Why is mortality from Covid-19 higher in Italy?

[Angela]

According to this article https://www.dailymail.co.uk/sciencet...ronavirus.html
Italy suffers from a different strain of coronavirus than elsewhere. "Methods used to trace the prehistoric migration of ancient humans were adapted to track the spread of the SARS-CoV-2 virus, which causes COVID-19. The team have now updated their analysis to include more than 1,000 COVID-19 cases up to the end of March to provide a clearer snapshot. It has not yet been peer-reviewed."

I wish someone could comment on how much this study could be trusted - if the predominant strain in Italy is different from other places in Europe and Americas, perhaps it is really more lethal ? On the other hand, if we take deaths per 1000 population, then Belgium is in the first place. At the same time, it is not reasonable to compare countries with different real infection rate, different progress in term of peak time, etc.

Well, that would certainly explain it, but the researchers say this:

"The virus appears to mutate very slowly, with only tiny differences between the different strains and that none of the strains of the virus are more deadly than another, experts say.They also added it does not appear the strains will grow more lethal as they evolve."


Do I believe that? I don't know. I don't think anyone really knows anything definitively yet.

As for the other assertions in the paper, they seem to contradict what "Next Strain" found. I linked to it above. Take a look and see what you think. More eyes and brains are always better than one. :)

They do seem to show two different entries into Europe, one from China directly, mediated mostly through Belgium, it seems, and one perhaps from Singapore. I can't tell from the map if that was directly from Singapore, or if it was mediated through Australia. However, although Italy does show up there as one of the infected countries, there don't seem to be any subsequent samples with that particular mutation from Italy. So, how could most of the cases in Italy be of that strain if their sampling was representative?

There are other strains into Italy from the "parent" one from Belgium.

I could be all wrong about this, let's be clear.

For what it's worth the original paper by this group was criticized in a lot of quarters.

https://nextstrain.org/narratives/nc.../zh/2020-04-10

As for Sweden, they seem remarkably comfortable, to me, with saying well, they're old, they were in poor health anyway, so that's a blow we can absorb. That's even before it was known there were lasting effects in people with severe cases.

I can only say I'm glad my elderly relatives don't live in Sweden.

[Regio X]

Theory for the lower mortality in South Italy compared to North Italy: human leukocyte antigen (HLA).


Coronavirus, il Sud Italia protetto da uno «scudo genetico». La nuova tesi degli immunologi
https://www.ilmessaggero.it/salute/f...0-5255221.html

[Maciamo]

Theory for the lower mortality in South Italy compared to North Italy: human leukocyte antigen (HLA).


Coronavirus, il Sud Italia protetto da uno «scudo genetico». La nuova tesi degli immunologi
https://www.ilmessaggero.it/salute/f...0-5255221.html

The article is only for subscribers. Do they mention which HLA types are more common in the North vs South?

[Regio X]

The article is only for subscribers. Do they mention which HLA types are more common in the North vs South?

They don't, unfortunately.

[Regio X]

The article is only for subscribers. Do they mention which HLA types are more common in the North vs South?

No association to HLA would have been found:
https://www.medrxiv.org/content/10.1....31.20114991v1

Apparently some genetic risks are:
- blood type A
- rs11385942 (insertion A)
- APOE-ε4 homozygosity ( https://academic.oup.com/biomedgeron...laa131/5843454 )

[Maciamo]

No association to HLA would have been found:
https://www.medrxiv.org/content/10.1....31.20114991v1

Apparently some genetic risks are:
- blood type A
- rs11385942 (insertion A)
- APOE-ε4 homozygosity ( https://academic.oup.com/biomedgeron...laa131/5843454 )

Thanks for the update. Too bad that rs11385942 is not tested by any of the main personal genomics companies like 23andMe, FTDNA, Ancetsry or Living DNA.

[Regio X]

Thanks for the update. Too bad that rs11385942 is not tested by any of the main personal genomics companies like 23andMe, FTDNA, Ancetsry or Living DNA.

You could check rs10490770 instead (apparently it doesn't work as proxy for people with African or Hispanic descent, but it'd work well for Caucasians - over 90% of cases).

From SNPedia:
"Note that rs11385942 is not present on the DNA chips used by the major direct-to-consumer genotyping companies such as 23andMe, Ancestry and MyHeritage. In Caucasians, a SNP present on most Ancestry chips, rs10490770, is a reasonable proxy for rs11385942. The minor allele of rs10490770(C) corresponds most of the time (r2 >0.9 in Caucasians) to the minor rs11385942(A) allele based on data available in ensembl. There is no equivalent linkage in those of African descent; and the correlation is low in Hispanic populations (r2 < 0.2)."

Fortunately, my rs10490770 result in 23andMe is TT.

But we should keep in mind that rs10490770(C) doesn't "always" correspond to rs11385942(A) even in Caucasians.

[ThirdTerm]

The new Swedish study by Soratto et al. (2020) found that the Italian strain of Covid-19 (B.1/G) mutated further in Sweden at position 364 in the S1 subunit, which destabilized the viral spike protein. This novel mutation in Sweden made Covid-19 less infectious by weakening the attachment of the viron to the cell. Sweden got a lucky break as a result of the fluke mutation, which is why the death rate is much lower as compared to that of Italy.


SARS-CoV-2 genome sequences from late April in Stockholm, Sweden reveal a novel mutation in the spike protein

Abstract
Large research efforts are going into characterizing, mapping the spread, and studying the biology and clinical features of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here, we report four complete SARS-CoV-2 genome sequences obtained from patients confirmed to have the disease in Stockholm, Sweden, in late April. A variant at position 23463 was found for the first time in one genome. It changes an arginine (R) residue to histidine (H) at position 364 in the S1 subunit of the spike protein. The genomes belonged to two different genetic groups, previously reported as two of the three main genetic groups found in Sweden. Three of them are from group B.1/G, corresponding to the Italian outbreak, reported by the Public Health Agency of Sweden to have declined in prevalence by late April, and more investigation is needed in order to ensure that the spread of different types of SARS-CoV-2 is fully characterized.

https://www.biorxiv.org/content/10.1...08.03.233866v1

[Angela]

Thanks very much for this, Third Term. That completely changes the analysis. All of that looking at government action, societal differences etc., and a lot of this is that they encountered a different virus.

I wonder if Germany also had a mutated and less contagious form?

By implication, Maybe Spain but perhaps even Britain has the more contagious version?

[Maciamo]

The new Swedish study by Soratto et al. (2020) found that the Italian strain of Covid-19 (B.1/G) mutated further in Sweden at position 364 in the S1 subunit, which destabilized the viral spike protein. This novel mutation in Sweden made Covid-19 less infectious by weakening the attachment of the viron to the cell. Sweden got a lucky break as a result of the fluke mutation, which is why the death rate is much lower as compared to that of Italy.

Interesting, but Sweden was one of the few countries that did not implement any kind of lockdown. As people move around Europe all the time, and with Covid being so infectious, I don't see why both strains of the virus shouldn't have reached Sweden?

[Angela]

Interesting, but Sweden was one of the few countries that did not implement any kind of lockdown. As people move around Europe all the time, and with Covid being so infectious, I don't see why both strains of the virus shouldn't have reached Sweden?

It was my understanding the "recommendations" were there; they just didn't impose legislation. The Swedish minister in charge of the response said they were wrong in their approach, by the way.

Plus, wouldn't it be more important to see how many people were going to Sweden and how many Swedes left and then returned?

I found the abstract a little confusing, also. Did they imply there was another strain as well, or did it all mutate?

Maybe someone has some other articles about it.

[ThirdTerm]

SARS-CoV-2 genomes obtained from patients in Stockholm belonged to the genetic strains 20C/B.1/G and 20B/B.1.1/GR. Along with B.1/G from Italy, they are the three main strains found in Sweden. B.1/G declined in prevalence by late April in Sweden, while 20C/B.1/G and 20B/B.1.1/GR mutated locally from B.1/G and they became more prevalent in the country. One of the Swedish strains carries the novel mutation, which affects the attachment of the virion to the cell, thus weakening the spike protein's infectivity. An earlier study by Indian researchers came up with similar results, which found two Swedish mutations, one of which was benign without being specific about the mutations.


A variant was identified that could have destabilizing effects

In one of the genomes, a variant was found at 23463bp that was not found in any other GenBank SARS-CoV-2 genome. The mutation changes an arginine residue to a histidine residue at position 364 in the S1 subunit of the viral spike protein.

The researchers say this variant in the spike protein could have destabilizing effects.

“The variant is located at the surface of the S1 subunit, and could possibly affect the attachment of the virion to the cell, even though it does not change the receptor-binding domain itself,” writes the team.

Three genomes were strains previously thought to have declined in Sweden

On comparing the four SARS-CoV-2 genomes obtained from patients in Stockholm with those detected globally, the researchers found that they belonged to the genetic strains 20C/B.1/G and 20B/B.1.1/GR.

The Public Health Agency of Sweden had previously reported these genetic groups as two of the three main strains found in Sweden.

However, three of the genomes are from group B.1/G, which was also reported by the Public Health Agency of Sweden to have declined in prevalence by late April, say Soratto and team.

https://www.news-medical.net/news/20...om-Sweden.aspx

[scandinavia]

One factor affecting Italy's death rate may be the age of its population, it has the oldest population in Europe, with about 23% of residents 65 or older

[Axion]

one reason is the health system, another is the social habits and for sure there are other not so noticeable aspects in the equation eg. 1. 5G experiments and 2. spiritual risks because lesser Grace because the decadent lifestyle if we take in account that the northern part of Italy is richer thus more hedonistic which by all means could be factor plus in this kind of pandemics!

[Wheal]

Quite honestly, not much of it makes sense when you are looking at actual cases.
Examples:
My Aunt-on a ventilator for 12 weeks. after 6 months Recovered. Age is 82. slightly active
My Father In Law- no symptoms. Age 86. Active
My Mother- few symptoms (and is prone to pneumonia). Age 87. wheelchair.

[Angela]

As was pointed out upthread, some scientists believe the virus mutated to become less lethal before reaching northern Europe. It makes sense. People are just not dying of it as they did at the beginning,and I don't think it's just the therapeutics.

[Axion]

Quite honestly, not much of it makes sense when you are looking at actual cases.

its fact that this virus is spreading everywhere with bigger consequences for chronically ill people, yet in some places like northern italy (havent followed the stats) it became aggressive at alarming proportions as media were reporting, now how much of this is just panic and how much dangerous level of fatality there I am not aware!

I have deliberately listed 5G experiments above, not that I am somehow knowledgeable in the matter, but eg. Milan was at risk if such networks produce somehow stress to the immunity coz constant microwave exposure, lets say any wifi is risk factor 2g 3g 4g etc. especially if the phones or modems dont have clear signal thus they are working on higher frequencies as devices so they can obtain their stable connection, so things can easily go in wrong direction, but what is more strange in Milan there is 5G institute department who is collaborating with the wuhan university responsible for the 5G network technology, does this means they are experimenting there and thus worsened the side effects of the local epidemiology can say, but assume that there is no coincidence in this case, tho again I havent seen the stats so all this guessing for the higher mortality in No.It. is more like speculation than logical thesis ...

probably the diet also have role, but unlike many thesis for what I have head about, i'll suggest that they the lombardians are maybe more prone to fatality coz higher rate of diary products consumption, also problematic -pril and -tan pharmaceuticals, in both cases like that stimulating the infamous ACE-2 receptors through which this virus is entering the human cells!

[Axion]

As was pointed out upthread, some scientists believe the virus mutated to become less lethal before reaching northern Europe.

this the logical outcome as collective immunity result with all the past pandemics in this century, and for sure if not now later this would become regular way of reducing its virtuosity! but on other hand there are speculation that this outcome is more like eugenic scenario , but my theory is focused just on the need for instant world economy shapeshifting from fiat to crypto money...

[RichardRichieR]

Statistics and data are of course cool. But don't you think it's simpler than that? Don't you think Mother Nature is just tired of what we do to her? Don't you think we just need to start going where we've already been and start creating with nature?

[bnuizqueb]

purely my personal opinion! Some countries work for statistics, others help their citizens! So it turns out that in some countries they want to talk about it openly, in others we have a situation of deliberately hidden monitoring! And this is undoubtedly one of the main problems with which it is unlikely that it will be possible to solve!