Is diet partly responsible for differences in COVID-19 death rates between and within countries?
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Clinical and Translational Allergy Open Access
REVIEW
Is diet partly responsible for differences in COVID‑19 death rates between and within countries? Jean Bousquet1,2,3,4* , Josep M. Anto5,6,7,8, Guido Iaccarino9, Wienczyslawa Czarlewski10,11, Tari Haahtela12, Aram Anto10, Cezmi A. Akdis13, Hubert Blain14,15, G. Walter Canonica16, Victoria Cardona17, Alvaro A. Cruz18, Maddalena Illario19,20, Juan Carlos Ivancevich21,22, Marek Jutel23, Ludger Klimek24, Piotr Kuna25, Daniel Laune26, Désirée Larenas‑Linnemann27, Joaquim Mullol28, Nikos G. Papadopoulos29,30, Oliver Pfaar31, Boleslaw Samolinski32, Arunas Valiulis33, Arzu Yorgancioglu34, Torsten Zuberbier1,2,3,4 and The ARIA group
Abstract Reported COVID-19 deaths in Germany are relatively low as compared to many European countries. Among the several explanations proposed, an early and large testing of the population was put forward. Most current debates on COVID-19 focus on the differences among countries, but little attention has been given to regional differences and diet. The low-death rate European countries (e.g. Austria, Baltic States, Czech Republic, Finland, Norway, Poland, Slova‑ kia) have used different quarantine and/or confinement times and methods and none have performed as many early tests as Germany. Among other factors that may be significant are the dietary habits. It seems that some foods largely used in these countries may reduce angiotensin-converting enzyme activity or are anti-oxidants. Among the many possible areas of research, it might be important to understand diet and angiotensin-converting enzyme-2 (ACE2) levels in populations with different COVID-19 death rates since dietary interventions may be of great benefit. Keywords: Coronavirus, Diet, Angiotensin-converting enzyme, Antioxidant, Food Introduction A novel strain of human coronaviruses, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), named by the International Committee on Taxonomy of Viruses (ICTV) [1], has emerged and caused an infectious disease referred to as “coronavirus disease 2019” (COVID-19) by the World Health Organization (WHO) [2]. COVID-19 has aggressively spread across the globe and over 160,000 deaths have been reported. However, there appears to be high- and low-death rate countries. After the outbreak in China, COVID-19 has also affected Europe after becoming a pandemic. Interestingly, *Correspondence: [email protected] 4 CHU Montpellier, 273 Avenue d’Occitanie, 34090 Montpellier, France Full list of author information is available at the end of the article
there is large variability across European countries in both incidence and mortality, and most current debates on COVID-19 focus on the differences among countries. German fatalities are strikingly low as compared to many European countries. Among the several explanations proposed, an early and large testing of the population was put forward [3]. However, little attention has been given to regional differences and diet [4].
Biases to be considered According to the Johns Hopkins coronavir
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