The Generation Above Me: Risk Factors for Severe Cases of COVID-19

Tuesday, April 14, 2020

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 aka the coronavirus, but I'm not an infectious disease specialist, an epidemiologist, or a community health expert. But I am reading about this every day.

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 during this pandemic. 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 (with or without complications)
coronary heart disease

On March 20, 2020, the British Journal of Medicine (BMJ) 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 pulmonary diseases (asthma, COPD, sleep apnea)
hypertension
cancer (sometimes listed as "malignancy")
obesity
smoking
being male

UPDATED: The BMJ published an article about risk factors for COVID-19 on May 22, 2020. There study adds the following risk factors to the list above:

dementia
chronic neurological disorder
rheumatological disorder
chronic hematological disease (sickle cell anemia, etc.)
malnutrition (anemia, etc.)
liver disease (mild, moderate and severe--with increasing risk)
AIDS/HIV

The CDC published information online about risk groups. This post lists many of the factors above, but adds to it these risks:

people who are immunocompromised, such as those living with poorly controlled HIV/AIDS, transplant recipients, those undergoing cancer treatments, and those on long-term use of corticosteroids and other immune weakening medications.
people with liver disease
chronic kidney disease undergoing dialysis

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).