Who is Most at Risk for Coronavirus Complications?
For months the novel coronavirus, also known as covid-19, has been at the top of the world’s consciousness.
There have been lockdowns in countries around the world, and even most states in the U.S. initiated some level of social distancing protocols or shutdowns to curb the spread.
Now that we’re a bit further into the pandemic, we have a greater understanding of who is potentially most severely affected by the respiratory illness, and what underlying conditions are most likely to contribute to complications.
With a lot of illnesses and infections, being pregnant, for example, can affect your immune system and make you more likely to get severely ill. What we know right now as far as pregnancy and covid-19 are that if you are pregnant you probably aren’t any more likely than the average person to develop complications.
Current evidence doesn’t show that birth defects or miscarriage are more likely if you contact covid-19 while you’re pregnant, or that the virus can be passed through breastmilk.
While pregnant women may need to just take the normal level of caution that most of us are being advised to follow in our daily lives, who could be more affected and perhaps should be more cautious right now?
It’s important to note when talking about who’s most at-risk for coronavirus that this isn’t necessarily a discussion of who’s most likely to get infected. Instead, it’s about who is most likely to get very sick or develop complications if they are infected.
We hear about how often younger people become infected with coronavirus, and the rates for infection are standard across age groups. In fact, it’s possible that younger people have even higher infection rates than older people because they’re more likely to be at work right now, or out and about more.
With that being said, older people do tend to develop more complications, including acute respiratory distress syndrome or ARDS.
ARDS is a condition where fluid collects in the sacs of the lungs, and it restricts how much air your lungs can take in.
That can then reduce the oxygen supply to your organs.
The average age of ARDS patients has been reported as 61 in China. Elderly patients were more likely to develop ARDS according to researchers, while in younger people, the WHO said only 2.4% in China developed ARDS.
Through mid-January, there were no reports of children in Wuhan even developing covid-19. This could still mean children had the virus, but maybe that they weren’t showing symptoms.
Asthma classified as moderate-to-severe could mean you’re more likely to develop severe illness if you contract covid-19.
For people who have asthma, the CDC recommends that you follow your asthma action plan and keep it under control. Continue all your medicines, and avoid triggers for your asthma.
Obesity is linked to the potential for more severe covid-10 symptoms and complications, even outside of other illnesses occurring like cardiovascular disease.
The CDC defines severe obesity as having a body mass index (BMI) of 40 or higher, and they list severe obesity as an official covid-19 risk factor.
In China, data were assessed from 383 patients, and it showed a 142% higher risk of developing severe pneumonia related to covid-19 in those patients who were obese.
There were similar findings in New York City. The study in New York looked at more than 4,000 patients and found severe obesity was a primary hospitalization risk factor, only behind the age.
A study in Seattle found 85% of patients with severe obesity required mechanical ventilation, which was compared to only 64% of non-obese patients. In the same Seattle study, 62% of patients with obesity died of covid-19, but only 35% of patients not classified as being obese died.
Doctors and researchers aren’t entirely why obesity and especially severe obesity are such a high-risk conditions for coronavirus complications.
People with obesity may have a higher level of resistance in their airways, as well as weaker respiratory muscles and lower lung volume. This could make someone more likely to develop pneumonia.
Obesity is also linked with heart disease, kidney disease, and diabetes, and these conditions are all associated with a higher risk of developing pneumonia.
Researchers found that having diabetes increases the risk of dying from covid-19 four-fold.
The risks for people with diabetes are particularly high when hyperglycemia isn’t well managed.
As well as a higher death risk, diabetes and poorly managed hyperglycemia can also lead to more extended hospital stays.
Currently, though, data isn’t distinguishing between type 1 diabetes which is an autoimmune disorder and type 2 diabetes which is usually related to being overweight.
If you are immunocompromised, you are probably used to taking extra precautions to protect yourself from illnesses, and covid-19 is no exception.
If you’re immunocompromised, it means you have a weak immune system and therefore are more likely to get infections and also to have a severe risk for coronavirus complications if you get sick.
Immunodeficiency can occur because of a health disorder or because of a medication.
Medications that can weaken your immune system include cancer treatments and medicines for autoimmune diseases like corticosteroids.
If you have a heart condition like heart failure, you may be at a higher risk of covid-19 complications.
What can put people at even higher risk is if they have a heart condition as well as other comorbidities like diabetes or hypertension, which is a fairly common scenario.
So what if you are someone who is at high risk for covid-19 complications?
You should always consult with your doctor first and foremost and get their advice.
You might work from home whenever possible, and follow the CDC’s guidance to wear a facemask.
You should wash your hands frequently and follow any infection control protocols that we’re all advised to follow right now. If you’re at severe risk for coronavirus complications, your health care provider will be able to provide you with a more specific direction in your situation.