition, the authors point out that the mucosal immune responses may vary depending on different age groups and populations.

 

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