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May 12 2021

Comorbidities and Their Impact on COVID-19

There are 219 countries and territories that have been affected by the infectious disease COVID-19, resulting in mass deaths worldwide. Along with other efforts to combat the pandemic, these countries’ governments have rolled out their respective vaccination programs.
As cases continue to surge, it has been identified that the elderly and those with comorbidities are more likely to suffer from the virus’s deadly effects, making them a priority for vaccination.

What are Comorbidities?

Comorbidities refer to the presence of one or more health conditions a person is having with a primary illness. For instance, a person who has diabetes and hypertension is considered to have comorbidities. Comorbid conditions are often chronic or long-term. When a person experiences them, they may have a compromised immune system.
Comorbidities or multimorbidity is common among adults. Since it targets the lungs, COVID-19 can lead to hospitalization, which may require intensive care and a ventilator to help the patient breathe. A study suggests that it may also potentially cause death, especially in the elderly.

Comorbidities That Have the Most Impact on COVID-19

  • Heart Conditions 

Having a heart disease such as heart failure, coronary artery disease, cardiomyopathies, or hypertension can make a patient more likely to get severely ill from COVID-19. 
The Harvard Medical School explains that damaged heart muscle or blocked heart arteries weaken the body’s ability to survive the stress of COVID-19. Accordingly, a person with a vulnerable heart is more likely to succumb to the effects of fever, low oxygen levels, unstable blood pressures, and blood clotting disorders—all possible consequences of COVID-19.
  • Chronic Lung Disease

As COVID-19 attacks the lungs, people with lung problems are more likely to develop severe symptoms. 
Lung cancer, chronic obstructive pulmonary disease (such as emphysema and chronic bronchitis), cystic fibrosis, pulmonary fibrosis, pulmonary hypertension (high blood pressure in the lungs), and moderate to severe asthma are linked to an increased risk of COVID-19 complications.
Patients with asthma are at a disadvantage because their respiratory tracts are affected, leading to increased asthmatic attacks, pneumonia, and acute respiratory distress.
  • Immunocompromised state (weakened immune system)

Someone who is immunocompromised has a weakened immune system that does not properly respond to invading infections. This means that the body cannot fight off the virus. Data show that immunocompromised people are at greater risk of respiratory infections, making them prone to COVID-19 complications.
  • Cancer 

Based on a study, people who have cancer or a history of cancer are at a high risk of developing severe complications from COVID-19 and its symptoms because treatments for many types of cancer can weaken the body’s ability to fight off diseases.
  • Diabetes

Generally, diabetes increases the risk of infections. People with diabetes have a higher chance of contracting COVID-19 and its severe symptoms due to impaired phagocytic cell capabilities. As a result, a person’s immune system is compromised.
  • Stroke 

Experts suggest that COVID-19 tends to trigger a heart attack, which can lead to a stroke. COVID-19 also seems to result in clot formation, which could block the flow of blood and oxygen to the brain, eventually leading to an ischemic stroke.
  • Dementia 

The Centers for Disease Control and Prevention notes that dementia is associated with COVID-19 complications.
One study shows that the chances of COVID-19 infection for patients with dementia are higher than those without because people with dementia have impaired blood flow in the brain, which is a risk for viral entry. In addition, their impaired memory limits their ability to comply with recommendations for social distancing, mask-wearing, and hand-washing.
  • Liver Disease

Research suggests that in some severe cases of COVID-19, the virus may prevent the liver from working. A study involving 7,162 people who tested positive for COVID-19 shows that those with any chronic health problems such as liver cancer make up about 1/3 (or over 2,300) of the confirmed cases. Two-thirds (roughly 4,700) of them required hospitalization.
  • Blood Disorders

Based on studies, people with blood disorders such as blood cancer and sickle cell anemia have a higher risk of developing COVID-19 symptoms. Sickle cell anemia causes the red blood cells to become hard and sticky. These deformed red blood cells die early, causing blockages in small blood vessels. As a result, oxygen cannot be transported around the body. 
  • Chronic Kidney Disease

According to a study, people with kidney disease are at risk of being seriously ill with COVID-19 because their condition weakens their immune system and significantly increases their chances of dying.
  • Down Syndrome

One study suggests that COVID-19 is ten (10) times deadlier for people with Down syndrome. Researchers suspect that background immune abnormalities, coupled with extra copies of key genes in people with Down syndrome, make them more vulnerable.
Experts add that the typical anatomy of people with trisomy 21—including large tongues, small jaws, relatively large tonsils, and adenoids, along with lax throat muscle tone—helps explain their higher rate of respiratory infections in general.  

Actionable Steps

  • Schedule a check-up with your attending physician

People with comorbidities should discuss with their attending physician the implications of their condition in relation to COVID-19. When possible, they should maintain preventive care and keep their routine healthcare appointments.
It is also advised that alternate ways of communicating with doctors should be established without leaving home. Some doctors are making appointments through phone or video conference platforms.
Should you need to undergo a medical procedure, do not hesitate to call a trusted hospital where you can book an appointment. They will either safely carry out the prescribed procedure at the institution or conveniently provide home services.
  • Continue medication

Doctors note that it is vital for people with comorbidities to stay on their maintenance medications to keep their condition under control. Most of the time, doctors need to see patients before they could adjust the medication dosage requirements or even issue refills for prescription medicines.
  • Stick to the current treatment plan

People with comorbidities are advised to follow their treatment plan. If they wish to modify it, they should first consult with their attending physician.
  • Have a supply of medicines

Having at least a 30-day supply of prescription and non-prescription medicines will help patients with multimorbidity manage their condition. They may also talk to their doctor about getting an extra supply to reduce trips to the pharmacy.
  • Stock up on food

Doctors recommend having shelf-stable food choices available to accommodate a patient’s dietary needs based on their medical condition.
  • Know the triggers

Knowing the triggers for someone’s condition is key to reducing risks associated with their illness. For example, a person with asthma should avoid being in a room where cleaning or disinfection is taking place. 
  • Cope with stress 

While stress cannot be avoided, there are things one can do to manage it. Getting enough sleep, exercising, and incorporating relaxation time into one’s routine will help individuals cope better with stress, which, in turn, not negatively affect their immune system.
  • Maintain sound mental health 

In a time of intense uncertainty, routines and schedules provide certainty and stability. Social interaction through video calls can make a big difference in alleviating some of the anxiety during these challenging times. In addition, maintaining healthy habits such as a healthy diet and routine helps maintain sound mental health.
  • Stay at home

Due to the compromised immunity of comorbid patients with comorbidities, it is advised that they stay at home. Frequent handwashing, social distancing, and good personal hygiene also prevent further infection. If they have household companions who go out frequently, it would be best for them to wear a mask at home.

Awareness is Key to Protecting Oneself 

Since people with comorbidities have a higher risk of developing severe COVID-19 symptoms, awareness becomes crucial for them to protect themselves. In this area, experts advise that they consult with a healthcare provider to fully understand how to manage their condition.
People with comorbidities can reach out to Makati Medical Center for teleconsultation, home and drive-through services, and emergency care at 8888 8999.