Risk Factors
Laila Khorasani and Yea-Lyn Pak
April 27 2021
April 27 2021
While still an emerging pandemic, epidemiologists now have the ability to study the percentage of patients who experience a deadly infection from two primary regions: China and Italy. Initial studies have used data from China, the pandemic’s origin, in order to better understand how to track and treat exposed patients. This presented problems as China’s health status is unique: a majority of the population has poor lung health due to ubiquitous cigarette usage and suboptimal air quality. As such, more recent information from Italy is now used to model the virus’s pathogenesis, an overall description of its infectious profile, within “western” countries. In the interest of transparency, however, this is also biased by Italy’s generally older population.
Many of the primary risk factors for COVID-19 are in patient demography, whereby the case fatality rate (CFR), the percentage of patients who experience a deadly infection, increases exponentially with age. In this sense, a maximum CFR of 17% is observed only in patients aged 80 and older, whereas this decreases exponentially to a CFR of only 0.2% of those below 39 years old. While age alone is thus a key indicator of risk, it is important to consider its underlying cause: comorbidity, the presence of multiple ailments in one patient. Current surveillance concludes that healthy individuals with no preexisting conditions exhibit a CFR of 0.9% irrespective of age. In contrast, the presence of other medical issues such as cancer (5.6%), hypertension (6.0%), asthma and COPD (6.3%), diabetes (7.3%), and cardiovascular diseases (10.5%) result in markedly increased mortality rates. These issues are also compoundable, enabling a high CFR of 48% in those with three or more conditions.
Interestingly, recent reports have highlighted that males exhibit up to twice the mortality risk than females, despite both having largely equal rates of infection. While research is ongoing, leading explanations point to both female immunophysiology and male sociobehavioral practices. Women have previously been shown to exhibit stronger immune responses than their male counterparts, possibly caused by how females retain both X chromosomes, each carrying genes for essential antiviral proteins. Furthermore, mice models suggest that estrogen signaling confers additional immunity against previous coronaviruses like SARS-CoV-1 and MERS-CoV. While this bestows some biological immunity, looking towards China allows us to shed more light on how substance abuse impacts health outcomes from COVID-19 infection. SARS-CoV-2 is known to attack tissues expressing ACE2 and BSG proteins that are found on cells of the cardiopulmonary system. As a result, male-dominated behaviors affecting lung health are now becoming a key focus of study. Researchers have found that chronic vaping and cigarette usage, which both damage lung tissues, result in a 300% increase in mortality from COVID-19. Furthermore, illicit use of methamphetamine (meth) and opioids are also posited to increased risk, as meth constricts lung blood vessels and opioids contribute to low-oxygen hypoxia.
Many of the primary risk factors for COVID-19 are in patient demography, whereby the case fatality rate (CFR), the percentage of patients who experience a deadly infection, increases exponentially with age. In this sense, a maximum CFR of 17% is observed only in patients aged 80 and older, whereas this decreases exponentially to a CFR of only 0.2% of those below 39 years old. While age alone is thus a key indicator of risk, it is important to consider its underlying cause: comorbidity, the presence of multiple ailments in one patient. Current surveillance concludes that healthy individuals with no preexisting conditions exhibit a CFR of 0.9% irrespective of age. In contrast, the presence of other medical issues such as cancer (5.6%), hypertension (6.0%), asthma and COPD (6.3%), diabetes (7.3%), and cardiovascular diseases (10.5%) result in markedly increased mortality rates. These issues are also compoundable, enabling a high CFR of 48% in those with three or more conditions.
Interestingly, recent reports have highlighted that males exhibit up to twice the mortality risk than females, despite both having largely equal rates of infection. While research is ongoing, leading explanations point to both female immunophysiology and male sociobehavioral practices. Women have previously been shown to exhibit stronger immune responses than their male counterparts, possibly caused by how females retain both X chromosomes, each carrying genes for essential antiviral proteins. Furthermore, mice models suggest that estrogen signaling confers additional immunity against previous coronaviruses like SARS-CoV-1 and MERS-CoV. While this bestows some biological immunity, looking towards China allows us to shed more light on how substance abuse impacts health outcomes from COVID-19 infection. SARS-CoV-2 is known to attack tissues expressing ACE2 and BSG proteins that are found on cells of the cardiopulmonary system. As a result, male-dominated behaviors affecting lung health are now becoming a key focus of study. Researchers have found that chronic vaping and cigarette usage, which both damage lung tissues, result in a 300% increase in mortality from COVID-19. Furthermore, illicit use of methamphetamine (meth) and opioids are also posited to increased risk, as meth constricts lung blood vessels and opioids contribute to low-oxygen hypoxia.
SARS-CoV-2 is largely transmitted via respiratory droplets resulting from coughs or sneezes. These droplets can settle on surfaces and remain in infectious state for two hours to nine days in general.
Image Source: analogicus
While these risk factors are largely related to the patient themselves, COVID-19 is now also known to affect our physical environment. SARS-CoV-2 is largely transmitted via respiratory droplets that are infectious through the eyes, mouth, and ears. Building upon research done on past coronaviruses, COVID-19 is now also known to exist on surfaces in an infectious state. In general, it persists for two hours to nine days in areas with 50% humidity and temperatures between 4–30℃ (39–86℉), and can even survive for up to 28 days in even colder environments. In regards to the differences between surfaces themselves, a new study suggests that the virus can remain active on plastics and stainless steel for three or more days. This poses a large risk in both home and office environments. Furthermore, cardboard has been shown to host the virus for up to one day, whereas copper can only do so for four hours. As a result, current WHO guidelines recommend that surfaces be cleaned with disinfectants containing either 0.1% sodium hypochlorite (bleach solutions) or 62-71% ethanol, both of which inactivate the virus after one minute of exposure. However, common antibacterial agents have proved ineffective at killing the virus, as these chemicals cannot puncture its surface. Recent research has further revealed that COVID-19 is rarely transmitted through surfaces and that the biggest threat of COVID-19 transmission is people. Nonetheless, disinfecting surfaces and ventilating spaces should be regularly done to decrease risks of contracting the virus.
Featured Image Source: Elien Dumon
