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Coronavirus Are We Going To Be OK?

People with high blood pressure could be at greater risk of dying from COVID-19, the disease caused by the new coronavirus, according to a doctor in China working on the outbreak.

Professor Du Bin, who was sent to the city of Wuhan where the outbreak started in December last year, told Bloombergthat of a group of 170 patients who died in the city, almost half had the condition also known as hypertension.

High blood pressure, which affects tens of millions of U.S. adults, means the heart must work harder to pump blood around the body. This is a risk factor for heart disease, heart attacks and strokes.

Du, director of the intensive care unit at Peking Union Medical College Hospital in the Chinese capital of Beijing, said on the phone from Wuhan: “That’s a very high ratio.”

“From what I was told by other doctors and the data I can see myself, among all the underlying diseases, hypertension is a key dangerous factor,” he said.

Older people, who are an at-risk group, and those with high blood pressure are a “key focus” for him and his colleagues.

His claims have not been published in a peer-reviewed journal, a process that allows experts to assess research to ensure it is of a high standard. Addressing this, Du said: “Though there is no research published on that yet, we believe hypertension could be an important factor in causing patients to deteriorate, leading to a bad prognosis.”

Sanjaya Senanayake, professor of infectious diseases at The Australian National University, told Newsweek when such an observation is made: “The first question is whether it is accurate or not.” If the finding holds up to analysis, he said, then the question is whether high blood pressure causes people to die of COVID-19 or if the two factors are simply linked. It isn’t clear whether it is an association or an example of causation, said Senanayake.

It could be that people with hypertension are likely to be older and have other underlying health issues. “Therefore, they are more prone to a severe bout of COVID-19. It is not that the hypertension per se leads to an increased susceptibility to death,” explained Senanayake.

“Causation means that hypertension can lead to increased susceptibility to death. For this to occur, it needs to be a biologically plausible explanation. One possibility is the effects that long-term hypertension can have on the cardiovascular system might affect the outcome when someone gets COVD-19,” said Senanayake. “Such effects on the heart include hypertensive cardiomyopathy where the pumping of the heart is affected.”

Dr. Eduardo Sanchez, chief medical officer for prevention at the American Heart Association, told Newsweek a JAMA study published two weeks ago on 72,314 cases of COVID-19 in China through February 11 showed there “appears to be an increased risk of more severe complications including death for people with high blood pressure.” The death rate was highest for people with cardiovascular disease at 10.5 percent, compared with 6 percent for those with hypertension.

“COVID-19 is a new coronavirus, so we are still learning about its pathology—how it is transmitted, the symptoms and severity of how it attacks the body, and understanding of which individuals are most vulnerable to severe complications and death,” said Sanchez.

“We are not at all surprised that individuals with cardiovascular disease, hypertension and diabetes in China experienced worse outcomes,” he said. “It is why we strongly encourage people with these conditions to get the annual influenza vaccine. The guidance from the CDC [U.S. Centers for Disease Control and Prevention] acknowledges that people with cardiovascular disease, hypertension and diabetes are at increased risk for influenza and viral pneumonia and should exercise a greater degree of prevention/protection from COVID-19.”

“For heart and stroke patients, prevention is key. Your risk is not higher for getting the coronavirus as a patient, but if you do get it you have a higher chance to suffer complications, just as you do with the seasonal flu. Patients should speak with their primary care doctor or cardiologists for specific concerns.” Sanchez explained. (The World Health Organization’s advice for preventing the spread of COVID-19 is outlined in the box beneath the map below).

coronavirus, covid-19, south korea, seoul,
Healthcare workers wearing protective gear prepare to take samples from workers in Seoul on March 10, 2020.JUNG YEON-JE/AFP VIA GETTY IMAGES

His observation came the day a study was published in The Lancet detailing the risk factors that might make an adult more likely to die from COVID-19. The team looked at 191 patients in two hospitals in Wuhan, 137 of whom were discharged and 54 died in hospital by January 31. Of the total, 48 percent had an underlying condition, with high blood pressure the most common and present in 30 percent of patients, followed by diabetes, and coronary heart disease.

The team found those with diabetes or coronary heart disease were more likely to die, as well as those with the symptoms of sepsis, or blood clotting problems, but didn’t mention high blood pressure.

Keith Neal, emeritus professor in the epidemiology of infectious diseases at the University of Nottingham, U.K., who was not involved in the research, said of the paper in a statement: “The risk factors for death of severe illness and increased age are already recognized and common to nearly all infections. Underlying health conditions associated with infection has also been previously reported.”

Since the outbreak of COVID-19 started in Wuhan, over 4,200 people worldwide have died in over 119,000 cases according to a virus tracker by Johns Hopkins University and indicated in the map by Statista (accurate as of March 10) below. A total of 65,000 people who have tested positive for the virus have recovered. Most of the deaths have occurred in Hubei, at over 3,000.

Statista World Map Coronavirus March 10, 2020
A map showing the cases of COVID-19 worldwide as of March 10, 2020, 4 a.m. EST.
https://www.newsweek.com/coronavirus-death-risk-could-higher-patients-high-blood-pressure-chinese-covid-19-doctor-claims-1490850


 

What Does The CDC Say About The Coronavirus

Symptoms

Call your doctor:  If you think you have been exposed to COVID-19 and develop a fever and symptoms, such as cough or difficulty breathing, call your healthcare provider for medical advice.

Watch for symptoms

Reported illnesses have ranged from mild symptoms to severe illness and death for confirmed coronavirus disease 2019 (COVID-19) cases.

The following symptoms may appear 2-14 days after exposure.*

  • Fever
  • Cough
  • Shortness of breath

*This is based on what has been seen previously as the incubation period of MERS-CoV viruses.

Symptoms fever.
Symptoms cough.
symptoms shortness of breath
If you develop emergency warning signs for COVID-19 get medical attention immediately. Emergency warning signs include*:
  • Difficulty breathing or shortness of breath
  • Persistent pain or pressure in the chest
  • New confusion or inability to arouse
  • Bluish lips or face

*This list is not all inclusive. Please consult your medical provider for any other symptoms that are severe or concerning.

Testing for COVID-19

Call your doctor:  If you think you have been exposed to COVID-19 and develop a fever and symptoms, such as cough or difficulty breathing, call your healthcare provider for medical advice.

If you are a close contact of someone with COVID-19 or you are a resident in a community where there is ongoing spread of COVID-19 and develop symptoms of COVID-19, call your healthcare provider and tell them about your symptoms and your exposure. They will decide whether you need to be tested, but keep in mind that there is no treatment for COVID-19 and people who are mildly ill may be able to isolate and care for themselves at home.

If you are at higher risk for serious illness

People at higher risk for serious illness from COVID-19 should contact their healthcare provider early, even if their illness is mild.

Older adults and people who have severe underlying chronic medical conditions like heart or lung disease or diabetes seem to be at higher risk for developing more serious complications from COVID-19 illness.

If you are very sick get medical attention immediately

If you develop emergency warning signs for COVID-19 get medical attention immediately. Emergency warning signs include*:

  • Difficulty breathing or shortness of breath
  • Persistent pain or pressure in the chest
  • New confusion or inability to arouse
  • Bluish lips or face

*This list is not all inclusive. Please consult your medical provider for any other symptoms that are severe or concerning.

For healthcare professionals

For information on testing for healthcare professionals, see recommendations for reporting, testing, and specimen collection at Interim Guidance for Healthcare Professionals.

If You Are at Higher Risk

Who is at higher risk?
Early information out of China, where COVID-19 first started, shows that some people are at higher risk of getting very sick from this illness. This includes:
  • Older adults
  • People who have serious chronic medical conditions like:
    • Heart disease
    • Diabetes
    • Lung disease

Get ready for COVID-19 now

Take actions to reduce your risk of getting sick
Group of senior citizens

If you are at higher risk for serious illness from COVID-19 because of your age or because you have a serious long-term health problem, it is extra important for you to take actions to reduce your risk of getting sick with the disease.

  • Stock up on supplies.
  • Take everyday precautions to keep space between yourself and others.
  • When you go out in public, keep away from others who are sick, limit close contact and wash your hands often.
  • Avoid crowds as much as possible.
  • Avoid cruise travel and non-essential air travel.
  • During a COVID-19 outbreak in your community, stay home as much as possible to further reduce your risk of being exposed.
Have supplies on hand
Prescription medicines and groceries
  • Contact your healthcare provider to ask about obtaining extra necessary medications to have on hand in case there is an outbreak of COVID-19 in your community and you need to stay home for a prolonged period of time.
  • If you cannot get extra medications, consider using mail-order for medications.
  • Be sure you have over-the-counter medicines and medical supplies (tissues, etc.) to treat fever and other symptoms. Most people will be able to recover from COVID-19 at home.
  • Have enough household items and groceries on hand so that you will be prepared to stay at home for a period of time.

See also: Get Your Home Ready

 
Take everyday precautions
washing hands

Avoid close contact with people who are sick.

Take everyday preventive actions:

  • Clean your hands often
  • Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing, or having been in a public place.
  • If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol.
  • To the extent possible, avoid touching high-touch surfaces in public places – elevator buttons, door handles, handrails, handshaking with people, etc. Use a tissue or your sleeve to cover your hand or finger if you must touch something.
  • Wash your hands after touching surfaces in public places.
  • Avoid touching your face, nose, eyes, etc.
  • Clean and disinfect your home to remove germs: practice routine cleaning of frequently touched surfaces (for example: tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks & cell phones)
  • Avoid crowds, especially in poorly ventilated spaces. Your risk of exposure to respiratory viruses like COVID-19 may increase in crowded, closed-in settings with little air circulation if there are people in the crowd who are sick.
  • Avoid all non-essential travel including plane trips, and especially avoid embarking on cruise ships.

See also: Protect Yourself

 
If COVID-19 is spreading in your community
Practice social distancing and stay away from anyone who is sick

Take extra measures to put distance between yourself and other people to further reduce your risk of being exposed to this new virus.

  • Stay home as much as possible.
  • Consider ways of getting food brought to your house through family, social, or commercial networks

If a COVID-19 outbreak happens in your community, it could last for a long time. (An outbreak is when a large number of people suddenly get sick.) Depending on how severe the outbreak is, public health officials may recommend community actions to reduce people’s risk of being exposed to COVID-19. These actions can slow the spread and reduce the impact of disease.

Have a plan for if you get sick
on the phone with doctor
  • Consult with your health care provider for more information about monitoring your health for symptoms suggestive of COVID-19.
  • Stay in touch with others by phone or email. You may need to ask for help from friends, family, neighbors, community health workers, etc. if you become sick.
  • Determine who can care for you if your caregiver gets sick.
Watch for symptoms and emergency warning signs
  • Pay attention for potential COVID-19 symptoms including, fever, cough, and shortness of breath. If you feel like you are developing symptoms, call your doctor.
  • If you develop emergency warning signs for COVID-19 get medical attention immediately. In adults, emergency warning signs*:
    • Difficulty breathing or shortness of breath
    • Persistent pain or pressure in the chest
    • New confusion or inability to arouse
    • Bluish lips or face

*This list is not all inclusive. Please consult your medical provider for any other symptoms that are severe or concerning.

What to do if you get sick

  • Stay home and call your doctor.
  • Call your healthcare provider and let them know about your symptoms. Tell them that you have or may have COVID-19. This will help them take care of you and keep other people from getting infected or exposed.
  • If you are not sick enough to be hospitalized, you can recover at home. Follow CDC instructions for how to take care of yourself at home.
  • Know when to get emergency help.
  • Get medical attention immediately if you have any of the emergency warning signs listed above.

What others can do to support older adults

Community support for older adults

  • Community preparedness planning for COVID-19 should include older adults and people with disabilities, and the organizations that support them in their communities, to ensure their needs are taken into consideration.
    • Many of these individuals live in the community, and many depend on services and supports provided in their homes or in the community to maintain their health and independence.
  • Long-term care facilities should be vigilant to prevent the introduction and spread of COVID-19. Information for long-term care facilities can be found here.

Family and caregiver support

  • Know what medications your loved one is taking and see if you can help them have extra on hand.
  • Monitor food and other medical supplies (oxygen, incontinence, dialysis, wound care) needed and create a back-up plan.
  • Stock up on non-perishable food to have on hand in your home to minimize trips to stores.
  • If you care for a loved one living in a care facility, monitor the situation, ask about the health of the other residents frequently and know the protocol if there is an outbreak.

https://www.cdc.gov/coronavirus/2019-nCoV/index.html

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