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Report: Obesity, diabetes among risk factors linked to coronavirus fatalities

A body mass index (BMI) of 40 and above is one of the risk factors associated with death if one is diagnosed with Covid-19, according to a report.

A BMI is a measure of body fat based on height and weight.

The study published on Wednesday by nature.com looked into the medical records of over 17 million people in the United Kingdom and found obesity as one of the risk factors.

As is also the case in Kenya, diabetes featured on the list and this is for individuals whose blood sugar level is above 58 millimoles per mole (mmol/mol.)

Persons with severe asthma and other respiratory diseases also fall into this category.

If you have chronic heart disease, liver disease, stroke, dementia or other neurological ailments you are also at risk.

Others are reduced kidney function, auto-immune disease like lupus, rheumatoid arthritis or psoriasis and other immuno-suppressive conditions.

Those with a recent history of haematological malignancy of five years and below have a 2.5 times increased risk, which decreases slightly after the five years.

“For other cancers, increased hazard ratios were smaller and mainly with recent diagnoses,” reads the report titled Factors associated with COVID-19 death in 17 million patients.

The study was conducted by a group UK-based scientists.

A history of dialysis or end stage renal failure was associated with increased risk when added in a secondary analysis.

These findings, to some extent, spell doom for Kenyans, considering the underlying non-communicable diseases.

In the Kenya National Bureau of Statistics' 2020 Economic Survey, upper respiratory tract infection was listed as the top disease documented in outpatient facilities among 76 illnesses monitored.

Most common condition

Pneumonia, which is a severe illness associated with SARS-CoV-2 infection, was number 12, hypertension number 14, asthma (19), diabetes (21), cardio vascular conditions (45), and newly diagnosed HIV (49).

The 2018 Economic Survey recorded 1.2 million cases of pneumonia in 2017, and 1.6 million in 2016. However, diseases of the respiratory system led, with 14.4 million hospital visits.

According to latest data by the Ministry of Health released on July 2, hypertension is the most common cardiovascular condition in Kenya.

“In Kenya, about 6.1 million adults live with hypertension, representing 24 per cent of the adult population. The Kenya Health Information System (KHIS), January to March 2020 reporting counties on hypertension indicate that a total of 67,465 hypertensive patients were seen and reported,” said Health Chief Administrative Secretary Dr Rashid Aman.

Of these 18,231 cases were male while 49,144 were female.

“This is just the tip of the iceberg, many more are yet to be diagnosed. The Covid-19 pandemic has exposed the vulnerability of people living with NCDS,” Aman said.

The findings in the UK report concurred with other data, including the UK ISARIC (International Severe Acute Respiratory and Emerging Infection Consortium) study of hospitalised UK patients with Covid-19.

The findings had it that the risk of death in Covid-19 patients increased with cardiac, pulmonary and kidney diseases, malignancy, obesity and dementia.

Another study by the Chinese suggested cardiovascular disease, hypertension, diabetes, respiratory disease and cancers to be associated with increased mortality.

“Our findings that severe asthma was associated with higher risk were notable since early data suggested under representation of asthma in patients hospitalised or with severe Covid-19 outcomes,” says the UK study.

The study notes that age and gender are well established risk factors for severe Covid-19 outcomes, with over 90 per cent of UK deaths being in people over 60, and 60 per cent in men.

Clinically suspected

“Both current and former smokers were associated with higher risk in models adjusted for age and sex only, but in the fully adjusted model, current smoking was associated with a lower risk,” it adds.

“Given the strong association between blood pressure and age we then examined an interaction between these variables; this revealed strong evidence of interaction with hypertension associated with higher risk up to age 70 years and lower risk at older ages.”

The study included 17,278,392 people of whom 1,851,868 had non-white ethnicities. The overall cumulative incidence of death 90 days after start of study was less than 0.01 per cent in those aged 18 to 39 years, rising to 0.67 per cent and 0.44 per cent in men and women, respectively aged 80 and above.

The study notes some limitations as it included clinically suspected (non-laboratory confirmed) Covid-19 cases, because testing has not always been carried out, especially in older patients in care homes.

“However, this may have incorrectly identified some patients as having Covid-19,” it explains.

As a result, some Covid-19 deaths may have been mis-classified as non-Covid-19, particularly in the early stages of the pandemic, though this is likely to have reduced quickly as deaths accumulate.

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