Red heads and fair skin, Vit-D, ACE-II and of course COVID-19


Here are some articles placed here in response to Michelle Nyland.


"I have a question, why is “Caucasian with red hair and light complexion” specifically called out, specifically? Is there evidence of a trend?"



When we provided results from our questionnaire two years ago, results for race looked like this.


Results from November 2020 - Q6 - Race


Overall, not a huge number of respondents at that time, overwhelmingly 'White or Caucasian' (89%) and those few with 'red hair and fair skin' were less than 5%.


Why had they even been included among the usual choices for race/ ethnicity?


At the time of creating this questionnaire, topics of interest included:


  • characteristics of the COVID-19 illness (of course!), but also
  • findings potentially related to race
  • findings potentially related to use of vitamins/ supplements
  • especially Vitamin D as importantly related to COVID-19
  • findings potentially related to the ACE-II receptor and other components of the renin-angiotensin-aldosterone system usually thought of primarily related to blood pressure control.


So as subjects for further exploration had through the questionnaire, come to mind,

certain choices were made and the 'red hair/ fair skin' choice included.


During the two years since, most of the above list were confirmed as important with respect to COVID-19 and its clinical presentation.


So the reasoning behind it then was that since Vitamin D has a link to COVID-19 diagnosis and treatment, and since red heads with fair skin make more Vitamin D precursor in their skin than BAME populations (for comparison) and since the entry of the SARS-CoV-2 virus is related to ACE-II which is also found in the skin, ...


... would their be a hint about this in the results of the survey?  Meaning, a proportion of respondents with red hair/ fair skin would be typical of the population (2% to 4% depending on location, of course more dense among the Scots), or not. For the 6 respondents above, supplementation with Vitamin-D and measurement of blood levels was variable. Some took more, some not.


All that to mean that no striking discoveries emerged from this component of our study two years ago. But that's OK.


Would "red heads" create enough Vitamin-D due to their fair skin creating more precursor, and through that have added protection against COVID-19? 


We certainly did not answer that question two years ago! But it did encourage us to be thinking at a cellular level where the problem (and solution) linked to COVID-19 is certainly still going on.


But the 'red hair/ fair skin' topic remains quite interesting. 


Here is a little bibliography from the experts that provides a nice background.


Michael F. Hollick of Boston is certainly a key name to remember when it comes to everything about Vitamin D, and including characteristics of its creation (or its precursor)  in the skin in response to UV-B light. We'll leave the topic of melanoma and other skin cancers in those with the fair skin/ red hair genetics aside for some other venue.


Vita-D and melanin during COVID-19


Red Hair__ A Mutation, A Royal Trait, and Sometimes a Curse (Sheikh 2009)


Vitamin D and Health Evolution Biologic Functions_


The Vitamin D Epidemic and its Health Consequences (Michael F Hollick)


The evolution of human skin pigmentation involved the interactions of genetic, environmental, and cultural variables


Deciphering the Potential of Pre and Pro-Vitamin D of
Mushrooms against Mpro and PLpro Proteases of COVID-19


Effects of Angiotensin II Receptor Signaling during Skin Wound Healing


Association of Vitamin D Status with SARS-CoV-2 Infection or COVID-19 Severity__ A Systematic Review and Meta-analysis


A computational model for previtamin D3 production in skin


Is the shielding effect of cholecalciferol in SARS CoV-2 infection 
dependable? An evidence based unraveling


Aging Decreases the Capacity of Human Skin to Produce Vitamin D3



So the answer to Michelle's question is that all of these components contribute to 

our understanding of why some people catch COVID-19, and some don't, and some several times, and some get sicker than others, and in some it will last much longer (see this article for that recent update to Duration of Illness in our own study).


Certainly who one is (and the genes one carries) contributes to the COVID-19 experience and how it might manifest in each of us: red heads, BAMES, old folks and all the rest! One should not just think of this as "premorbid conditions" but try to get beyond that to a deeper level.


Thanks for the question Michelle !


When I was in Medical School and afterwards a Surgical Resident, I had the pleasure of working with Dr. Alex Breslow. He was a Pathologist best known for his system of analysis of melanomas and their prognosis based on depth of penetration into the skin. I even had the privilege of having him become one of my patients.


Anyway, Doctor Breslow was a wonderful man. Always quite busy of course as head of the Path department and Researcher.


But never too busy for a question.

Sometimes, and rather sheepishly, a student would see Breslow's coat tails flying by and would risk a ... "Doctor Breslow... excuse me but ..." as introduction to a student's question.


Breslow would always wheel around and shout: "Yes?! Please!!" as if to say, thank you for stopping me to ask your question. If his obvious enthusiasm hadn't quickly scared off the student, he would get an answer to his question right then and there. Always.


So I'll close here and in memory of Doctor Breslow, say to Michelle: "Yes! Please!!"


And Thank you for asking.



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