Early data from China, where the new coronavirus COVID-19 first started, shows that some people are at higher risk of serious health complications from the new coronavirus. Per the Centers for Disease Control and Prevention (CDC), this includes people who have serious chronic medical conditions like heart disease, diabetes, lung disease, and mental health conditions such as depression and anxiety.
Here’s why these conditions increase the risk for COVID-19 complications—and what you should do if you’re affected.
People with heart disease tend to have other underlying conditions like high blood pressure, elevated cholesterol, diabetes, and lung disease, which weaken the body’s health defense systems (including the immune system) against a viral infection, William Li, MD, physician scientist and author of Eat To Beat Disease: The New Science of How Your Body Can Heal Itself, tells Health.
“The fever associated with COVID-19 puts additional strain on the body’s metabolic demands, stressing out the already weakened heart,” explains Dr. Li. “Pneumonia, which is commonly seen with COVID-19, makes it harder for the lungs to oxygenate the blood. This puts further stress on the heart.” Plus, inflammation caused by the infection can damage the lining of blood vessels through which the heart pumps blood.
In February, the American College of Cardiology issued a bulletin to warn patients about the potential increased risk of COVID-19 that included additional precautions to take. The bulletin recommends that people with cardiovascular disease stay up to date with vaccinations, including for pneumonia, and get a flu shot to prevent another source of fever.
Dr. Li advises regular exercise (while social distancing, of course) and a healthy diet to help strengthen the heart during the COVID-19 era.
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Chronic respiratory disease
Chronic respiratory diseases (CRDs), which include asthma and pulmonary hypertension, are diseases of the airways and other parts of the lung. People with CRDs need to be especially vigilant about the coronavirus because one of the possible complications is pneumonia. “Pneumonia compromises the lung, which brings oxygen to the body,” explains Dr. Li. “In patients who already have a chronic respiratory disease, it can be lethal.”
Besides following the CDC guidelines for handwashing, social distancing, and other coronavirus preventive steps, The COPD Foundation has issued further advice for people with chronic obstructive pulmonary disease (such as chronic bronchitis or emphysema). As reported in Pulmonary Advisor, this includes having at least a 30-day supply of all required medications on hand. If a patient requires an oxygen supply, they should contact their supplier to find out how to prepare for a COVID-19 outbreak in their area.
Last week, actor Tom Hanks revealed on Instagram that he and his wife, Rita Wilson, tested positive for COVID-19. Hanks previously shared that he has type 2 diabetes, which means he’s at an increased risk of serious illness from the new coronavirus.
What makes the coronavirus so dangerous for people with diabetes? First, because the immune system is compromised, it’s harder for the body to fight off the coronavirus, states the International Diabetes Foundation (IDF). Viruses also may thrive when blood glucose levels are high.
People with diabetes have heightened levels of inflammation throughout their bodies, which is another risk factor. "If you have a viral infection, that can turn into pneumonia easier, because diabetes itself is an inflammatory disease," Maria Pena, MD, director of endocrine services at Mount Sinai Doctors Forest Hills, previously told Health. “It's also important to note that when a person has diabetes, episodes of stress, like a viral infection, can increase blood sugar levels, which can also lead to complications.”
Everyone should be taking precautionary measures during the COVID-19 outbreak (whether they have preexisting health conditions or not), and the IDF says it’s even more crucial for those living with diabetes. That means washing your hands thoroughly and frequently, avoiding touching your face as much as possible, cleaning and disinfecting frequently touched surfaces, and avoiding close contact with those showing symptoms of a respiratory illness.
The IDF also recommends additional precautionary steps for those with diabetes. Monitoring blood glucose levels should be a priority, because any kind of infection can raise blood sugar levels. This increases the need for water, so it’s important to have an adequate supply. To prepare for a quarantine, make sure you have enough medication, testing supplies, and food to last for at least a month.
People with diabetes should be particularly careful about social contact. “As a diabetic, I would avoid supermarkets or other public gatherings,” Dr. Pena said.
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Depression and anxiety
COVID-19 doesn’t only affect people with pre-existing physical conditions—it can have a serious impact on those with mental health issues, like anxiety and depression, even if you are not infected with the coronavirus.
“Fear of the virus and all the changes it’s causing are driving anxiety levels up for everyone, but for people who have an anxiety disorder it’s so much worse,” Gail Saltz, MD, associate professor of psychiatry at the NY Presbyterian Hospital Weill-Cornell School of medicine and host of the upcoming Personology podcast from iHeartRadio, tells Health. Dr. Saltz warns that people who have managed their disorder may relapse, and those actively struggling may be much more symptomatic.
“Anxiety also worsens depression, particularly those whose depression is of the ‘agitated’ variety, a subtype of the illness characterized by jittery, anxious, irritable behavior,” she adds.
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People with anxiety or depression who are at home with someone who has COVID-19 may find the burden of caregiving to cause their mental health to deteriorate further. “Caregiving is very stressful,” says Dr. Saltz. “In many cases it’s a 24/7 role and for those already struggling, it can be overwhelming.” She adds that social distancing, quarantining, and losing the structure of work or school can also increase symptoms of both anxiety and depression by increasing feelings of loneliness.
By actively focusing on mental health, however, those symptoms can be reduced. Dr. Saltz recommends exercising for 30 minutes each day and trying relaxation techniques like deep breathing and mindfulness to help keep anxiety at bay.
It’s also important to have structure in your day, even if you’re self-isolating or in quarantine, she says. This means getting up at the same time as you normally would, taking a shower, getting dressed, creating and sticking to a schedule, and maintaining normal sleep. If you work from home, make a dedicated workstation.
If you need professional help, it’s still there for you even if you can’t get to the doctor’s office. “Most therapists are moving to online sessions to accommodate their patients,” says Dr. Saltz. If you take medication for your mental health, make sure you have a 30-day supply.
Loneliness is an issue for people in all age groups, and even if you don’t have mental health issues yourself, you probably know someone who does. “Check in with those you know who are also self-isolating,” says Dr. Saltz says. “Talking to and supporting others is likely to make you feel better as well.”