Corona Virus Mortality Risk for Diabetes and High Blood Pressure

(Windmill Tilter) #1

Lots of news stories mention that CV19 death rates are affected by age and “underlying conditions”. Almost none of them actually offer detailed risk data, and none that I’ve found actually quantify death rates for underlying conditions controlled for age. Smoking is a big confounder too, since smoking is more prevalent in China. The last chart controls for age and smoking status. If you’re curious about your odds of kicking the bucket, here you go! :yum:

Long story short, if you’re a man over 70 and you have type 2 diabetes and high blood pressure, catching this is no more dangerous than Russian roulette. If you’re under 50 with an underlying condition, it’s only 20 times as dangerous as a normal flu. That said, it’ll be months before we have a clear picture of the true risks. The Italian data should tell us a lot more. So far the Italian numbers are much bleaker than the Chinese data that the tables below are based on.

This is a damn good time to be eating keto, reversing T2 diabetes, lowering blood pressure, and losing weight. This virus seems to be targeting the obese (like me), which seems like bullying. When it comes to the US, it’s going to going to highlight the literal meaning of “morbidly obese”. I don’t know why more people aren’t being made aware of that!

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This is based on the largest dataset published to date. The first link is the table source. Second link is the data source.

https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/#ref-1

http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9a9b-fea8db1a8f51

These stats are a bit misleading however when it comes to “underlying conditions”, because it doesn’t control for age, or quantify the risk if you have more than one of the underlying conditions. This table appears to control for age. For a quick and dirty estimate of your own personal risk of dying from CV19, take your age related risk from chart 1, and multiply it times the multiplier found in the below based on your underlying conditions.

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Here is the source paper. It’s worth reading if you like this sort of thing. Great data.

https://www.medrxiv.org/content/10.1101/2020.02.25.20027664v1.full.pdf+html

In case anyone was wondering, it appears that the diabetes risk isn’t just for they Type 1 folks, because most of those who died of CV19 had Type 2 diabetes. If you’ve ever been curious about trying extended fasting, this would be a good time to start. A doctor in Northern Italy has been tweeting about his experience treating patients in the center of this crisis. He tweeted a few days ago that they’ve had to start triaging cases, and folks with diabetes (regardless of age) aren’t even being intubated anymore in his hospital. They save respirators for people with better chances of survival. Not good!

(Rebecca 🌸 Frankenfluffy) #2

Thanks for this post, @Don_Q - I’ll have a look at the links after work!

Quick question in the meantime though - could you clarify what you wrote above? Do you mean that most of those who died of CV19 had Type 2 diabetes, or do you mean that most of those with diabetes who died of CV19 had Type 2 diabetes?

Thanks!

(Windmill Tilter) #3

The latter.

(Rebecca 🌸 Frankenfluffy) #4

Thanks, Don! :+1::+1::+1:

Let’s all take really good care of ourselves! :slightly_smiling_face:

(bulkbiker) #5

And I’m guessing poorly controlled (high HbA1c levels) although nobody probably ever checked those…

#6

This may be a time when high cholesterol is beneficial. Ive always handled the flue quite well with hardly any symptoms and no fever but all my life I always suffered secondary respiratory infections that required antibiotics until going keto when they stopped happening. I did catch something 5 weeks ago and got over it in 10 days but it left me with a slight cough with some back of throat mucus (still have it). I was nervous so I had a chest Xray and it was CLEAR. Nothing at all in my lungs . . . I’m 65 yo

(bulkbiker) #7

It might always be beneficial?

(charlie3) #8

My consuming hobby for the past 2 years is getting healthy with diet and exercise same as a lot of people here. Now that work is put to the test. What are my 71-year-old risk factors? I was warned but blood pressure and blood sugar, went to work on those and normalized them with diet and exercise, not medication. I don’t want to be compared with people who are sedentary and eating crappy food.

P.S. If high LDL is protective I should be immortal.

#9

I guess I should have said “might show itself to be beneficial”

(Michael - When reality fails to meet expectations, the problem is not reality.) #10

@Don_Q thank you for doing the research and posting it here.

I had read that in China, at least, that the majority of fatalities were among older men who smoked. Smoking among men of all ages is quite common in China, but not among women. That tells me that if one’s lungs have been compromised in some way, such as by smoking, the risk of infection and severity and death are higher. I would also suspect that repeated episodes of pneumonia over the course of one’s lifetime might also result in the lungs being more susceptible to infection.

Speculation: maybe having endured and survived ordinary flu during the past few months would prime one’s immune system to high alert/readiness and might make it easier to kill incoming coronavirus particles. It would be interesting to see what % of those who did not show symptoms of corona had ordinary flu within the past 3-4 months.

(Utility Muffin Research Kitchen) #11

IDK. Chances are that lack of blood glucose control greatly hampers the immune system. (The correlation to T2D appears to be very strong. Still doesn’t imply causation, but occams razor suggests this is the most likely explaination.)

That is, if you’re obese but have been on keto for a while your chances might be a LOT better than the chances of someone who is diabetic and eating carbs.

(Utility Muffin Research Kitchen) #12

Smoking also causes low HDL levels, and HDL is a part of the immune system. It also causes systemic inflammation, weakening the immune system. But you’re certainly right in the assumption that damage to the lungs might increase the risk of contracting an airborne virus. So many ways how smoking can kill us.

Well, we’ll see. And chances are that we won’t have to wait long :frowning:

(Windmill Tilter) #13

The probably did at the clinical level for triage purposes to decide who gets a ventilator, but in the data I’m finding it’s been aggregated into the “diabetes” bucket.

I might get my HbA1c updated now that I’ve been keto for a year.

(Bunny) #14

Was wondering how many people died of various strains of the flu last year as pointed out in another thread?

Politicalized Pandemic[1][2]?

Any Good Samaritan have any stats?

Another mathematical question; what would be the infection rate in the past two months at 4,633 compared to 34,200 yearly in total number of deaths? Single country or world-wide?

Any mathematicians?

What ratios or sampling rates would you use to reach a static rather than dynamic model?

References:

[1] “…CDC estimates that influenza was associated with more than 35.5 million illnesses, more than 16.5 million medical visits, 490,600 hospitalizations, and 34,200 deaths during the 2018 –2019 influenza season. …” …More

[2] Year 2020 COVID-19 CORONAVIRUS Deaths: 4,633?

image

7 billion people would fit in a 30 mile square radius standing shoulder to shoulder!

(Utility Muffin Research Kitchen) #15

ThisLancet article mentions that only 9% of the observed mortaliities were smokers. 31% were diabetic. 48% had hypertension, which is of course a classic indicator of metabolic syndrome.

5 of 17 smokers died (29%), 49 of 228 nonsmokers died (21%).

(Michael - When reality fails to meet expectations, the problem is not reality.) #16

Thank you. I have no idea where the claims I cited originated. The Lancet article was a study of 191 patients of which 135 were from one hospital in Wuhan. So it’s possible that it’s biased. As this unfolds, we’ll get better info. Certainly any/all with compromised immune systems and/or other health issues are at higher risk. At 74, I’m in the second highest risk group.

(Windmill Tilter) #17

That’s a bit disconcerting. I was kind of hoping that the smoking rate in China impacted the mortality rate and that it might be lower here. I hope I’m wrong, but given the rate of obesity rate and metabolic syndrome prevalence in this country compared to China, the corona virus might have a higher mortality rate in the US. That would certainly help to explain the surprisingly high mortality rates we’re seeing in Italy.

(Ethan) #18

This is likely the case. They did not break down how well controlled diabetes is. As we know, for MOST T2DM people have poor glucose control.

(charlie3) #19

I suspect additional risk factor, I don’t recall being mentioned, are having a common cold or seasonal flu and corona at the same time. So anybody with any cold or flu like symptoms wants to self isolate as though they have the virus.

So may be seasonal flu kills more people but it’s never overwhelmed the hospital system as is happening in Italy and may have happened in China.

Tomorrow morning early I go to my produce store early to top off the beef supply and buy the next batch of salad veggies. I’m trying to have enough of the items that keep well so if something is not in stock it can wait until the next shopping trip which is about every 10 days.

British spokesmen say they are looking for at least some be infected too get herd immunity. At 71 I think I’ll let some others go first if possible.

(Ethan) #20

There is also double infection of COVID-19. There are two strands known so far: S and L, and it is possible to have BOTH.