Sickle cell trait makes Covid-19 infections more serious

Black people are more likely to die of Covid-19.

This is not only the case in the US but also in the UK and France.

Although economic disparities are a major factor in developing severe infections, another factor is the high prevalence of sickle cell trait among people with ancestry from areas of Africa where malaria is endemic.

People with sickle cell disease are known to be at higher risk of severe illness from covid-19. The virus is known to increase blood clotting in seriously affected individuals whether they have a blood disease or not.

People with sickle cell anemia got the gene that causes the anemia from both parents. People with sickle cell trait got the anemia gene from one parent and a normal gene from the other parent. They are likely to have more serious problems with covid-19 than people with the normal gene from both parents.
https://pubmed.ncbi.nlm.nih.gov/32589774/

According to the CDC on May 16, 2020:

SCD affects approximately 100,000 Americans.
SCD occurs among about 1 out of every 365 Black or African-American births.
SCD occurs among about 1 out of every 16,300 Hispanic-American births.
About 1 in 13 Black or African-American babies is born with sickle cell trait (SCT).

This is why I was so concerned about the situation in the favelas in Brazil. Many people there are not only living in overcrowded conditions, but also are descended from former African and indigenous slaves. There is a very high rate of sickle cell trait in many parts of Africa, although the relative youth of the people in many African countries will somewhat mitigate the problems.

Edited for spelling typos

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adequate levels being necessary for proper immune system response.

Black skin is a positive adaptation in terms of protection from UV damage in sunny, low-latitude environments, but it inhibits Vitamin D production from sunlight.

Black people in the US often have lower Vitamin D levels than whites, possibly due to it taking a greater amount of sun exposure to produce the same amount of Vitamin D.

It's very conceivable that lockdown conditions keeping people inside could have suppressed levels further. Seems that the Vitamin D levels of every COVID patient should be tested, I wonder if this is being done?

Interesting comments to this video - many of them from Africa:

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Not Henry Kissinger's picture

that sickle cell may be factor, but the articles you cite do not reach any definitive conclusion.

The Guardian article makes no mention of sickle cell at all, while the Pub Med article (according to the summary) discusses the possibility but makes no concrete claims.

The most the PUB Med summary is wiling to claim is:

Emerging trends in the United States suggest possibly higher mortality rates of COVID-19 amongst African Americans, although detailed epidemiological study data is pending.

So IMO the most one might conclude from your sourcing is that those of African descent MAY be at higher risk of complications from COVID because of their higher susceptibility to sickle cell, but no studies have yet actually determined that to be the case, nor (more importantly) has any study determined to what extent the presence of sickle cell affects disease recovery/morbidity versus other factors that also may be in play.

Reading the Guardian article, there certainly appears to be a significantly higher death rate among African Americans who contract COVID, but I am more inclined to chalk most of that up to historically documented disparities in access to medical care than to any particular genetic trait.

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The current working assumption appears to be that our Shroedinger's Cat system is still alive. But what if we all suspect it's not, and the real problem is we just can't bring ourselves to open the box?

@Not Henry Kissinger I only cited the BBC and Guardian articles to show that there is a problem with higher mortality rates for people of African descent. I do not get technical information from the MSM. I suggest reading the references cited by the Pubmed article.

Being the carrier state for an autosomal recessive genetic disorder, sickle cell trait is
frequently perceived to be a relatively benign condition, however this remains controversial. 26-30
Conditions of increased oxygen demands may trigger sickle-related complications in heterozygotes.
31-44 COVID-19 causes severe pneumonia in at-risk individuals resulting in an increased oxygen demand.

I has long been established that people with sickle cell trait can develop problems under conditions where they are not getting enough oxygen. There is no debate about this. There are plenty of articles on PUBMED discussing it.

The risk of hypercoagulability in sickle cell carriers is a subject of active investigations and discussions.66-68 A prospective study of African Americans demonstrated a 2-fold increase in the risk of pulmonary embolism in carriers of sickle cell trait.63 A recent study demonstrated an increased risk of ischemic stroke in individuals who carry sickle cell trait and have concomitant chronic kidney disease. 69 Likewise, sickle cell trait has been associated with an increased risk of coronary artery diseases in African American men who have chronic kidney diseases.70 The potential contributions of thrombosis related complications of sickle cell trait to the severity of COVID-19 necessitate further studies particularly due to the higher risk of thromboembolism in COVID-19.3-5

In April I realized there might be a problem for people with sickle cell trait and some other unusual blood types. Since I am not currently affiliated with a university my research was hampered by the paywalls that prevented access to many of the journals I wanted to read. Then it was difficult to find a way to publish my work without a university affiliation.

I was about to publish when the BLM protests started. I know they would have the same political response as you have shown. There have almost certainly been others who realized the risk sickle cell trait poses, but Cancel Culture has almost certainly terrorized them into silence. Cancel Culture not only results in the destruction of careers, but can escalate into stalking, harassment and violence. It is not necessary to commit any act of political incorrectness, but simply to tell an inconvenient scientific truth.

People with sickle cell trait need to be identified if they become infected with the virus. They will need more careful monitoring and may need more aggressive treatment. This will be a serious risk factor in older people who do not have other risk factors. It is already well-established that sickle cell disease is a risk factor, but sickle cell trait needs to be a matter of concern as well.

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Not Henry Kissinger's picture

@ScienceTeacher

I know they would have the same political response as you have shown.

Happy to have a rational discussion about the literature, but not if you are going to impune my motives and/or assume my political stance for no apparent reason.

Lotsa people around here lately making a lot of strong claims with little if any tangible support. If you consider simply taking the time to examine your sourcing to be a 'political response', then I'm not sure there's a real discussion to be had here.

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The current working assumption appears to be that our Shroedinger's Cat system is still alive. But what if we all suspect it's not, and the real problem is we just can't bring ourselves to open the box?

Not Henry Kissinger's picture

@ScienceTeacher

People with sickle cell trait need to be identified if they become infected with the virus. They will need more careful monitoring and may need more aggressive treatment. This will be a serious risk factor in older people who do not have other risk factors. It is already well-established that sickle cell disease is a risk factor, but sickle cell trait needs to be a matter of concern as well.

Treatment protocols should definitely include increased awareness of susceptibility to complications for those with the sickle cell trait. And thank you for supplementing your essay with more info.

But I still think we need to very careful about suggesting particular significance of a genetic trait over environmental risk factors. We don't have any data yet and as you point out, claims like that are easily misinterpreted.

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The current working assumption appears to be that our Shroedinger's Cat system is still alive. But what if we all suspect it's not, and the real problem is we just can't bring ourselves to open the box?

@ScienceTeacher

about COVID-19 and malaria. It seems that damage from COVID to capillaries and thence to surrounding tissues deprived of oxygen resembles how malaria kills, and also sickle cell anemia - in sickle cell the distorted shape of the red blood cells makes it difficult for them to pass through the capillaries.

Then there is the fact that, at least for many people, quinine/chloroquine/hydroxychloroquine - all known for and/or specifically developed for malaria - appear to be effective against COVID. And also that people with O blood type, apparently at low risk for developing severe symptoms from COVID are also known to be at low risk for developing severe symptoms from malaria.

But sickle cell trait is well known to have evolved in response to malaria and having the single allele provides considerable resistance to malaria. Sickle cell anemia - which occurs when an individual has two of the relevant alleles is a serious disease in and of itself, of course.

But I'm curious as to why when there are medicines that appear to be effective against both malaria and COVID as well as other, non-sickle cell evolutionary factors (such as type O blood) that seem to enhance resistance to both, that sickle cell trait - instead of providing some protection (as it does against malaria) would be a risk factor when it comes to COVID-19? Seems counter-intuitive somehow?

It seems that different populations have evolved a number of different strategies in response to malaria - would be interesting to see if/how they differ in their susceptibility to COVID-19, no?

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Was the creation of bioweapons that could be genetically vectored. Ie hit specific races or nations.

I will link to that section when I am not on my phone. Assuming it hasn't disappeared into the memory hole yet again.

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The Liberal Moonbat's picture

@Battle of Blair Mountain This PROVES that as far at the LOTE marathon-to-the-bottom goes, the neocons are worse than Team Trump.

Second of all, however: Since the obvious implication is that COVID's a bioweapon engineered to kill Subsaharans, it seems like...kind of a poor one, given OP's statistics on sickle-cell prevalency? What about Type-A blood types (like my mother and I)? That's a risk-factor, too. Have they got something against Type-A blood types?

https://www.babymed.com/pregnancy-test/ethnic-distribution-of-blood-types

Wellll, seems "US blacks" don't need to particularly fear on that front, buuut...

Oh shit, watch out Armenians!!! It must have been Erdogan all along...

Or maybe it was Indigenous-American-supremacists...? "Quickly, we must wipe them all out before they make something that targets type-O!"

...and Pacific Islanders are in deep trouble, too...
...and...
...Norwegians??? S'matter, some Cthulhu-cult want revenge for the valor of Gustaf Johansen?

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In the Land of the Blind, the one-eyed man is declared insane when he speaks of colors.

an internist and also a friend, says that since sunscreen became commonly used that Americans have trended to be vitamin D deficient. He said he has seen very few Americans with normal vitamin D levels in his large internal medicine practice. My wife and I were both found to be below the suggested levels and went on and stayed on a high dose vitamin D supplement. We only stopped using them after moving to slightly less than 3 degrees south of the equator living at over 9000'. We get plenty of UV now. Our first physicals here showed normal levels which our new doc assured us would remain as long as we live here.

I really don't have anything to add to the discussion on whether vitamin D supplements might have some beneficial effect on preventing a Covid infection or if it has an effect on recovery from an infection. Taking a supplement is unlikely to do any harm.

The increasing evidence and a rising consensus among the global medical community that Covid is primarily a disease of the blood triggered by a hyperactive immune system would suggest any blood abnormality or chronic illness like sickle cell is going to be a risk factor. One good friend has had blood and immune system issues for a long time and is a fanatic about researching his issues. He's a great source of information where his problems intersect with Covid. His research and his doctor have lead him to think those like him with blood and/or immune system issues need to be extra aware and careful in their lives. Seems reasonable to me. Prevention is still our only tool and until something else comes along we're stuck with risk avoidance and PPE.

Let me add my concurrence with a comment by NHK. We're stuck with a pandemic that has turned so many of our lives upside down. We're in a terribly caustic environment where the pandemic has been politicized along with almost everything in our day-to-day lives. We can't do much about the pandemic except remain as safe as possible until there are more real answers. We don't have to let politics and the bad environment politicization of everything has created get between us. There's way too much of that with family, friends, neighbors and the hordes of roving free range asshats and idiots. Let's try to be more considerate of each other here. Sometimes it's better to just let go of an ill considered or emotion driven jab. I know I've been less than perfect at being kind and considerate at times lately and need to stay away from the keyboard while I play the tape all to the end before blasting out a comment that didn't need to be made. Think about it.

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Roy Blakeley's picture

@vtcc73 Last time I reviewed the literature, admittedly a few years ago now, studies failed to show that sunscreens reduced the probability of getting skin cancer. If anything, the probability of contracting skin cancer showed a slight positive correlation with sunscreen use. Sunlight is not only important for vitamin D production, but also testosterone (testosterone levels have plummeted over the past 40 years), and there was a paper in Cell not long ago (which I admittedly have not had a chance read), the abstract of which indicated that sun exposure boosts intelligence and suggested a plausible mechanism.

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@Roy Blakeley
Low testosterone and low intelligence

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We are so screwed.