SAN DIEGO (KGTV) — There are still many unknowns surrounding SARS-CoV-2, the official name of the new coronavirus, but almost from the beginning one thing has been clear: people with underlying health conditions are more at-risk.
San Diego County Health officials released new data this month showing which underlying conditions pose the greatest risk of death from COVID-19, based on the number of times a condition was listed on death certificates and other medical records.
Among the 626 COVID deaths recorded in San Diego County as of Tuesday, 96 percent of the victims had at least one underlying condition. Only 4 percent, or 27 people, died without evidence of an underlying condition.
- Hypertension (high blood pressure) -- listed in 50% of deaths
- Diabetes -- 35%
- Cardiac Disease -- 31%
- Dementia/Alzheimer’s -- 27%
- Chronic Kidney Disease -- 18%
- COPD/Asthma -- 13%
- Obesity -- 8%
- Immunocompromised -- 5%
- No underlying condition -- 4%
So what makes these conditions more risky than others? It may have to do with the prevalence of these conditions in the population and the way SARS-CoV-2 attacks the body, according to Sharp Rees-Stealy physician Dr. Abisola Olulade.
Scientists are still scrambling to understand exactly how SARS-CoV-2 attacks and kills patients, but emerging research offers some theories.
It starts when virus particles enter a person’s nose or mouth. The coronavirus makes it way towards the lungs first, and the immune system tries to fight it, causing inflammation along the way that can lead to pneumonia.
People with hypertension and diabetes, the top two underlying conditions in San Diego County’s data, often have existing damage to their blood vessels.
Based on early studies, scientists theorize the virus may be causing more damage to the vessel through inflammation and clotting, or outright attacking the blood vessels themselves.
On top of that, hypertension is common: “Almost half of all adults in the United States have hypertension,” Dr. Olulade said. “45 percent.”
Patients with cardiac disease, like coronary heart disease and congestive heart failure, have existing damage to their heart.
Early research shows the coronavirus can cause inflammation of the heart muscle. It might also damage the heart indirectly, as the fight with the immune system in the lungs lowers oxygen levels in the blood.
“If your heart isn’t pumping enough oxygen out to the blood, that amplifies the risk and the threat of dying from COVID,” Dr. Olulade said.
Patients with dementia, the fourth most common condition on the list, already have an elevated risk of dying from pneumonia, one of the calling cards of a severe COVID-19 infection. People with diabetes also have a risk of pneumonia. In fact, the risk is so high, the CDC recommends patients with diabetes get a pneumonia vaccination.
For individuals with chronic kidney disease, scientists aren’t yet sure if the virus attacks the kidneys directly or the kidneys get hit with collateral damage from other body system failures.
Regardless of the underlying condition, Dr. Olulade said taking steps to treat and keep it under control can greatly reduce your risk from the coronavirus.
Individuals with mild or controlled asthma, for example, are not considered to be at higher risk of severe illness, she said.
San Diego County’s list does not include two underlying conditions considered high risk by the Centers for Disease Control and Prevention: cancer and sickle cell disease.
That might be because the 626 deaths are a small sample size, Dr. Olulade said.