People with underlying medical conditions: Subjects vulnerable to Covid-19 attack

2021-06-02 05:10 PM

Italy is one of the "top" Covid-19 epidemic areas in the world. A study here showed that 99% of the deaths were people with chronic diseases. In which, nearly half of cases have at least 3 underlying diseases and about 1 quarter has 1 or 2 pre-existing conditions. More than 75% of people have high blood pressure, about 35% have diabetes, and a third of all patients have heart disease.

Not only that, people with many chronic diseases are often the elderly. The resistance of the elderly group with chronic diseases is lower than that of other age groups. If the elderly get sick, the virus will make those chronic diseases accelerate into an acute phase or an exacerbation, so the patient is very likely to die.

In addition to having to take a lot of drugs to treat the underlying disease, the elderly's body is also immunocompromised, prone to other diseases. When the elderly have Covid-19, they are often very sick due to the interaction of the new disease with the underlying disease as well as the interaction of many drugs. When infected with a virus, the body is not strong enough to fight, and at the same time, it starts a series of accompanying disorders on the background of the disease such as liver failure, kidney failure, multi-organ failure, complicating and difficult to treat.

People with underlying medical conditions are at high risk of dying if they contract Covid-19. Therefore, people with the following diseases need to be very cautious, well control the underlying disease, and improve their health:

1. Have chronic kidney disease

Chronic kidney disease is a global killer. People with chronic kidney disease at any stage are at increased risk of worsening and dying if they contract Covid-19. The risk seems to increase with the severity of the disease, especially in people on dialysis.

The researchers found that SARS-CoV-2 can affect kidney function during the course of the illness, even after the patient recovers. Some people with severe Covid-19 show signs of kidney damage, even if they had no previous kidney problems. Preliminary reports show that up to 30% of patients hospitalized with SARS-CoV-2 in China and New York have moderate or severe kidney damage. According to doctors in New York, the actual number is even higher.

The impact of Covid-19 on the kidneys is still unclear, but researchers say: Coronavirus can attack kidney cells; Too little oxygen in the blood causes the kidneys to malfunction; The immune system's violent reaction to the new coronavirus can destroy kidney tissue; Covid-19 can cause blood clots, block the kidneys, etc. At the same time, the need for dialysis and dialysis is a concern in Covid-19 patients.

2. Chronic obstructive pulmonary disease

Because of pre-existing lung conditions, people with chronic lung disease (COPD) are at high risk for Covid-19 and can lead to mild to severe respiratory complications. Accordingly, people infected with SARS-CoV-2 with COPD have a significantly increased risk of developing serious infections, because the virus affects the respiratory system, damages the lungs, and makes it harder for the lungs to fight infections.

One study found a correlation between high mortality rates from Covid-19 and people diagnosed with COPD. Specifically, among patients with Covid-19 with COPD, there is a 63% risk of severe progression and a 60% risk of death. However, Covid-19 patients without COPD had only a 33.4% risk of worsening and 55% of death.

At the same time, the risk can vary depending on the type of respiratory disease: COPD and interstitial lung disease, characterized by fibrosis and loss of elasticity of the lungs, will reduce the patient's ability to breathe on their own if they have Covid. -19; Asthma does not cause fibrosis, but infection with Covid-19 can cause a severe attack and even death, especially in people with poorly controlled asthma; Bronchiectasis causes accumulation of excess mucus. If pneumonia develops due to Covid-19, the airway obstruction can be life-threatening.

3. People with liver disease

People with chronic liver disease, especially cirrhosis (scarring of the liver), may be at increased risk for serious illness from Covid-19. In addition, the disease tends to progress rapidly, with possible respiratory failure due to poor resistance to the attack of the SARS-CoV-2 virus in these subjects.

Some patients hospitalized with Covid-19 have elevated levels of liver enzymes, such as alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Viruses can complicate existing liver disease in some people, cause elevated liver enzymes, and make the disease worse. Some drugs including antibiotics, antivirals, and steroids used to treat Covid-19 also damage liver cells.

4. People with cardiovascular disease (heart failure, coronary artery, myocardium)

Cardiovascular patients - "favorite" subjects of Covid-19. According to WHO statistics, the death rate from Covid-19 in people with cardiovascular disease accounts for more than 10%, followed by diabetes with more than 7%. That shows that the risk of death from Covid-19 in people with cardiovascular disease is the highest and 10 times higher than the general population.

The reason is that when the SARS-CoV-2 virus enters the body, it will trigger underlying heart disease and cause a severe inflammatory response in the blood vessels and heart muscle leading to heart attack, arrhythmia, acute coronary syndrome, acute heart failure. In addition, heart function has weakened, patients who are already short of breath, tired because of existing diseases, now have even more difficulty breathing because SARS-CoV-2 causes acute pneumonia syndrome, making them not strong enough to fight back. fight disease. If infected with a virus, the disease will progress more complicated, the ability to recover is also difficult compared to the average person.

However, the patient should be calm, not panicking, but should pay special attention to improving their health and protecting their heart.

5. People with the weakened immune system

According to CDC statistics, people with weakened immune systems are at increased risk of severe illness from SARS-CoV-2. They can also be infectious for a longer period of time than other patients.

According to the CDC, people with weakened immune systems are more susceptible to Covid-19 infection:

Half of the Covid-19 patients with diabetes require hospitalization.

78% of people requiring hospitalization for Covid-19 requiring intensive care have at least one underlying medical condition.

71% of Covid-19 patients (but not in intensive care) have at least one underlying medical condition.

People with weak immune systems such as people with HIV; undergoing chemotherapy and radiation therapy for cancer; organ transplant recipients; people with primary immunodeficiency, etc. may not be able to resist the attack of Covid-19 like other people. These subjects' bodies do not have the necessary immune responses to fight the entry of SARS-CoV-2 in the early stages. The ability to make antibodies may also be limited, so the immune system may not be able to get rid of the virus if it happens to be infected.

On the other hand, an overactive immune system can also cause lung damage and pneumonia in patients with Covid-19. When the immune system is activated, it releases chemicals called cytokines. Cytokines can be beneficial for the body, but they can also cause tissue damage when overused.

6. Nervous disorders

Although not on the CDC's list of risk factors, some scientists have noted that certain neurological disorders, such as multiple sclerosis, Parkinson's, or motor neuron disorders, have may increase the severity of Covid-19, by easily disrupting the swallowing reflex, reducing the cough reflex or causing respiratory muscle weakness.

At the same time, many drugs used to treat neurological disorders and myasthenia gravis actively suppress the immune system, making it easier to facilitate more severe Covid-19 symptoms.

7. Obesity

Scientists have found that obese people are twice as likely to be hospitalized for Covid-19 than patients of normal weight, obese people need urgent care more urgently. double and three times more likely to be in the intensive care unit.

The United States - a country with more than 40% of the population is obese and it is no doubt a contributing cause of the increased morbidity and mortality from Covid-19 compared to other countries. Jennifer Light (NYU School of Medicine in New York City) said that obese people have higher rates of obstructive sleep apnea, asthma problems, reflux and restricted lungs, etc. affects the respiratory system, by severe infection caused by Coronavirus.

8. Pregnancy

In 2020, WHO declared the global Covid-19 outbreak a "public health emergency of international concern". That's scary for billions of people around the world. In addition to the Zika virus and other risk factors for abnormalities during pregnancy, pregnant women may have another worry – SARS-CoV-2.

According to the US CDC recommendations: Pregnant women are much more susceptible to respiratory infections, such as the flu than the general population. This is because pregnancy changes the immune system and impacts the lungs and heart. Therefore, pregnant women are at high risk of contracting Covid-19 and experiencing dangerous complications, such as premature birth.

SARS-CoV-2 is especially dangerous for people with weak immune systems, the elderly, children, and people with chronic underlying medical conditions. These subjects are highly infectious, difficult to treat, and the disease progresses quickly and is life-threatening. In particular, the virus is extremely dangerous for pregnant women. When pregnant women get the disease, it will leave especially serious consequences. The level of danger of this disease to pregnant women is similar to the level of the MERS epidemic in 2014.

9. Sickle cell disease

SARS-CoV-2 has been posing huge challenges to the global health system, especially for people with blood disorders, both benign and malignant, especially People with sickle cell disease need special attention during this time of crisis.

People with sickle cell disease (SCD) have deformed red blood cells that block blood flow, inhibit oxygen supply, damage blood vessels, and cause inflammation. Coronavirus increases the formation of sickle cells, as infection in the lungs leads to low oxygen levels and worsening inflammation. At the same time, SARS-CoV-2 can cause lung damage, vaso-occlusive crisis (VOC), and even death in people with SCD.

10. Smoking

Tobacco is known to increase the risk and severity of respiratory infections. According to an assessment by the WHO's Council of Public Health Experts, teenagers who smoke e-cigarettes are five times more likely to contract Covid-19 than non-smokers. More seriously, young people who smoke both e-cigarettes and regular cigarettes are seven times more likely to contract Covid-19. This is really an alarming number recently published in the journal Adolescent Health, USA.

Covid-19 is an infectious disease that mainly attacks the lungs. Smoking impairs lung function, damages the respiratory epithelium (lung lining) and the immune system, making it difficult for the body to fight SARS-CoV-2 and other diseases. In addition, there is a pathway that SARS-CoV-2 relies on to enter cells more quickly, which is e-cigarettes.

Specifically, if one person becomes infected, the next person using an e-cigarette device can inhale the viral particles deep into their lungs. Exhaled breath can also contain viruses and potentially infect those around them. Tobacco kills more than 8 million people globally each year. Of which, more than 7 million people die from direct tobacco use and about 1.2 million people die without smoking but are exposed to secondhand smoke.

11. Diabetes

Diabetes (diabetes) is a health disorder that compromises the immune system, especially in type 2, making people more susceptible to Covid-19 if exposed to risk factors. Experts from the International Diabetes Federation (IDF) emphasized: The virus can thrive in the body when there is high blood sugar.

Prolonged hyperglycemia can lead to acidosis, in which acids called ketones to reduce the production of immune cells, including T lymphocytes and neutrophils. And the results could increase your chances of being infected with Covid-19. In addition, a person with diabetes, when infected with a virus, can lead to unpredictable complications.

For people with disorders related to high blood sugar, it is important to monitor blood sugar regularly, manage blood sugar, avoid stress... and take other precautions to help prevent Covid- 19.

12. Cancer

Cancer patients often have weakened immune systems, due to medical conditions or treatment. Currently, there is little evidence that people with cancer or those receiving treatments that suppress the immune system, such as chemotherapy or radiation, can be more severely affected by this strain. Covid-19 virus or not.

However, experts make several assumptions: When the body's cells that help fight infections are low or not functioning enough, the body's ability to fight infection decreases accordingly. And chemotherapy, or radiation, can decrease the body's ability to fight infection. As a result, cancer patients who are being actively treated may be at higher risk of contracting Covid-19.

In particular, people with blood cancers, diphtheria, lymphoma, and multiple myeloma, are at higher risk of contracting coronavirus than people with other types of cancer. Blood cancers often disrupt the normal production of immune cells. Similarly, Covid-19 has the nature of attacking the lungs of the human body, people with lung cancer also have a higher rate of severe symptoms than the rest.