COVID-19 occurs due to the infection of a novel human coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This virus was first identified in China in 2019 and has since spread across human populations in more than 180 countries.
SARS-CoV-2 can infect people of all age groups and genders. It can present with mild, moderate, or severe disease and usually involves respiratory symptoms. By June 2022, more than 530 million people worldwide had been diagnosed with COVID-19, with more than 6.3 million deaths.
Comorbidity indicates when a person has more than one health condition simultaneously. Each condition is then considered a comorbidity (e.g., if a person with diabetes develops COVID-19).
What Is the Impact of COVID-19 on Patients With Respiratory, Cardiovascular, and Metabolic Conditions?
COVID-19 disease progression is said to be much faster and more severe, even leading to death in some cases, among people with underlying health conditions.
Studies show that people with obesity, complicated diabetes, and anxiety-related disorders have a higher risk (almost three times) of developing severe COVID-19 disease. Other diseases that have been associated with a higher COVID risk include cardiovascular (heart) disease, infections like viral hepatitis, metabolic conditions like diabetes and obesity, and respiratory diseases like asthma.
Based on the prevalence of comorbid conditions globally, one in five people is believed to be at a higher risk of adverse COVID-19 outcomes. This risk also increases with age and the number of underlying health conditions. For instance, older adults, especially those above the age of 50 years, have a fourfold higher risk, whereas those above the age of 85 years have a tenfold higher risk.
Meanwhile, the risk of COVID-related death also increases with the number of comorbidities. Compared to people with no underlying conditions, people with one comorbidity have a 1.5 times higher mortality risk, whereas people with more than 10 comorbidities have a 3.8 times higher mortality risk.
How Can Healthcare Providers Protect Their Vulnerable Patients?
Here are some recommendations from Health Canada for infection control during the COVID-19 pandemic:
- Prior to any patient interaction, all healthcare workers need to assess the infectious risks posed to themselves, other healthcare workers, and other patients and visitors from a patient, situation or procedure.
- Plans should be in place for managing occupational exposures (i.e., unprotected contact without wearing the PPE indicated by the PCRA or while wearing PPE improperly) while providing care to patients
- All healthcare workers should receive ongoing education, training, testing on, and monitoring of compliance with IPC practices
- All surfaces or items outside of the patient room that are touched by or in contact with healthcare professionals should be cleaned and disinfected at least daily and when soiled.
- Active screening, universal masking and eye protection, physical distancing, engineering and administrative controls, Routine Practices, and if necessary Additional Precautions should be adhered to in order to prevent nosocomial transmission of SARS-CoV-2, including more transmissible variants
- COVID-19 vaccines are strongly recommended for healthcare workers who do not have a contraindication
What Are the Long-Term Effects of COVID-19 on Patients With Comorbidities?
If COVID symptoms persist for more than 35 weeks, it’s considered a long-term illness (long COVID). In most cases, people with COVID-19 recover fully, but there have been cases of a long illness. Long COVID symptoms include fatigue, dyspnea, cough, anosmia, and myalgia.
According to research, 43 percent of people with COVID continue to experience at least one symptom even after 4 weeks, and this number rises to 57 percent among people who have been hospitalized.
In fact, pre-existing conditions have been associated with a greater chance of persistent COVID symptoms. In a UK study of almost 500,000 community patients with confirmed COVID-19, a long illness of more than 12 weeks has been associated with comorbidities like fibromyalgia, chronic obstructive pulmonary disease, and celiac disease and risk factors like obesity and tobacco smoking.
Additionally, COVID-19 has been linked to the development of new chronic diseases. According to data from an administrative claims database in the United States, 14 percent of people with COVID-19 experienced new health conditions like type 2 diabetes, congestive heart failure, arrhythmia, respiratory failure, and interstitial lung disease within 6 months.
Finally, with the rise in the use of COVID-19 vaccines, the risks of SARS-CoV-2 infection, severe illness, and death have gradually decreased among most vaccinated populations. However, adults older than 65 years and people with comorbidities remain high-risk groups because the effectiveness of the vaccine is considerably decreased in these two population groups. Although vaccines can minimize the likelihood and duration of long COVID, this effect is also less potent than the reduction in severe disease and mortality risks.
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Our understanding of underlying health conditions that can raise the risks of severe COVID-19 disease and death is gradually increasing. Join the MDBriefCase community for free to discover more about these comorbidities and stay updated on the latest medical guidelines and methods to support vulnerable populations.