COVID-19 – Why Its Prognosis Is Poor In Patient With Cardiac Issues, Diabetes, HIV, Renal, and Lung Disorders

With the recent scare of  the outbreak of coronavirus disease, which has almost bought the entire world to a standstill, everyday new challenges and new findings come up and with limited knowledge on this subject. So, COVID-19 has put the doctors of all fraternities and scientists in a spin.

Several factors are still unclear, but, looking at the statistics globally, the most severe cases and the highest rates of death are among the elderly and the one with the compromised health condition, that is in the patients who are either suffering from cardiac conditions, have chronic diabetes (both Type I and Type II), HIV patients, chronic renal disorder cases, and severe pulmonary disorders. Results from the study show that 80.9% of people in China who have been diagnosed with COVID-19 have had a mild illness. (Ref: JAMA, Zunyou Wu, MD, Ph.D., and Jennifer M. McGoogan, Ph.D.)
Let’s have a look at the facts and see who is at a higher risk of being the victim of COVID-19 and its hazardous effects.
Diabetic Cases: Every individual who has Type 1, Type 2, or gestational form of diabetes is at a larger risk of developing complications when they catch the infection of coronavirus. The intensity of the symptom-presentation may differ largely from case to case.

So, what happens in such cases? Let’s have a look at it.

When a diabetic person becomes sick, your blood sugar increases as your immune system tries to fight the disease by releasing stored glucose reservoirs into your main bloodstream to give your body the strength to fight. But, at the same time, your body can’t produce enough insulin to cope up with this crisis. As a result, the levels of blood sugar increase.
People who are known case of Diabetic complications, such as Diabetic Retinopathy, Diabetic Nephropathy, and Diabetic Neuropathy, are more vulnerable as your system is working hard to control your diabetes and, in this process, it may cause a sudden rise and drop of blood sugar that can worsen the existing condition further. In most cases, this virus may mimic as a mild illness, but, in certain cases, it can take a lot more serious form which can prove fatal.

Cardiac Patients: Individuals with pre-existing cardiac conditions, such as hypertension, heart murmurs, and cardiovascular disorders, may experience serious conditions due to this viral infection. Coronavirus may attack the patient in various ways. Primarily, the virus attacks the lungs, but, soon, it may attack the heart, which is already in the compromised state, which in turn has to work harder to get the oxygenated blood supply throughout the body. This, in turn, could exaggerate the problems in cardiac patients with cardiac failure, as the heart is already finding difficulty in pumping out the blood. Another factor is that such patients also have a weak immune system, which causes the virus to multiply at a much faster pace and makes it more difficult to get rid out of the body.

Chronic Renal Affected People: The patients with pre-existing Chronic Kidney Disorders (CKD) are at increased risk of serious complications of coronavirus disease. The mortality rate among them ranges between 60%-90*. This is likely to happen in CKD patients due to the high fever, toxic blood, reduced fluid intake due to anorexia, diarrhea, and NSAIDs used by patients for treatment of various conditions, such as aches and pains and headaches.

HIV Patients: Currently, there are no proven facts or specific details about HIV people who have a larger risk of developing COVID-19. But, considering the facts, the compromised medical condition of such people, the risk for HIV infected people getting complicated in noticeably higher in the following categories for obvious reasons.
Patients who are not yet on Antiretroviral Therapy or ART.
Patients with a low CD4 count of less than 150/cmm.
HIV infected patients with other associated medical conditions, such as Koch’s, diabetes.

Chronic Lung/ Pulmonary Disorder Patients:
Coronavirus is known to directly attack the air passages resulting in the inflammation and drastic damage to the respiratory linings. This process happens at a much faster pace in the patients who are known cases of tuberculosis, pneumonia, and lung carcinoma, as the lung tissues are already in the fibrosis phase, which in turn aggravates the condition making it more challenging for such patients to survive.

What Precautions You Need to Follow?
People with the above categories need to be highly cautious with their medical conditions. Following some of these steps can prevent you from being the victim of the dreadful coronavirus infection.

Be regular with your health check-ups with your doctor.
Take your medications on time.
Don’t ignore your early symptoms, even if they are mild, such as mild sore throat, fever, and body pain. Immediately, call and consult your primary attending doctor.
If required and teleconsultation Is not sufficient then only step out for further examination.
Stock up your medicines stock for at least 2 months’ timeframe to avoid the last-minute hassles.
Pay attention to your diet, focus more on cooked fresh veggies, properly washed fruits, and avoid cold food of all forms.
Regularly do gargling with warm water with salt mixed in it.
Have sips of the warm water throughout the day.
Do breathing exercises.
Take enough rest.
Most importantly, do not step out of the house. Step out only when it is required

Written by Dr. Samreen Syed., Associate doctor to Dr. Rajesh Shah