An Outlook on the COVID-19 Infection Magnitude in Pakistan and Potential Factors Contributing to Low Mortality Rates

Abstract

Background: COVID-19 has severely affected some countries with a high mortality rate than others. In Pakistan, its mortality rate is lower (2.06%) than neighboring countries and even economically advanced countries. Here we discuss the distinct characteristic of the Pakistani population that might have contributed to this lower mortality. Methods: COVID-19 mortality data were collected from December, 2019 to July, 2020 and studied for population age spectrum, health facilities, immunization profiles, physical activity, and obesity from Pakistan and other countries. Results: Lower COVID-19 related mortality rate was observed in Pakistan (2.06%) as compared to France (18.02%), Italy (14.45%), UK (14.01%), Spain (9.56%), the USA (4.71%), and Iran (4.77%). Small proportion (3.5%) of the elderly population (>65 years of age), exposure to different viral antigens, a higher rate of BCG vaccination, better physical activity practices, and lower obesity prevalence in Pakistani population as compared European and North American population may contribute to lower COVID-19 related mortality rate. Conclusions: Multiple factors may have contributed to this lower mortality rate in Pakistan. Our observations may facilitate clinicians to identify individuals who may have low risk to COVID-19 related deaths. Comprehensive studies are warranted to address it further.