Certain Health Conditions Up Risks For Severe COVID-19

New research suggests that having an underlying health condition might be one of the most significant risk factors for developing a severe case of COVID-19.

Scientists at the US Centers for Disease Control and Prevention took a look at a group of US adult COVID-19 patients and found roughly three-quarters of those who wound up in the hospital had at least one underlying health issue.

For 457 patients who were admitted to intensive care, 78% had other health conditions, while 71% of 732 patients admitted to the hospital, but not intensive care, had at least one other health issue.

The mortality data showed an even stronger correlation: Among all hospitalized COVID-19 adult patients with complete information on underlying conditions or risk factors, 184 deaths occurred. Of those, 173 (94%) involved patients with at least one underlying condition, according to the CDC's COVID-19 Response Team, led by researcher Nancy Chow. Those conditions include diseases that strike people of all ages, including asthma and diabetes, along with heart disease and lung disease.

Unfortunately, those very conditions are quite common among Americans, the researchers noted: In 2018, the prevalence of diagnosed diabetes among US adults was just over 10%, while the prevalence of heart disease was 10.6% in 2017. Meanwhile, the prevalence of COPD (chronic obstructive pulmonary disease) among US adults was almost 6% and the prevalence of asthma among persons of all ages was nearly 8% in 2018.

The findings were published March 31 in the CDC publication Morbidity and Mortality Weekly Report.
Dr. Robert Glatter is an emergency physician in New York City, tasked with treating many patients hit by coronavirus. He said the new findings are all too familiar.

"On the front lines what we are seeing is that patients with chronic lung disease, cardiovascular disease, and diabetes are at higher risk for admission, as well as respiratory failure due to ARDS," he said. "Patients with asthma, COPD, as well as sleep apnea are at elevated risk for adverse outcomes including pneumonia, ARDs, and subsequent intubation.

That doesn't mean that everyone with these conditions is certain to suffer severe illness, Glatter stressed.

"It's unclear if those patients with underlying chronic disease who adequately manage their conditions are at lower risk for complications and adverse outcomes," he said.

Underlying conditions can be a big player in COVID-19 severity, but many young adults mistakenly believe that only older people are affected by the coronavirus—a misconception that puts themselves and others at risk, experts warned.

A growing number of 20- to 44-year-old Americans have been hospitalized for COVID-19.

While the rate of COVID-19 deaths is highest for those older than 85, the rate of confirmed cases is highest (29%) among 20- to 44-year-olds, according to the CDC.

Those between 65 and 84 years of age represented more than a third of hospitalized patients, the CDC says, but 20% of hospitalized patients were between 20 and 44.

It's highly likely that someone in that younger group knows someone from a high-risk group, said Dr. Michael Chang, an assistant professor of pediatrics at the University of Texas Health Science Center at Houston.

"Even if your individual risk of severe disease is low, it would be very unfair for those high-risk patients if your actions exposed them to what could be life-threatening disease," Chang said in a UT Health news release.

Young adults need to be aware that while their risk of death if they contract COVID-19 is lower than for older adults, they can spread the illness to their more vulnerable parents, grandparents and other loved ones, said Dr. George Delclos, a professor of public health at UT Health.

High-risk people need to take social distancing seriously to avoid contracting the coronavirus, said Catherine Troisi, an infectious disease epidemiologist at UT Health School of Public Health.

People with elevated risk include those who have underlying health conditions such as chronic lung disease, diabetes or heart disease; are overweight; have a weakened immune system; are pregnant; or are older than 65.

But everyone is at risk, including young people, Troisi emphasized.

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