{"id":896,"date":"2020-06-12T14:26:36","date_gmt":"2020-06-12T14:26:36","guid":{"rendered":"https:\/\/uni.hi.is\/apalsson\/?p=896"},"modified":"2020-06-12T14:26:36","modified_gmt":"2020-06-12T14:26:36","slug":"icelandic-hefur-covid-19-lagst-hardar-a-karla-en-konur-og-hvad-gaeti-skyrt-thad","status":"publish","type":"post","link":"https:\/\/uni.hi.is\/apalsson\/IS\/2020\/06\/12\/icelandic-hefur-covid-19-lagst-hardar-a-karla-en-konur-og-hvad-gaeti-skyrt-thad\/","title":{"rendered":"Hefur COVID-19 lagst har\u00f0ar \u00e1 karla en konur og hva\u00f0 g\u00e6ti sk\u00fdrt \u00fea\u00f0?"},"content":{"rendered":"

Arnar P\u00e1lsson. \u201eHefur COVID-19 lagst har\u00f0ar \u00e1 karla en konur og hva\u00f0 g\u00e6ti sk\u00fdrt \u00fea\u00f0?<\/a>\u201c V\u00edsindavefurinn<\/i>, 12. ma\u00ed 2020. http:\/\/visindavefur.is\/svar.php?id=79406.<\/p>\n

Fyrstu t\u00f6lur um dau\u00f0sf\u00f6ll vegna veirunnar sem veldur COVID-19 bentu til \u00feess a\u00f0 karlar v\u00e6ru \u00ed meiri h\u00e6ttu \u00e1 a\u00f0 f\u00e1 alvarlegan sj\u00fakd\u00f3m en konur. \u00deetta vir\u00f0ist vera r\u00e9tt, en ekki er vita\u00f0 hva\u00f0 veldur \u00feessum mun \u00e1 \u00e1h\u00e6ttu og hvort \u00fea\u00f0 er a\u00f0eins kyni\u00f0 sem hefur \u00fear \u00e1hrif. Veiran sem veldur COVID-19 hefur brei\u00f0ist mj\u00f6g hratt \u00fat, gjarnan me\u00f0 mj\u00f6g alvarlegum aflei\u00f0ingum. F\u00f3lk er samt \u00ed mismikilli h\u00e6ttu \u00e1 a\u00f0 veikjast illa og vir\u00f0ist sem margir \u00fe\u00e6ttir skipti \u00fear m\u00e1li. Undirliggjandi sj\u00fakd\u00f3mar, margir og misjafnir, vir\u00f0ast auka h\u00e6ttu \u00e1 alvarlegri einkennum og dau\u00f0a. Aldur er annar \u00fe\u00e1ttur sem skiptir miklu m\u00e1li en svo vir\u00f0ist sem d\u00e1nart\u00ed\u00f0ni s\u00fdktra aukist me\u00f0 aldri. \u00cd n\u00fdlegri breskri ranns\u00f3kn var lagt mat \u00e1 \u00e1h\u00e6ttuaukninguna.<\/span>[1]<\/a><\/sup> Ranns\u00f3knin kallast OpenSAFELY og \u00ed henni voru g\u00f6gn um heilsu, aldur og fleira fyrir um 17 millj\u00f3nir Englendinga greind \u00ed gegnum dulk\u00f3\u00f0a\u00f0ar sj\u00fakraskr\u00e1r og s\u00ed\u00f0an sam\u00fe\u00e6tt vi\u00f0 lista um andl\u00e1t af v\u00f6ldum COVID-19-veirunnar.<\/span>[2]<\/a><\/sup> Mati\u00f0 byggir \u00e1 d\u00e1nart\u00ed\u00f0ni \u00e1 t\u00edmabilinu 1. febr\u00faar 2020 til 25. apr\u00edl 2020. Mi\u00f0a\u00f0 vi\u00f0 aldursh\u00f3pinn 50-60 \u00e1ra var aukning \u00e1 \u00e1h\u00e6ttu andl\u00e1ts me\u00f0al 60-70 \u00e1ra \u00e1\u00e6tlu\u00f0 tv\u00f6f\u00f6ld, hj\u00e1 70-80 \u00e1ra var h\u00fan 4,8-f\u00f6ld og um 12,6-f\u00f6ld hj\u00e1 f\u00f3lki eldra en \u00e1ttr\u00e6tt. \u00deeir sem voru yngri en 50 \u00e1ra voru s\u00ed\u00f0an \u00ed minni \u00e1h\u00e6ttu. Einnig var lagt mat \u00e1 h\u00e6ttu \u00e1 andl\u00e1ti \u00fat fr\u00e1 kyni. Ni\u00f0urst\u00f6\u00f0urnar meta h\u00e6ttuna \u00e1 andl\u00e1ti s\u00fdktra karlmanna tv\u00f6falda umfram konur (tafla 1). Margar a\u00f0rar ranns\u00f3knir og greiningar hafa gefi\u00f0 svipa\u00f0 mynstur \u00ed mismunandi l\u00f6ndum, \u00fe\u00f3 mati\u00f0 \u00e1 \u00e1h\u00e6ttuaukningunni s\u00e9 mismunandi.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n
Aldur<\/strong><\/td>\nEinstaklingar<\/strong><\/td>\nFj\u00f6ldi l\u00e1tinna<\/strong><\/td>\n<\/tr>\n
18-39<\/td>\n5.990.809<\/td>\n40<\/td>\n<\/tr>\n
40-49<\/td>\n2.875.761<\/td>\n94<\/td>\n<\/tr>\n
50-59<\/td>\n3.068.883<\/td>\n355<\/td>\n<\/tr>\n
60-69<\/td>\n2.405.327<\/td>\n693<\/td>\n<\/tr>\n
70-79<\/td>\n1.948.095<\/td>\n1.560<\/td>\n<\/tr>\n
80-<\/td>\n1.948.095<\/td>\n2.941<\/td>\n<\/tr>\n
Kyn<\/strong><\/td>\n<\/td>\n<\/td>\n<\/tr>\n
Konur<\/td>\n8.729.741<\/td>\n2.098<\/td>\n<\/tr>\n
Karlar<\/td>\n8.695.704<\/td>\n3.585<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Tafla 1. Uppl\u00fdsingar um fj\u00f6lda og d\u00e1nart\u00ed\u00f0ni Englendinga vegna COVID-19 \u00far handriti OpenSAFELY-ranns\u00f3knarh\u00f3psins (sj\u00e1 heimildaskr\u00e1). D\u00e1lkarnir tiltaka fj\u00f6lda einstaklinga \u00ed hverjum h\u00f3pi (\u00e1 vissu aldursbili e\u00f0a kyni), og fj\u00f6lda \u00feeirra sem l\u00e9tust \u00e1 t\u00edmabilinu. Heildarfj\u00f6ldi \u00ed hvorum h\u00f3pi er gefinn ne\u00f0st.\u00de\u00e1 liggur beinast vi\u00f0 a\u00f0 spyrja hva\u00f0 geti sk\u00fdrt \u00feennan mun? Svari\u00f0 er enn \u00e1 huldu. M\u00f6gulega er munurinn vegna ytri a\u00f0st\u00e6\u00f0na, umhverfis \u00ed sinni v\u00ed\u00f0ustu mynd, e\u00f0a innri \u00fe\u00e1tta, \u00fea\u00f0 er erf\u00f0a og l\u00edfe\u00f0lisfr\u00e6\u00f0i. Eins g\u00e6ti veri\u00f0 um samspil umhverfis og erf\u00f0a a\u00f0 r\u00e6\u00f0a.<\/p>\n

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Margar tilg\u00e1tur um mun \u00e1 \u00e1hrifum veirunnar eftir kynjum sn\u00faast um \u00f3n\u00e6miskerfi\u00f0.<\/p>\n<\/div>\n<\/div>\n

Vera m\u00e1 a\u00f0 kynjamunurinn sk\u00fdrist af f\u00e9lagslegum, menningarlegum e\u00f0a atferlislegum \u00fe\u00e1ttum a\u00f0 hluta. Margar mismunandi tilg\u00e1tur hafa veri\u00f0 settar fram. Hittast karlar oftar utan heimilis? Eru \u00feeir me\u00f0 vi\u00f0kv\u00e6mari \u00f6ndunarf\u00e6ri vegna vinnuumhverfis e\u00f0a lifna\u00f0arh\u00e1tta? \u00devo \u00feeir s\u00e9r sjaldnar um hendur og s\u00fdkjast \u00fev\u00ed af st\u00e6rri skammti af veirunni? Reykja karlmenn a\u00f0eins meira en konur og einnig oftar? E\u00f0li m\u00e1lsins samkv\u00e6mt er mj\u00f6g erfitt a\u00f0 meta \u00feessa \u00fe\u00e6tti, eins og umhverfis\u00fe\u00e6tti almennt. St\u00f3ra \u00e1skorunin er a\u00f0 \u00fe\u00e6ttirnir skipta hundru\u00f0um og jafnvel \u00fe\u00fasundum og m\u00e6lingar \u00e1 \u00feeim eru mikilli \u00f3vissu h\u00e1\u00f0ar. L\u00edfe\u00f0lisfr\u00e6\u00f0ilega eru konur og karlar \u00fe\u00f3 \u00f3l\u00edk um marga \u00fe\u00e6tti.<\/span>[3]<\/a><\/sup> Margt er \u00e1 huldu var\u00f0andi \u00fea\u00f0 hvernig veiran dregur f\u00f3lk til dau\u00f0a, \u00fea\u00f0 g\u00e6ti tengst l\u00edffr\u00e6\u00f0i lungna, \u00f6ndunarf\u00e6ra og \u00f3n\u00e6miskerfis. Flestir s\u00e9rfr\u00e6\u00f0ingar telja a\u00f0 \u00fea\u00f0 s\u00ed\u00f0astnefnda skipti mestu m\u00e1li. Ein tilg\u00e1ta er a\u00f0 ofvirkni \u00ed vissum hlutum \u00f3n\u00e6miskerfisins geti stu\u00f0la\u00f0 a\u00f0 b\u00f3lgusv\u00f6run og l\u00edff\u00e6rabilun. Margar tilg\u00e1tur um mun \u00e1 \u00e1hrifum veirunnar eftir kynjum sn\u00faast einmitt um \u00f3n\u00e6miskerfi\u00f0. Ein er s\u00fa a\u00f0 mismunur \u00ed sterab\u00faskap karla og kvenna geti haft \u00f3l\u00edk \u00e1hrif \u00e1 \u00f3n\u00e6miskerfi\u00f0. \u00d6nnur tilg\u00e1ta er a\u00f0 vegna \u00feess a\u00f0 X-litningar bera gen sem tengjast \u00f3n\u00e6miskerfinu s\u00e9u konur betur var\u00f0ar me\u00f0 s\u00edn tv\u00f6 eint\u00f6k af \u00feeim litningi. \u00dev\u00ed til stu\u00f0nings er s\u00fa sta\u00f0reynd a\u00f0 genin fyrir \u00f3n\u00e6misvi\u00f0takana TLR7 og TLR8 eru \u00e1 X-litningi karla. \u00deessir vi\u00f0takar binda ein\u00fe\u00e1tta RNA \u00far veirum og r\u00e6sa \u00f3n\u00e6miskerfi\u00f0. Erf\u00f0aefni veirunnar sem veldur COVID-19 er einmitt \u00e1 \u00fev\u00ed formi.<\/span>[4]<\/a><\/sup><\/p>\n

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Lega TLR7 og TLR9-genanna \u00e1 X-litningi \u00ed erf\u00f0amengi manna. Mynd fengin af vef erf\u00f0amengjavafra Kaliforn\u00eduh\u00e1sk\u00f3la \u00ed Santa Cruz (UCSC genome browser).<\/p>\n<\/div>\n<\/div>\n

\u00deri\u00f0ja tilg\u00e1tan er s\u00fa a\u00f0 virkni \u00f3n\u00e6miskerfisins s\u00e9 mismunandi milli kynja. \u00deessi tilg\u00e1ta er studd nokkrum ranns\u00f3knum sem s\u00fdna me\u00f0al annars kynjamun \u00ed sv\u00f6run karla og kvenna vi\u00f0 infl\u00faensuveirunni, og mun \u00ed sv\u00f6run kynja vi\u00f0 b\u00f3lusetningum. \u00d3n\u00e6miskerfi hryggd\u00fdra er oft skipt \u00ed me\u00f0f\u00e6dda e\u00f0a \u00f3s\u00e9rt\u00e6ka \u00f3n\u00e6miskerfi\u00f0 (e. innate<\/em>) og \u00e1unna e\u00f0a s\u00e9rt\u00e6ka \u00f3n\u00e6miskerfi\u00f0 (e. adaptive). Ein ranns\u00f3kn \u00e1 tj\u00e1ningu gena \u00ed frumum \u00f3n\u00e6miskerfisins hj\u00e1 heilbrig\u00f0u f\u00f3lki \u00e1 aldrinum 22 til 95 \u00e1ra greindi mun \u00e1 kynjum og benda ni\u00f0urst\u00f6\u00f0urnar til \u00feess a\u00f0 me\u00f0f\u00e6dda kerfi\u00f0 s\u00e9 virkara hj\u00e1 k\u00f6rlum eftir 65 \u00e1ra aldur, en s\u00e9rt\u00e6ka \u00f3n\u00e6miskerfi\u00f0 veikara. \u00deetta birtist \u00feannig a\u00f0 gen sem tengjast b\u00f3lgusv\u00f6run voru meira tj\u00e1\u00f0 \u00ed k\u00f6rlum eftir \u00feennan aldur, og \u00e1 m\u00f3ti var f\u00e6kkun vissra frumuger\u00f0a \u00ed s\u00e9rt\u00e6ka \u00f3n\u00e6miskerfinu. N\u00e1kv\u00e6mlega hva\u00f0a \u00e1hrif \u00feetta hefur \u00e1 \u00f3n\u00e6miskerfi\u00f0 \u00ed heild sinni er \u00f3v\u00edst. Sabra Klein, pr\u00f3fessor \u00e1 John Hopkins-sj\u00fakrah\u00fasinu sag\u00f0i \u00ed vi\u00f0tali vi\u00f0 The Guardian<\/cite> um karla: \u201eme\u00f0f\u00e6dda \u00f3n\u00e6miskerfi \u00feeirra getur e.t.v. ekki brug\u00f0ist r\u00e9tt vi\u00f0 \u00feegar \u00fea\u00f0 m\u00e6tir veirunni\u201c.<\/span>[5]<\/a><\/sup> \u00dea\u00f0 \u00e1 eftir a\u00f0 koma \u00ed lj\u00f3s hvort a\u00f0 \u00feessir \u00fe\u00e6ttir e\u00f0a einhverjir a\u00f0rir skipti m\u00e1li fyrir mun \u00e1 d\u00e1nart\u00ed\u00f0ni milli kynja. Samantekt<\/strong><\/p>\n