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Risk Factors for Severe Cases of COVID-19

By Thegenaboveme @TheGenAboveMe

Risk Factors for Severe Cases of COVID-19

Image by Pariswestren via Creative Commons

I have been hesitant about posting, because I feel as though all interest is about COVID-19, but I'm not an infectious disease specialist, an epidemiologist, or a community health expert. But I am reading about this every day. When I experience conflict, my usual strategy is to read and write about it. For example, I did this when I got a diagnosis of osteoporosis.
Right now, I am interested in risk factors for serious if not fatal cases of COVID-19 aka coronavirus.  Travel and contact with an infected people are chief risk factors, but what other risk factors are emerging?
Note: This article does not offer medical advice. It only is an invitation to increase awareness. If you have any questions about your risk for contracting COVID-19 or any other infectious disease, please see a licensed medical professional. 
I imagine that people in clinical practice as well as medical researchers will be publishing data about this over the next few weeks if not months. Consequently, I plan on updating this post from time to time.
To start, on March 10, 2020 the Center for Infectious Disease Research and Policy (CIDRAP) published a summary of a Lancet article, published that week. The study examined the risk factors for people in Wuhan, China who died from COVID-19.
  • advanced age 
  • blood pressure
  • diabetes
  • coronary heart disease
The following are really more complications than a prior risk
  • secondary infections 
  • blood clotting problems
  • sepsis
On March 20, 2020, the British Journal of Medicine published an article that looked at risk factors for those who died from COVID-19 as it spread. It does not conduct primary research; it's a review of available studies and statistics from China, Europe and the UK. The article itself is more  nuanced, but here is a list of the risk factors that it discusses:
  • age, particularly for those 70 and over. 
  • cardiovascular disease
  • diabetes 
  • chronic respiratory disease (asthma, COPD, sleep apnea)
  • hypertension
  • cancer
  • obesity
  • smoking
  • being male
An article published in LabRoots on March 22, 2020 suggests that the higher risk factors for males is not entirely due to lifestyle factors such as workplace pollution, smoking, or disregard for practices such as social distancing and handwashing. Instead, there is evidence that estrogen levels offer immunity against respiratory infection. The article refers to research by Dr. Stanley Perlmen (and others) about the immunity properties of estrogen to protect against respiratory infection (SARS). 
  • estrogen levels
Over the next few weeks, I've read of additional risk factors. 
  • exposure to air pollution 
A Newsweek article published on April 8, 2020 summarizes a report on the relationship between living in an area with significant air pollution and the severity of COVID-19 cases. The study is at yet unpublished, but it's been submitted to the New England Journal of Medicine.
  • African American / Hispanic heritage (I've read elsewhere about Native Americans being at risk, but they are not mentioned in the NYC data.)
On April 8, 2020, the NBC affiliate in New York reports that African Americans and Hispanic residents are dying at a higher rate than Asian and non-Hispanic whites. For example, the city African Americans make up 13% of the city, but they are 33% of those hospitalized with COVID-19. The causes are not due to biology but systemic disadvantages, such as poverty and the lack of health care. Read the article for more details.  
On April 9, 2020, CIDRAP published a summary of another article, this one from the European Respiratory Journal about risk factors. Some of the factors already appear above. However, this information adds risk factors in enzymes that were correlated with more severe COVID-19 cases:
  • advanced age
  • underlying cardiovascular (heart) issues 
  • underlying cerebrovascular (strokes, TIAs, clots) issues
  • labs that indicate damaged immune response
  • labs that indicate heart damage
  • increased levels of ACE2 (which weakens the lungs immunity response)
I read this article three times in an effort to summarize the technical information, but I am not trained in biology, so I recommend reading the article itself instead of just the highlights listed above. 
Coronavirus, Ageism and Ableism

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