Death Risk Factors Identified for COVID-19 Coronavirus

Medical and public health experts have estimated that over 90% of Americans will be exposed to the COVID-19 coronavirus. Estimates of infection run as high as 98 million Americans. How many of them will die? What are the risk factors and who should be concerned?

Since it first became a story months ago, the Chinese coronavirus COVID-19 has been the focal point of thousands of news stories. Some of them are aimed at the truth, but many are aimed at panicking the public, creating conspiracy theories and even gaining more political or governmental power.

Whatever the original source of the virus and however it got its start, medical, research and public health officials are in full emergency mode over it. But should they be? What makes this worse than the flu? Far more people will die of seasonal flu than will die of the Wuhan coronavirus.

It isn’t worse than the flu, at least not for the majority of people who will come down with it. The overall case fatality rate remains much lower than that of the seasonal flu, even though it has been revised upward. Early on, most reports had the CFR at about 1.5 to 2.3 percent. That number has risen to an estimated 3 to 3.4 percent.

Why that has happened is an important question. Caught up in that question is another, perhaps more important question: who, exactly, is dying from COVID-19? What are the known risk factors for death from this virus?

A study of people who died of the COVID-19 virus in Wuhan, China provides some important answers. The study, published in The Lancet, was small but focused on the “other” factors, called comorbidities, that seemed to increase the likelihood of dying from the virus.

The study revealed that older people, above age 60, have a higher likelihood of contracting the virus and of dying from it. The 60 to 70 crowd was best off among the older group, and likelihood of death from COVID-19 increased slightly with every additional year of age.

In the original outbreak, 87 percent of all positive-testing patients were between the ages of 30 and 79, according to the Chinese Centers for Disease Control. (1) This same report also tells us that while only 3.2 percent of all confirmed cases (through February 11, 2020) were 80 years or older, that age demographic saw over 20 percent of all deaths.

The findings of China’s CDC mirror what the Lancet study tell us about who is at risk of dying from the COVID-19 virus. The Lancet study pointed specifically to older age, history of blood clotting issues, sepsis and a high Sequential Organ Failure Assessment score (SOFA) as key factors in increased risk. (2)

However, there are other risk factors as well. In the Chinese CDC report, they showed that hypertension, diabetes, cardiovascular disease, chronic respiratory disease and cancers of all kinds increase the likelihood of death from COVID-19.

The authors of the Lancet report reinforced that. According to co-author Dr Zhibo Liu from Jinyintan Hospital, China:

“Older age, showing signs of sepsis on admission, underlying diseases like high blood pressure and diabetes, and the prolonged use of non-invasive ventilation were important factors in the deaths of these patients. Poorer outcomes in older people may be due, in part, to the age-related weakening of the immune system and increased inflammation that could promote viral replication and more prolonged responses to inflammation, causing lasting damage to the heart, brain, and other organs.”

All of this makes sense. The observed conditions which make people more likely to die from COVID-19 all put stress on the immune system, thereby weakening the body’s defenses against infection in general.

There is one mildly disturbing statistic in the Chinese CDC report. While men make up a slightly higher percentage of confirmed cases (51.4% vs. 48.6%,) they die at a much higher rate. Over 63% of all the deaths in the report were men. Statistically speaking, that is a large deviation.

Millions of people are extremely concerned about COVID-19. The majority of them probably shouldn’t be worried. Unless you have one of the underlying conditions which would put you at risk of death, you probably shouldn’t be overly concerned, either.

Public health officials here in the US have stated that the overwhelming majority of confirmed cases show no symptoms to mild symptoms. In fact, in the Chinese CDC report, the only deaths occurred in those cases labeled “critical.” Those with mild to even severe symptoms all survived.

If you’ve ever had a bad cold or the flu, chances are that, even if you do contract the Chinese coronavirus, it will pale in comparison to that experience. Something to bear in mind while you worry about it.

By no means am I suggesting we should ignore this virus. In the coming days, I’ll offer some real-world tips for minimizing your exposure to the virus and for preventing yourself from getting sick. Here’s a little secret: a lot of what I’ll write about will sound really, really familiar.

In the meantime, take a deep breath and relax a little. If you have one of the predisposing conditions, you probably have something to be concerned about. The rest of us? Let’s keep getting some stuff done and enjoying our lives. After all, we only get one and worrying won’t make that one life any longer – or any better!

Keep the faith and keep after it!

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  2. Fei Zhou, Ting Yu, Ronghui Du, Guohui Fan, Ying Liu, Zhibo Liu, Jie Xiang, Yeming Wang, Bin Song, Xiaoying Gu, Lulu Guan, Yuan Wei, Hui Li, Xudong Wu, Jiuyang Xu, Shengjin Tu, Yi Zhang, Hua Chen, Bin Cao. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet, 2020 DOI: 10.1016/S0140-6736(20)30566-3

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