Coronavirus, diabetes, obesity and other underlying conditions

Though people of all ages are affected by coronavirus, many of those who develop severe complications have preexisting medical conditions.

Is obesity a risk factor for coronavirus?

According to data released in February by the Centers for Disease Control and Prevention, the U.S. obesity rate reached 42.4% during 2017-2018, the highest in history. One in six children are obese. Louisiana and Mississippi are among states with the highest obesity levels in the country. They both have a high number of deceased COVID-19 patients who were obese. In Mississippi, this included more than 40% of the COVID-19 patients who died.

Chronic inflammation is usually present in overweight people and can weaken the immune system, impairing the healing process and prolonging the recovery.

Does diabetes affect coronavirus risk?

When coronavirus gets into a body, there are four major factors that will decide the outcome: the total amount of virus, how much the virus replicates, how much of this replication happens on lung tissue and the amount of cytokines, molecules that help coordinate immune response.

Individuals with diabetes usually have a delayed immune response to the infection. That can cause overproduction of cytokines, triggering a “cytokine storm” or surge of activated immune cells into the lungs. It results in lung inflammation and fluid buildup that can lead to respiratory distress.

Studies show that people with diabetes tend to have higher levels of receptor ACE2. A study published in Journal of Virology demonstrated that coronavirus uses ACE2 to enter cells.

This receptor is typically found deep in the body, in the lungs, kidney, heart, and gut. However, a preprint study in the BMC Infectious Diseases, suggests that the receptor may be prevalent in nose cells, a key vector for COVID-19. Some scientists are evaluating the hypothesis that higher levels of this receptor may offer more entry points for coronavirus.

As USA TODAY reported, patients with Type 1 diabetes are at increased danger of developing ketoacidosis, a serious complication that occurs when a body produces high levels of blood acids called ketones.

Diabetic ketoacidosis can result in severe dehydration, exacerbating other severe complications observed in COVID-19 cases, such as sepsis. Sepsis occurs when chemicals released to fight infection trigger inflammation throughout the body. If this happens, the body needs increased amounts of fluid to prevent kidney failure.

It is unclear whether it’s diabetes or a high blood sugar level that leads to complications. Getting sugar consumption under control might be a good idea in addition to staying hydrated and taking medications regularly, says Ranganath Muniyappa, chief of the clinical endocrine section at the National Institutes of Health.

Underlying conditions of those who died from coronavirus

Top underlying health conditions in deceased COVID-19 patients:

Coronavirus and hypertension?

Nearly half of the U.S. population has hypertension. Only 1 in 4 of those affected has their condition under control. When not managed, hypertension can put stress on the heart, increasing the risk of a heart attack or a stroke. For patients who take medications, it’s important to avoid abrupt changes to their care without consulting with their doctor, said Sahil Parikh, an interventional cardiologist at Columbia University’s Irving Medical Center.

Cardiovascular disease and COVID-19

There is not enough evidence to suggest a link between COVID-19 and cardiovascular disease. Age might be the primary factor as older people are more likely to have cardiovascular disease. However, some evidence suggests patients might be putting themselves at risk by avoiding going to the hospital out of concern of catching coronavirus. Also, the reduction in visits could be due to misinterpreting heart attack symptoms for COVID-19. “We want patients who are experiencing chest pains and trouble breathing, just like they would have maybe four months ago, to alert their doctor and seek care and not just sit it out at home,” Parikh said. According to a March Study in the Journal of the American Medical Association, more than 1 in 5 patients in Wuhan, China might have developed heart damage as a result of COVID-19.