- Summary: Almost everyone hospitalized with COVID-19 has a pre-existing health problem!
One of the things I find most frustrating is how the news media has not accurately portrayed the health risks from COVID-19. It seems there is an ongoing effort to scare the general population about their risk of getting sick and dying from COVID-19. Some of this focus has been on the higher death rates in the elderly population, particularly those over the age of 60. This was first noted in Wuhan (Figure 1); however, the reasons for the increasing death rate with age have not been discussed.
Also frustrating are the numerous news reports about seemingly healthy young people who have dropped dead from COVID-19 infection. While a very few of these patients exist and are tragic, the stories are reported so frequently, often highlighting a single death over and over again, that people are beginning to think anyone is at high-risk of becoming ill and dying from COVID-19. This is not the case.
A recent study from the Northwell hospital system in New York City has really clarified this issue. The paper, published in the Journal of the American Medical Association, analyzed 5,700 Covid-19 patients admitted between March 1 and April 4 in New York City and the surrounding area into the hospitals of the Northwell Health system. Scientists at Northwell used electronic medical records to review the characteristics of the patients.
Of the COVID-19 hospitalized patients 94% had one prior medical issue (comorbidity) and 88% had two. Nearly 60% of those hospitalized had high blood pressure, 40% were obese, and about 30% had diabetes. Fewer patients had other chronic diseases, including heart, kidney and chronic respiratory problems.
Given these statistics, almost all people who get ill from COVID-19 have pre-existing medical problems. The increase in death rates with age mirrors the increase in chronic diseases in the elderly, and this is likely the reason why they are at greater risk.
Of the remaining 6% of patients without a defined comorbidity, one worries that they had another illness that was overlooked or was silent until the stress of COVID infection occurred. Also, the toll hypertension, obesity and diabetes play in weakening the cardiac and respiratory systems suggests the majority of hospitalized patients had broader health problems.
Finally the data are backed up by numbers now available on COVID-19 deaths from NYC. Almost all deaths from COVID are in people with underlying conditions. People most likely to not have a comorbidity are aged 45-64. This is when these medical conditions often first present, so that it is possible they were missed.
In conclusion, while even 70 year olds have a 92% chance of surviving COVID, those with medical conditions need to take precautions. Also, talk to your doctor and make sure your health problems are well managed!
Pandemic Pondering 
I think we have to have a somewhat broader view, particularly if we think about inequality issues. This virus is not an equal opportunity virus. I threw together some of the preliminary evidence for that the other day in a very short presentation. It can be seen at this link https://umich.box.com/shared/static/w8oygfiw2pyx30ruhl5haowru5x3t905.mov .
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No question if you have poor health care and cannot get your pre-existing medical problems controlled you have greater risk. I think this information should motivate everyone to manage their heath better. Of course, no one can get to the doctor right now…..
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At 10:12 in the video we see that 41% of covid-19 cases in Philadelphia are non-Hispanic blacks. Well, according to the census, 41% of all the PEOPLE in Philadelphia are black. So that seems pretty representative.
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There is now a great deal of evidence that infection rates are elevated in many places in LatinX, Black, and poor populations, and death rates are also elevated. CDC and many other sources have presented these data in a number of places and there has been much written about it. What is also of interest, as shown in one of my slides, is that there is considerable variation by race and ethnicity between places. So, it is not about race or ethnicity per se, but rather how those matter with regard to vulnerability, exposure, care, etc., and how that varies by race and ethnicity between places.
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Do you have a post discussing if it’s safe to take iron supplements, due to anemia, if infected with COVId19?
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I have no post but that should not be a problem. Being anemic is the worst thing for someone with COVID pneumonia.
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Thank you. Why are you frustrated by the media response, and not by both the response of the media and Trump Administration with the pandemic team’s portrayal of the risks of the virus? The administration has shared little empirically useful data, or I haven’t seen any. In this regard your post appears politically postured. Is the COVID death rate chart by age based on population or based on those who have contracted COVID? Is there any statistically sound data on death rates based on who has had COVID without more widespread testing? How do you propose the population should progress regarding herd immunity? Peace
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Don’t mean to suggest that I am not broadly frustrated. Just so much more of the media storytelling it is hard to avoid!
See today’s blog for a potential way forward with herd immunity. Thank you! JB
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