COVID-19 is the disease caused by the newest member of the coronavirus family, which has been named SARS-CoV-2 and is often referred to as “novel coronavirus.” Research is finding that a large percentage of those who become infected only have a mild form of the disease, and they’re able to manage and easily recover from symptoms at home
However, the World Health Organization (WHO) statistics show that about one in five infected with novel coronavirus will need hospital care. The CDC and WHO have also identified certain underlying health conditions that are connected to placing people at higher risk of developing the severest form of the disease.
What Is An Underlying Health Condition?
An underlying health condition is a long-term or chronic health factor that exists independent of the novel coronavirus. Keep in mind that these can be known or unknown, meaning you may have already been diagnosed or simply have the condition and not be aware of it. In either case, the underlying health condition exists to worsen symptoms of COVID-19 or create complications in its coexistence with your underlying health issue.
1. Chronic Lung Disease and Asthma
SARS-CoV-2 causes acute respiratory disease. The virus enters a healthy cell in the respiratory tract and multiplies by using the cell to make new virus parts to infect nearby cells. Your immune system responds, which causes inflammation. If the swelling continues, the lungs fill will fluid and debris. Pneumonia occurs when the lung’s alveoli become inflamed. Inflammation and fluid make it harder for the lungs to swap oxygen and carbon dioxide, which can lead to acute respiratory distress syndrome and the need for a ventilator.
Those with chronic respiratory disease and conditions already have vulnerabilities in their respiratory system, which provides an environment that SARS-CoV-2 can be more severe and destructive to respiratory tissue.
• COPD – chronic obstructive pulmonary disease
• Mild to severe asthma
• Lung cancer
• Cystic fibrosis
• Pulmonary fibrosis
• Chronic bronchitis
2. Heart Conditions
Those with underlying heart disease have been found to be most at risk for heart attack and congestive heart failure following a SARS-CoV-2 infection.
Research suggests that the viral disease increases demand on an already compromised cardiovascular system via certain heart conditions. Fever, for example, often causes tachycardia. Pneumonia decreases blood oxygen levels and increases the risk for blood clot formation. Myocarditis, which is inflammation of the heath muscle, can also be triggered by COVID-19 and cause deadly irregular heart rhythms.
Research is just starting to emerge on the possible connection between COVID-19 and certain hypertension medications. Two of the most commonly prescribed are ACE inhibitors and ARBs. Both of these increase the number of ACE2 receptors found in heart and lung tissue, which happens to be the types of receptors that SARS-CoV-2 latches to for multiplication.
Of the top 19 comorbidities listed by New York health officials, hypertension was number one, and four of the top six were related to cardiovascular health.
• Atrial fibrillation
• Coronary artery disease
• Congenital heart disease
• Stroke and heart attack survivors
3. Compromised Immune System
Those with conditions and diseases that leave them immunocompromised are at great risk for COVID-19 in its severest form because their immune systems are already weakened, which leaves them without the proper tools to fight the infection.
From eating disorders to cystic fibrosis and cancer, there are over 350 disorders that can cause immunodeficiency. If you suspect any underlying health condition, speak with your physician about how it may influence your immune system function.
Keep in mind that this isn’t just a matter of the underlying disease itself. Certain medications, such as those for cancer and HIV, often result in immunodeficiencies and comprising. It’s the same case for certain treatments, such as stem cells, organ transplants, and radiation therapy. It’s also important to remember that certain non-disease health behaviors, such as drug and tobacco use, can lower the immune system.
Severe obesity, which is classified as a BMI of 40 and above, is emerging as a common factor in severe COVID-19 cases amongst those under 60-years-old.
Severe obesity increases the risk of one of COVID-19’s most deadly complications – acute respiratory distress syndrome (ARDS.) Severe obesity also increases the likelihood of living with other unknown, underlying health conditions like diabetes, asthma, and heart disease, which are all also risk factors that increase the severity of COVID-19 disease.
It’s particularly important for those who have a tangible risk factor like obesity to speak with a physician if they haven’t had consistent access to routine healthcare. It’s very likely that the coexistence of limited healthcare and obesity holds other unidentified underlying health issues that may further increase the morbidity and seriousness of novel coronavirus.
Diabetics are a group that is always more prone and susceptible to infectious diseases of any nature. This is because of the impaired immune response in relation to both T-cell and macrophage activation and cytokine profile. In other words, diabetes can interfere with the ability of white blood cells to fight infection.
Poor glycemic control further compromises the immune response system and leaves diabetics ill equipped to fight secondary lung infections, such as bacterial pneumonia. Like obesity, diabetes is also a folded risk in that diabetics are more likely to be obese.
Diabetes was second on that comorbidity list released by New York health officials, and almost every reporting state has listed diabetes in their own top five morbidly reports and COVID-19 risk lists.
6. Kidney Disease
Those with chronic kidney disease, nephrotic syndrome and established renal failure have been identified as an at-risk group for novel coronavirus.
Dialysis patients have a weakened immune system that leaves them susceptible to disease. Dialysis patients must also continue their clinical dialysis treatments as scheduled, which means they’re a group often unable to shelter in place as a protective measure.
CKD patients often have limited/poor fluid intake, pyrexia, and eating disturbances that all increase the severity and complications of infections. Remember, respiratory symptoms aren’t the only signs of COVID-19. Diarrhea, nausea, and vomiting are well documented SARS-CoV-2 early symptoms.
Dialysis patients are also common users of NSAIDs for myalgia and headaches, and NSAIDs have been recognized to
exacerbate symptoms of the novel coronavirus.
Those who’ve had a kidney transplant are likely taking immunosuppressive medicines to prevent organ rejection, which lessens the immune system’s ability to fight COVID-19.
7. Liver Disease
Underlying liver disease, particularly nonalcoholic fatty liver disease, could make SARS-CoV-2 carriers more susceptible to liver injuries both from the virus itself and the supportive medications being used to manage symptoms. Liver enzymes naturally rise during systemic infection. Immune system overreacting can cause organ failure or significant damage from hepatic oxidative stress.
In conclusion, underlying health conditions and issues like the above create an environment where sufferers are more susceptible to infectious illnesses like novel coronavirus, more prone to that infection being serious versus mild in nature, and at the greatest risk of developing life-threatening complications.