Covid-19 – What puts you at higher risk?

COVID-19 is still very new, with limited information regarding risk factors, but some data is becoming very apparent based on the experiences in China, Italy and other countries. Based on currently available information older adults and people of any age who have serious underlying medical conditions might be at higher risk for severe illness from COVID-19. Data from China shows that the fatality rate of healthy individuals having no underlying condition is 0.9%. The conditions which significantly increase the fatality rates are –

Heart disease

Heart disease in general is accompanied by underlying conditions like high blood pressure, elevated cholesterol, diabetes, and lung disease. All of this weakens the immune system and makes the body more susceptible to the infection. Pneumonia caused by COVID-19 also makes it tougher for the heart to pump blood.

The fatality rate for heart patients is highest at 10.5%.

Diabetes

Diabetes causes heightened levels of inflammation throughout the body and compromises the immune system. According to the International Diabetes Foundation, when people with diabetes develop a viral infection, it can be harder to treat due to fluctuations in blood glucose levels and, possibly, the presence of diabetes complications. There appear to be two reasons for this. Firstly, the immune system is compromised, making it harder to fight the virus and likely leading to a longer recovery period. Secondly, the virus may thrive in an environment of elevated blood glucose.

The fatality rate for diabetes patients was observed to be around 7%.

Chronic Respiratory Disease

Chronic respiratory diseases are diseases of the airways and other parts of the lung. Lung diseases like emphysema or bronchitis leave the lungs weaker when trying to fight off the respiratory infection. Pneumonia is one common complication of COVID-19 that can additionally put stress on the weak lung and prove fatal. Fatality rates, in this case, is around 6.3%.

Hypertension

Data from China and Italy, show a higher risk of COVID-19 infections and complications in people with high blood pressure. According to WebMD, a possibility is that the higher risk comes not from high blood pressure itself, but from certain drugs used to treat it — ACE inhibitors and angiotensin receptor blockers (ARBs). This is just a theory since there’s no research yet on what impact, if any, these medications might have on COVID-19. The theory is based on the fact that ACE inhibitors and ARBs raise levels of an enzyme called ACE2 in your body. And to infect cells, the COVID-19 virus must attach itself to ACE2. This has caused an increased fatality rate of around 6%.

Cancer

Cancer leaves the immune system compromised. The fatality rates in patients who had cancer or recently survived cancer were observed to be around 5.6%.

Smoking

A study published in the European Respiratory Journal shows that Smokers and people with chronic obstructive pulmonary disease may have elevated levels of an enzyme called ACE-2, which helps the virus enter cells in their lungs, where it replicates. One of the speculations, since the crisis started, is that the higher mortality rate for men than women in China is because about half of males smoke compared with some 2% for females.

Other conditions

Apart from these conditions other conditions that increase risk include –

• chronic kidney disease
• chronic liver disease, such as hepatitis
• chronic neurological conditions, such as Parkinson’s disease, motor neuron disease, multiple sclerosis (MS), a learning disability or cerebral palsy
• problems with spleen – for example, sickle cell disease or spleen has been removed
• autoimmune diseases
• a weakened immune system as the result of conditions such as HIV and AIDS, or medicines such as steroid tablets or chemotherapy
• being seriously overweight (a BMI of 40 or above)
• those who are pregnant
• aged over 70, regardless of whether they have a medical condition or not.