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Fig. 2 | Egyptian Journal of Medical Human Genetics

Fig. 2

From: Low iron mitigates viral survival: insights from evolution, genetics, and pandemics—a review of current hypothesis

Fig. 2

Case Fatality Rate world map, based on data accessed on June 3, 2020. CFR is defined as the number of deaths divided by the number of incident patients within a specified time. CFR is least affected by reporting bias but maybe underestimated by time lag bias due to diagnosing and reporting cases, and the assumption that all cases have been reported, while it may be overestimated by the definition of a case, either confirmed or closed. This map depicts the CFR so far. The highest CFR (> 10%) is reported in Belgium (16.21%), France (15.47%), Italy (14.35%), Hungary (13.54%), the Netherlands, Sweden (11.64%), Spain (11.32%), and Mexico (10.58%). Comparing this map to the IDA prevalence Map in Fig. 1, a stark contrast is seen. Countries with high IDA prevalence have yet to report CFR > 3%. This includes the majority of SSA, excluding Kenya and Mali, as well the South East Asia. Meanwhile, countries with mild anemia prevalence appear to be reporting much higher CFR. There appears to be a connection between severe anemia and lesser CFR, bolstering the notion that the anemic defense is an evolutionary response to acute infection in the endemic setting, a chronic anemia “herd immunity” of sorts that may protect populations rather than a case by case basis

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