Who Is More Likely to Get Severe COVID-19?
When you have a disease that impacts some very hard, and others not at all, the single biggest question on everyone’s mind is whether they’re in that group of people who are more or less likely to end up hospitalized. This past week, more research has been emerging on this trillion-dollar question. Let’s dig in.
The World’s Most Awful Lotto Ticket
There’s that moment in many stories where they ask the protagonist if they want the good news or the bad news. Hence, with COVID-19, the good news is clearly that the most recent data is showing that the fatality rate is between 0.1-0.2%. In addition, we’ll soon have another dataset on actual fatality rates from New York as they begin to test for people in the community who have have been infected with the coronavirus and showed little or no symptoms.
The bad news is that we keep hearing these stories of entire families or parts of families who have lost both the young and the old. Which is frankly frightening. You would expect the older members of a family who were sicker to be at risk for perishing, but not the twenty or thirty-something son or daughter. So what buys you the world’s most awful lotto ticket?
The Simple Science Behind Risk
We’ve all been hearing that the elderly and those with pre-existing conditions are more likely to get hit the hardest by COVID-19. In fact, a research study was just published out of New York that shows that in a large hospital system, here’s what we know about COVID-19 patients that needed hospital care (1):
- The average age was 63 with half of this group being age 52-75
- They were 60% male and 40% female
- 57% had high blood pressure
- 42% were obese
- 34% had diabetes
So this data fits nicely with the messaging out of the CDC. However, there were clearly people hospitalized here that had none of the known risks. They weren’t older and they didn’t have a risk factor. Is there something else we’re missing?
Before you can get a transplanted organ or stem cells, both the tissue and you need to be HLA matched. What’s that? All cells have a code on the outside that helps your body identify your cells from foreign cells. So the first thing your body does during infection is to check every cell, like a barcode reader checking tickets at a concert to make sure that the cell is yours. If the cell has the wrong code (HLA antigens), then it’s marked for destruction.
A recent research study out of OHSU looked at these HLA types (the codes on the outside of the cells) to see if certain ones would be more suspectable to coronavirus (2). In fact, based on this lab study, the group predicted that several HLA types were likely to be more susceptible to the virus. This isn’t a crazy idea, as other studies have shown that the MERS virus also attacked certain HLA types with more vigor (3). However, one caveat is that this OHSU study has yet to be peer-reviewed.
One recent study (also not peer-reviewed yet) also looked at blood-types in China versus susceptibility to severe COVID-19 (4). They found that those with blood type A were at about 20% more risk. So while statistically significant, not sure 20% more likely is something to get worked up about.
What Can You Do Today?
As I have been saying, given that the single biggest risk factors that we can modify are high blood pressure, obesity, and diabetes, you need to exercise like your life depended on it. All of these problems are solvable with diet and exercise. You can’t change your age and you can’t change your genes, but you can get outside and soak up the sun (which will raise vitamin D and immunity) and get your heart pumping.
Can’t exercise because of a bad back or neck bum shoulder or hip or knee, or an old ankle injury? Then get on a telemedicine consult today with one of our physician super specialists who can tell you if you can avoid surgery and heal that injury using the healing power of your body’s own stem cells or platelets. Click below to set that visit up:
The upshot? There is likely some hereditary component at play here looking at the stories of whole families perishing. What exactly that is or isn’t has yet to be determined. However, since you can’t change our genes, your best bet is to get as healthy as possible!
(1) Richardson S, Hirsch JS, Narasimhan M, et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA. Published online April 22, 2020. doi:10.1001/jama.2020.6775
(2) Nguyen A, et al. Human leukocyte antigen susceptibility map for SARS-CoV-2. medRxiv. https://www.medrxiv.org/content/10.1101/2020.03.22.20040600v1.full.pdf
(3) Hajeer AH, Balkhy H, Johani S, Yousef MZ, Arabi Y. Association of human leukocyte antigen class II alleles with severe Middle East respiratory syndrome-coronavirus infection. Ann Thorac Med. 2016;11(3):211–213. doi:10.4103/1817-1737.185756
(4) Zhao J, et al. Relationship between the ABO Blood Group and the COVID-19 Susceptibility. medRxiv 2020.03.11.20031096; doi: https://doi.org/10.1101/2020.03.11.20031096