We are searching data for your request:
Upon completion, a link will appear to access the found materials.
It is well known that people of old age or with respiratory problems are more vulnerable by the effects of COVID-19. However, I wasn't able to find information on any similar trends on catching the disease in the first place.
So what are the factors predicting the most significant differences in the chance of catching COVID-19?
I'm looking for predictors of the immune system response, whether that would be smoking, age or gender, not obvious notions such as "people from populated areas".
I know the role of ethnicity is much debated but since there's no conclusive evidenence yet, I'm not interested in its role.
Evidence suggests higher death rates from COVID-19 including among racialised groups might be linked to higher levels of a cell surface receptor molecule known as ACE2. But this can result from taking drugs for diabetes and hypertension, which takes us back to the point about the social causes of such diseases. (The Conversation)
There are populations that might be more vulnerable due to genetics surrounding the ACE2 receptor. For instance, men are more likely than women to get severe cases of COVID-19:
A growing body of evidence reveals that male sex is a risk factor for a more severe disease, including death. Indeed, globally, ~60% of deaths from COVID-19 are reported in men7,8, and a recent cohort study of 17 million adults in England reported a strong correlation between male sex and risk of death from COVID-19 (hazard ratio 1.99, 95% confidence interval 1.88-2.10)8
The ACE2 gene lies on the X chromosome. In addition to polymorphisms distributed by ethnicity, women have two X chromosomes and may gain some protection from differences in their two alleles of the ACE2 gene, which could make viral binding more difficult, or alter the signaling pathways which result in the subsequent autoimmune response that damages internal organs:
In addition to differential polymorphisms which may explain susceptibility and even outcome in different ethnic populations, the fact that ACE2 is localized to Xp22.2 may help explain the observed male-associated risk. As such, even in the absence of variation in this gene, the monoallelic versus biallelic presence of this gene may impact the natural history and prognosis of COVID-19 in males.
Additionally, in some ethnic populations, expression of the ACE2 gene (as measured by mRNA levels) is lower in women than in men, which may account for reduced infectivity or disease severity in women:
In the normal human lung, ACE2 is expressed on type I and II alveolar epithelial cells. Among them, 83% of the type II alveolar cells have ACE2 expression. Men had a higher ACE2 level in their alveolar cells than women. Asians have a higher level of ACE2 expression in their alveolar cells than the White and African American populations. The binding of SARS‐CoV‐2 on ACE2 causes an elevated expression of ACE2, which can lead to damages on alveolar cells. Damages to alveolar cells can, in turn, trigger a series of systemic reactions and even death.
This aspect of research seems to be ongoing. Region-specific behavior does seem to be the main driver for new infections, however: Ignoring public health guidelines and reopening economies early, calling the virus a hoax, giving healthcare workers garbage bags for PPE, etc. etc. Biology takes a backseat, when governments deliberately put people in harm's way.
This Blood Type Makes You More Likely to Catch COVID, New Study Says
Researchers say the virus can more easily infect people with this blood type.
By now, a year into the pandemic, most of us know that certain conditions or personal habits can affect our chances of catching coronavirus or developing severe COVID. But there is also mounting research that certain genetic traits that aren't always visible to the naked eye could also put you at higher risk of the disease. Now, a new study from scientists at Harvard Medical School and Emory University School of Medicine has found more evidence that blood type can play a factor in how likely you are to catch COVID overall. Read on to see how what's in your veins could increase your risk, and for more on what else could be increasing your chances of getting sick, see If You've Done This Recently, You're 70 Percent More Likely to Get COVID.
The team of scientists at Harvard and Emory conducted a laboratory study to better understand how SARS-CoV-2 interacts with A, B, and O blood types. The researchers focused on the part of the virus known as the receptor binding domain (RBD), which the pathogen uses to attach to cells once it enters the body.
The results, which were published in the journal Blood Advances, showed that the virus was more likely to attach to type A cells, specifically the type of blood cells found lining the respiratory system. The virus showed no preference for cells from other blood types or respiratory cells from the B or O blood groups, as Live Science reports.
The study authors believe that their results can help explain why some people are more susceptible to COVID. "It is interesting that the viral RBD only really prefers the type of blood group A antigens that are on respiratory cells, which are presumably how the virus is entering most patients and infecting them," Sean Stowell, MD, one of the study's authors from Brigham and Women's Hospital in Boston, said in a statement.
The study's authors pointed out that unlike other potentially high-risk conditions, nothing can be done to lessen the risk created by our genetic makeup. "Blood type is a challenge because it is inherited and not something we can change," Stowell said. "But if we can better understand how the virus interacts with blood groups in people, we may be able to find new medicines or methods of prevention," he added.
The study authors said the findings also raised even more questions that warranted further examination. "Does this really influence the ability of the virus to get into cells? Does it just influence its ability to adhere to the cells? That's open-ended," Stowell said. "We're working on that right now, but the jury is still out." And for more on how you can help improve your odds, check out These 3 Vitamins Could Save You From Severe COVID, Study Finds.
The recent research is far from the only study to consider different blood types and how they present different COVID risks. Other studies have recently found that blood type can affect susceptibility to COVID. In December, researchers from the GenOMICC Consortium, an international association of scientists that study the connections between severe illnesses and genes, compared the genes of more than 2,000 COVID-19 patients in the U.K. with those of healthy people, The Washington Post reports.
Initial research from the same team, published in the journal Nature in October, found that those with type A blood were more likely to develop serious illness when infected with the novel coronavirus. "Blood group A was associated with a higher risk than non-A blood groups," the authors wrote. And for more COVID news delivered right to your inbox, sign up for our daily newsletter.
Conversely, a study published in the journal Annals of Internal Medicine in November found that your risk of catching COVID-19 is slashed if you have type O blood. The researchers behind the study at St. Michael's Hospital in Toronto, Canada, examined the COVID-19 test results of 225,556 Canadians between Jan. 15 and Jun. 30. They looked at both how likely a patient was to contract the virus, as well as how likely they were to become seriously ill or die as a result. They found that people with type O blood were 12 percent less likely to contract COVID-19 and their risk for severe COVID-19 or death was 13 percent lower, compared to those with A, AB, or B blood types.
The four main blood groups—A, AB, B, and O—can also be Rh-positive or Rh-negative. When the researchers looked at this second classification, they found that those with Rh-negative blood are also "somewhat protected" from the virus. "An Rh− status seemed protective against SARS-CoV-2 infection," the study authors wrote. Additionally, "Rh− had a lower [adjusted relative risk] of severe COVID-19 illness or death."
And if you're O-negative, which is very rare, you may be even further protected from COVID. "Rh− blood type was protective against SARS-CoV-2 infection, especially for those who were O-negative," the authors wrote. According to Reuters, study co-author, Joel Ray, MD, of St. Michael's Hospital, suggested that people with these more resistant blood types may have already developed antibodies that can recognize certain aspects of COVID-19 and are therefore better prepared to fight it off. And for more on how you could potentially keep yourself safe, check out This Common Medication Could Save You From Severe COVID, New Study Says.
Genes May Influence COVID-19 Risk, New Studies Hint
As COVID-19 continues its fateful march around the globe, researchers have seen patterns of characteristics tied to bad cases of the disease. Increased age, diabetes, heart disease and lifelong experiences of systemic racism have come into focus as risk factors. Now some connections to certain genes are also emerging, although the links are fuzzier.
Combing through the genome, researchers have tied COVID-19 severity and susceptibility to some genes associated with the immune system&rsquos response, as well as a protein that allows the disease-causing SARS-CoV-2 coronavirus into our cells. They have also turned up links between risk and a person&rsquos blood type&mdashA, B, AB or O. The findings are not cut-and-dried, however. Scientists caution that even valid effects may be small, although knowledge about genes involved in serious disease outcomes may help to identify therapeutic drugs. Complicating the work are the effects of social and economic inequalities that also increase risk and tend to be concentrated in populations with specific ethnic backgrounds and ancestries.
The work of separating the genetics from these inequalities is important, says Priya Duggal, director of the genetic epidemiology program at the Johns Hopkins Bloomberg School of Public Health. &ldquoWe don&rsquot want that to be conflated,&ldquo she says. &ldquoRace is representing many factors, including people who are essential workers&rdquo and may be routinely exposed to more chances of infection because of their job or who may not have good access to health care. &ldquoThese are things we have all known to have existed in this country for a long time, and COVID-19 just brings them right to the front.&rdquo
Another caution about the genetics studies, says Teri Manolio, director of the Division of Genomic Medicine at the National Human Genome Research Institute, is that the searches for genes are &ldquomost often are based on biased data sets&rdquo that are largely derived from people of European ancestry. Omitting other populations, she says, &ldquomay entirely miss folks at greatest risk,&rdquo leaving important gaps. Indeed, one of the most significant peer-reviewed genetic studies to date, published on June 17 in the New England Journal of Medicine, relied on two European populations.
In that study, researchers picked through the genomes of 1,610 hospitalized patients in Italy and Spain to find DNA changes that were common among people who developed COVID-19 respiratory failure. These small DNA alterations, which may have only subtle effects on how a gene functions, are variants from the more typical version of the genetic sequence. The investigators found many patients with severe disease had variants in a complex of genes on chromosome 3. Some of these genes encode proteins called chemokines that interact with immune system molecules. Chemokines serve as chemical bread crumbs to attract immune cells to tissues under attack, allowing them to destroy infected cells. But with the coronavirus, they often appear to go into overdrive and trigger assaults that destroy the lungs.
The scientists found a key variant that was about 1.5 times more common in people who had to be put on ventilator machines than it was among those who needed milder interventions, such as some supplemental oxygen. Severely affected patients with two copies of this variant were somewhat younger than those with one or no copy, suggesting that a double dose trumped some of the protective benefits of younger age.
The study authors say that this small DNA change is linked to decreased activity of a gene that helps regulate chemokines. The alteration is also associated with increased activity of another gene, one that encodes a protein that interacts with the molecular gatekeeper for SARS-CoV-2&rsquos entry into cells. This gatekeeper, called angiotensin-converting enzyme 2, or ACE2, is active in many tissues, including the lungs. Several of these chromosome 3 genes had already emerged as candidates of interest in early analyses by other scientists in the global COVID-19 Host Genetics Initiative.
The researchers in the New England Journal of Medicine study also found an association with a region on another chromosome that determines blood type. This stretch of DNA sits on chromosome 9. Patients with the gene for type A had 1.5 times the chances of respiratory failure, compared with those who had other blood types. People with type O, though, had lower chances of such failure. Studies by other groups that were published in preprint papers before peer review linked blood type A with a higher risk for getting COVID-19 and reported a lower risk for type O as well. (The research also jibes with a small study of patients from the 2002&ndash2004 outbreak of the earlier SARS-causing coronavirus that hinted at a possible reduced risk for type O.)
Of these genetic findings, the region on chromosome 3 seems to have the strongest association with disease severity, says Andrea Ganna, a group leader at the Institute for Molecular Medicine Finland, which is part of the COVID-19 Host Genetics Initiative. The tie to blood types is less certain, he says. Duggal notes that some factors unrelated to COVID-19 could explain these results. For example, she says, studies have compared sick hospital patients with groups of blood donors from the community, who may be unexposed. If those donors tended to be type O, their data could bias the study toward a conclusion that Type O is somehow protective. Still, Duggal adds, blood types have previously been linked to susceptibilities to different diseases, such as malaria and pancreatic cancer, so it is not an unreasonable possibility.
Ganna says that any genetic effects on their own are likely to be small, which means that they probably will not be useful for screening tests that tell people if they have particularly high or low risks for disease.
What the genetics findings can do, he and other scientists say, is reveal information about biological pathways involved in disease susceptibility or resistance&mdashopening the way to testing drugs that target those pathways. The biology underlying severe disease, especially in people without other obvious risk factors, is &ldquoan extraordinarily important and interesting question,&rdquo says Leslie Biesecker, chief of the Medical Genomics and Metabolic Genetics Branch of the National Human Genome Research Institute. Examining that biology in serious COVID-19 cases might&mdasheventually&ndashcreate a route to therapies that work across the entire afflicted population, not just in people with specific genetic changes.
The Activities Of The Covid-19 Antibodies
A follow up on 346 seropositive individuals among the samples after three months revealed ‘stable’ to ‘higher’ antibody levels against SARS-CoV-2, but declining plasma activity for neutralising the virus, Shantanu Sengupta, senior scientist at IGIB and one of the co-authors of the paper said.
A repeat sampling of 35 individuals, at six months, revealed declining antibody levels while the neutralising antibody remained stable compared to three months.
However, both the normal antibody as well as the neutralising antibody were much above the required threshold, he said.
Those mitigation tools include those officials have been publicizing since the beginning of the pandemic — mask-wearing, social distancing, avoiding gatherings and getting tested for COVID.
"Those findings are now in bold, italics and underlined," said Butler. "We've gone from 11-point font to 16-point font."
Experts aren't sure why some people develop symptoms of COVID and others don't. But it's been clear for months that asymptomatic transmission is frequent. That has complicated efforts to stem the pandemic, which has killed more than 365,000 people nationwide.
Earlier this month, Dr. Anthony Fauci, the nation's leading infectious disease expert, called COVID's tendency to spread asymptomatically a "surprising and disturbing" facet of the disease that has affected everything from testing to prevention.
"Mask wearing became much more important, because if you're only worried about somebody who's symptomatic, then you'll know who you're dealing with," he said. "But if you don't know who's infected, then everybody should be wearing a mask, which is the real fundamental rationale for saying we need universal and uniform wearing of masks."
On Thursday, the U.S. reported a record number of daily deaths (4,027) and hospitalizations (132,000) from coronavirus.
MIT Medical answers your COVID-19 questions. Got a question about COVID-19? Send it to us at [email protected], and we’ll do our best to provide an answer.
I have read that people with certain blood types are more susceptible to contracting COVID-19. My understanding is that people with Type O blood are less susceptible than people with other blood types. Is this true? And would my blood type be part of my record at MIT Medical — maybe from lab work I’ve had done in the past? If so, how can I get that information?
The question of a possible relationship between blood type and disease risk has been a topic of active research since early in the pandemic. The first hint of a possible relationship came in March, from researchers in China, who compared nearly 2,200 hospitalized COVID-19 patients to a control group of approximately 27,000 healthy individuals. They observed that individuals with Type A blood appeared to be at significantly higher risk of contracting the virus — constituting nearly 38 percent of the ill patients, compared with the 31 percent of healthy individuals with this blood type. The risk for individuals for Type O blood appeared to be significantly lower, just 26 percent of the cases versus 34 percent of the healthy control group. Individuals with Type A blood type also represented a higher percentage of patients who succumbed to the illness — 41 percent versus 25 percent for Type O.
In April, researchers at Columbia University reported similar risks associated with Type A blood after blood-typing more than 1,500 New Yorkers and testing them for COVID-19. While the distribution of blood types is different in New York City than in Wuhan and Shenzhen, after controlling for other risk factors, they found that individuals with Type A blood were 34 percent more likely to test positive for the coronavirus, while having Type O or AB blood was associated with a lower probability of testing positive. However, they did not find strong evidence for a relationship between blood group and risk of intubation or death.
Both of these studies were posted to the MedRxiv website, where researchers share preliminary, unpublished data, before it has undergone peer review. However, a genome-wide association study (GWAS) recently published in the New England Journal of Medicine (NEJM) is both consistent with, and potentially explains, these earlier results. GWAS is a methodology used in genetics research to identify specific genetic variations associated with particular diseases. The NEJM study analyzed genetic data from more than 1,600 patients who had been hospitalized with severe cases of COVID-19 in Italy and Spain and compared them with about 2,200 uninfected individuals. The analysis turned up gene variants in two regions of the human genome that were associated with severe illness and greater risk of COVID-19-related death. One of these areas contains genes that determine blood type along with other genes that are known to be associated with immune function.
And, in fact, these researchers, like the researchers in China and New York City, found a higher risk for severe illness among individuals with Type A blood and a protective effect for Type O. Type A blood was associated with a 45 percent increased risk of having respiratory failure, while Type O was associated with a 35 percent reduction in risk.
The reason behind this association remains unclear. The authors of the NEJM study hypothesize that different combinations of A and B antigens may change how the immune system produces infection-fighting antibodies or have some other, unknown effect on how the body responds to infection. Or, they suggest, perhaps the genes associated with blood type also have some effect on the ACE2 receptor, the protein that allows the SARS-CoV-2 virus to infect human cells.
As far as determining your blood type, it’s unlikely to be part of your medical record at MIT Medical. Our clinicians do not order blood typing routinely, other than for pregnant patients. If your clinician has ordered medically necessary blood typing for you in the past, the result would be available in your patient portal. If not, you can order an inexpensive kit to test your blood at home by pricking your finger to get a small blood sample, which you can then mix with antibodies to the A and B antigens that come on the card. But an even better way to get your blood type tested is to donate blood, which, by the way, is still a safe thing to do, even during a pandemic.
Of course, your blood type is not a risk factor over which you have any control. You shouldn’t panic if you have Type A blood, and you shouldn’t feel complacent if you’re Type O. These studies are fascinating from a scientific perspective, but at this point, they have no practical implications for the way we live our lives and the precautions we should be taking to protect others and ourselves. So, keep wearing that mask, socially distancing, and washing your hands — actions that are proven to reduce the risk of illness for people of every blood type.
This news story has not been updated since the date shown. Information contained in this story may be outdated. For current information about MIT Medical’s services, please see relevant areas of the MIT Medical website.
Even in Wealthy Areas of the U.S., People of Color Are More Likely to Get and Die from Coronavirus, Study Says
Poverty is one of the clearest consequences of structural racism, and one of the easiest to link to health inequity. You can trace an unbroken line from racist real estate and employment policies to the struggle of many Black and brown families to afford things like fresh food, insurance and quality medical care. These disadvantages always have a direct impact on health&mdashbut especially during a pandemic.
The new study, however, shows that structural racism affects health in ways that go beyond poverty. “Income is one feature that’s important,” says senior author Andrea Troxel, director of the division of biostatistics at the New York University Grossman School of Medicine, “but there are so many others.”
Troxel’s paper drew on publicly available data from counties surrounding 10 of the country’s largest urban areas. The researchers first sorted the counties into those with relatively high and low rates of poverty. The median income across high-poverty counties was about $60,000, compared to about $80,000 for low-poverty counties.
Next, the researchers looked at the racial makeup of each county, along with the local incidence of COVID-19 infection and death through May 10. They found that people living in substantially non-white communities were significantly more likely to contract and die from the novel coronavirus, no matter how affluent their community.
COVID-19 death rates were about nine times higher in lower-income, predominantly non-white communities, compared to lower-income, mostly white communities, according to the study. Even in richer areas, coronavirus death rates were almost three times higher if the county was predominantly non-white, versus heavily white.
Disparity is “very pronounced in counties with higher levels of poverty, but it’s certainly present in the lower-poverty counties as well,” Troxel says. “That was a little bit of a surprise to us.”
Troxel’s team didn’t have access to household-level data, so the paper couldn’t assess granular factors like how much money an individual family made, how many people lived in a specific home or how easily a family could secure medical care. For that reason, she says, it’s impossible to say exactly what’s behind the disparity the research team observed.
But this isn’t the first time research has shown that race-based health disparities persist even in higher-income populations. One 2017 paper looked at the health of people making at least $175,000 per year. Even in this wealthy group, the researchers found that Black Americans experienced worse outcomes than their white peers in six out of 16 categories, including prevalence of diabetes, high blood pressure and physical inactivity. Hispanic Americans were disadvantaged in three categories, including rates of obesity.
“Even among those with high income, blacks and other minorities are unable to escape discriminatory treatment,” the authors of the 2017 study wrote. This could have a direct impact on wellness, since studies have shown that the stress and trauma of discrimination may put people of color at higher risk for physical and mental health issues.
When it comes to COVID-19, the type of job someone holds also matters&mdashprobably as much, if not more than, their salary. Someone with a desk job that lends itself to working from home has a much lower chance of exposure than an essential worker who must physically report for duty each day. Data show Black Americans disproportionately hold essential jobs in fields like transportation, health care and child care.
Troxel says she hopes her research, though preliminary, will encourage lawmakers to address health inequity at a policy level, and to examine it with the nuance it deserves.
“It’s not a question of biology or some sort of innate susceptibility [to disease],” she says, “but a question of [how] the racism of structures and the history of our society has developed to the extent that it goes well beyond income.”
Groups A and AB at increases risk of severe clinical outcome
Among the COVID-19 positive, researchers found fewer people with blood type ‘O’ and more people with ‘A’, ‘B’, and ‘AB’ types. The study results suggest that people with blood types ‘A’, ‘B’, or ‘AB’ may be more likely to be infected with COVID-19 than people with type ‘O’. The researchers did not find any significant difference in the rate of infection between ‘A’, ‘B’, and ‘AB’ types. The findings also showed that blood groups ‘A’ and ‘AB’ associated with an increased risk of severe clinical outcomes of COVID-19 infection. Also Read - Tamil Nadu Reports First Death Due To Delta Plus Covid Variant, Centre Asks State Govt To Tighten Norms
How COVID-19 Causes Loss of Smell
Ending the Pandemic
The rise of COVID-19 in all corners of the world sent scientists scrambling to find characteristics that might render individuals more susceptible to the virus, as well as risk factors that might intensify its severity and progression.
This has resulted in numerous theories and reports about the association between COVID-19 and blood type, which have often led to more questions than answers.
HMS researchers at Mass General launched their own investigation by drawing on the massive database of the Mass General Brigham Health system’s Research Patient Data Registry.
A study population of 1,289 symptomatic adult patients, who tested positive for COVID-19 and had their blood group documented, was culled from more than 7,600 symptomatic patients across five Boston-area hospitals, including Mass General and Brigham and Women’s Hospital, treated from March 6 to April 16 of this year.
The statistical analysis determined the independent effect of blood type on intubation and/or death of these infected patients.
The large retrospective review showed no significant connection between blood type and worsening of the disease, between blood type and the need for hospitalization, positioning requirements for patients during intubation, or any inflammatory markers.
“Inflammation is a particularly important finding because prevailing scientific thought is that COVID-19 wreaks havoc on the body through systemic inflammation, which can lead to morbidity and death,” Dua said. “We found, however, that inflammation markers remained similar in infected patients regardless of their blood type.”
An intriguing finding from the study was that there appeared to be a greater chance of people with blood types B and AB who were Rh positive testing positive for the virus. Even stronger evidence was assembled by the team that symptomatic people with blood type O were less likely to test positive.
“These findings need to be further explored to determine if there is something inherent in these blood types that might potentially confer protection or induce risk in individuals,” Dua said.
For now, though, the researchers are confident that their principle finding—that ABO blood typing should not be considered prognostic in patients who acquire COVID-19—will help debunk the kinds of clinically unfounded rumors and misinformation that can readily gain traction in the midst of a pandemic, and in some cases become part of accepted medical practice.
What Is the COVID-19 Risk for People with Diabetes?
As scientists learn more about COVID-19 , it has become clear that the virus impacts people in different ways and that symptoms can range in severity. This is especially true for those with existing medical conditions or whose immune systems have a harder time fighting disease.
Janaki Vakharia, MD, clinical fellow in the Endocrinology Division at Massachusetts General Hospital, discusses the impact of COVID-19 on people with diabetes, and offers tips on how to manage diabetes during this time.
The Misconception of Diabetes and COVID-19 Risk
Some people with diabetes, a disease that affects the body&rsquos ability to produce or use the hormone insulin to reduce glucose (sugar) in the blood, may be concerned about being at higher risk of getting COVID-19. However, Dr. Vakharia points out that this is a misconception.
&ldquoWe do not believe that people with diabetes are more likely to get COVID-19 than the general population,&rdquo says Dr. Vakharia. &ldquoThey are, however, at risk for more severe outcomes, based on what we have been learning so far from research studies. We know from our experiences with other viral illnesses that patients with diabetes also tend to have more severe reactions to those illnesses.&rdquo
The Connection Between Diabetes and COVID-19
Though the exact cause of severe outcomes in patients with diabetes and COVID-19 is unknown, research over the years has suggested that people who have diabetes may have impaired immune systems, which would affect their ability to heal from an illness or disease quickly. Additionally, diabetes, especially if uncontrolled for a long period of time, may cause inflammation, which also affects the immune system.
&ldquoInflammation happens when there is a level of injury to a cell. For example, let&rsquos say you cut yourself while cooking and that area gets inflamed. The purpose of that inflammation is to bring different molecules and proteins to that site to improve its healing. But it doesn't always work that way on a microvascular level with chronic disease. And so, inflammation, over time, can actually be more damaging than helpful,&rdquo says Dr. Vakharia.
We do not believe that people with diabetes are more likely to get COVID-19 than the general population. They are, however, at risk for more severe outcomes, based on what we have been learning so far from research studies.
&ldquoThere are markers in blood that can measure inflammation. Clinically, we've been seeing patients who have more severe COVID-19 to have higher markers of inflammation. These markers also seem to be higher in patients who have poorly controlled diabetes.&rdquo
Diabetes and COVID-19: Who is Most at Risk?
While diabetes type does not affect a person&rsquos response to the coronavirus, how well-managed their diabetes is, or whether or not they have co-morbidities such as obesity or hypertension, has an impact.
&ldquoThe body recognizes and responds to hyperglycemia (when there is too much glucose in the blood) regardless of the cause. We do know that patients who have type 1 diabetes compared to type 2 diabetes tend to get complications from diabetes later on, whereas someone with type 2 diabetes may have complications already at diagnosis or within the first few years of diagnosis.
"Studies have reported that patients with well-controlled diabetes who have been hospitalized for COVID-19 have a higher rate of survival. Better controlled diabetes is also associated with lower markers of inflammation, which may explain this better rate,&rdquo says Dr. Vakharia.
&ldquoAdditionally, the trends we are seeing within the diabetes population for those most at risk for severe COVID-19 outcomes are elderly patients, though we are increasingly seeing younger patients coming in, and men. Hispanic and Black patients seem to be disproportionately affected, which could be related to social determinants of health or differences in job type (essential workers), extended-family home structure (making it more difficult to physically distance) or reliance on public transportation.&rdquo
What to Do if You Have Diabetes and COVID-19
If you are a patient with diabetes and have COVID-19, you may be able to manage your care at home, especially if you are able to remain physically distant from other people in your household.
&ldquoPatients who have mild disease or who are relatively asymptomatic from COVID-19 can be managed at home, even if they have diabetes. It is important for these patients to monitor their symptoms and blood sugar levels closely. Patients should call their provider immediately if they are not able to control their blood sugars or if their symptoms worsen and they experience nausea, vomiting or trouble breathing. This could mean that the infection is worsening,&rdquo says Dr. Vakharia.
However, COVID-19 may make it difficult to manage diabetes. According to Dr. Vakharia, patients with diabetes admitted to the hospital have had higher insulin requirements and higher rates of diabetes complications, such as diabetic ketoacidosis (sometimes known as DKA), which occurs when the body breaks down fat too quickly and, as a result, creates ketones and causes the blood to become acidic.
Dr. Vakharia recommends that patients who are insulin-dependent or take a class of diabetes medication called SLGT-2 inhibitors should have ketone testing kits at home in order to monitor their ketone levels when they are sick. Additionally, patients should review their medications with their doctor to see if any should be placed on hold or if dosages should be changed during this time.
If hospitalization is required, Dr. Vakharia suggests that patients consider bringing their own supplies to help reduce the exposure of the patient and clinical staff from repeated entry into the room. This includes:
- Glucometer or continuous glucose monitor (with supplies)
- Extra supplies for your insulin pump
- Insulin pens/needles
- Cell phone chargers to ensure call access to family, friends and providers
Managing Your Diabetes During COVID-19
Dr. Vakharia emphasizes the need to follow the Centers for Disease Control and Prevention&rsquos recommendations to reduce the risk of catching COVID-19:
- Avoid large gatherings
- Practice hand hygiene
- Maintain a distance of more than six feet from others and wear a mask when this is not possible
- Keeping blood sugars at goal and prevent fluctuations in blood sugars
- Improving diet
- Exercising at home
- Ensuring that other co-morbidities, such as hypertension or heart disease, are being treated appropriately
Additionally, patients should also make sure that they are maintaining any medical appointments they have, especially if they can have these appointments virtually.
&ldquoIn the Endocrinology Division, we have been able to connect with some of our patients virtually, by either phone or video, and it has been successful. Patients like it. They have their glucometers and medications available. We are able to discuss all of the same things and provide the same education as if they were in the office,&rdquo says Dr. Vakharia. &ldquoIt can actually make the appointment much more productive and less stressful for the patient.&rdquo