TreatmentUpdate
236

May 2020 

Underlying conditions in some people in the U.S. with COVID-19

The U.S. Centers for Disease Control and Prevention (CDC) has received information from clinics across that country on 7,162 people diagnosed with COVID-19 who had laboratory confirmed infection with SARS-CoV-2. The CDC scientists focused on underlying conditions and potential risk factors (such as smoking) that increase the chances for respiratory diseases.

The CDC found the following:

  • underlying conditions were common – found in 38% of people
  • the proportion of people with underlying conditions was greater among those who were admitted to the hospital in general (71%) and to the ICU in particular (78%)

The most commonly reported underlying conditions were as follows:

  • type 2 diabetes
  • chronic lung disease – this included people with asthma, chronic obstructive lung disease (COPD) and emphysema
  • cardiovascular disease

The CDC scientists stated that their findings are “consistent with findings from China and Italy, which suggest that patients with underlying health conditions and risk factors, including but not limited to diabetes, hypertension, COPD, coronary artery disease, cerebrovascular disease, chronic [kidney] disease and smoking might be at higher risk for severe disease or death from COVID-19.”

Controlled conditions

Many people who are diagnosed with underlying conditions, such as higher-than-normal blood pressure, cardiovascular disease, type 2 diabetes and so on, are prescribed medicines that can help bring these conditions under control. Unfortunately, due to the overwhelmed nature of health systems, detailed data capture has not been possible so far. As a result, the CDC scientists stated:

“It is not yet known whether the severity or level of control of underlying health conditions affects the risk for severe disease associated with COVID-19.”

The scientists stated that underlying health conditions are “common” in the U.S. population. For instance, surveys over the past several years found that self-disclosed rates of such conditions were as follows:

  • all types of heart disease (except hypertension) – 11%
  • diabetes – 10%
  • asthma – 8%
  • COPD – 6%

The CDC’s findings of the high prevalence of these conditions underscores the importance for people with these conditions to take steps to reduce the risk of SARS-CoV-2 infection.

Bear in mind

The current analysis is preliminary. Health systems are overwhelmed by COVID-19 and unable to collect all the background information on underlying conditions when patients are admitted to the hospital.

If testing for infection with SARS-CoV-2 becomes more widespread, perhaps more people with less severe infection will be documented.

The scientists note that for some underlying health conditions and risk factors “few severe outcomes were reported; therefore, conclusions cannot be drawn about the risk for severe COVID-19 among persons [with the following]”:

  • neurological disorders
  • chronic liver disease
  • being a smoker
  • pregnancy

—Sean R. Hosein

REFERENCE:

CDC COVID-19 Response Team. Severe outcomes among patients with coronavirus disease 2019 (COVID-19)—United States, February 12‑March 16, 2020. Morbidity and Mortality Weekly Report. 2020;69:343-346.