The clinical risk for severe Covid-19 is dramatically higher for people who are unaware that they are living with chronic conditions such as the ‘silent killers’ of diabetes and hypertension, according to a leading South African clinical risk expert.
The first wave was really a wake-up call about the extent to which chronic conditions can affect a person’s individual clinical risk for Covid-19,” said Dr Jacques Snyman, medical advisor to Health Squared Medical Scheme.
“During the first wave, scheme data shows that out of those admitted to hospital almost 80% had co-morbid conditions – specifically, more than half had cardiovascular co-morbidities or diabetes. International studies also suggest that people with poorly controlled chronic conditions are at particularly high risk for Covid-19.”
According to Dr Snyman, because conditions such as high blood pressure and type-2 diabetes are often largely asymptomatic until they come to the fore with a major health event, they are regarded as ‘silent killers’.
“This is even more dangerous, as many South Africans have no idea that they are at increased risk for serious Covid-19 infection because they have not been screened for these common health concerns,” he said.
“The relationship between these specific conditions and more severe Covid-19 risk is not yet fully understood, but what we do know is that the receptor site for the virus on the lining of the lungs and blood vessels is the same receptor associated with blood vessel type diseases.
“Diabetes is also a risk for blood vessel diseases, as high blood glucose causes an inflammatory reaction in the blood vessels, and this process in combination with the virus using this same receptor system allows it to easily enter the person’s cells, where it multiplies to intensify the viral load and is likely to cause much more damage in the body due to the putative inflammatory storm. The latter results in significant lung damage and or clotting in blood vessels resulting in heart attacks, stroke and pulmonary embolism.
“In the second wave, however, we found that members with these types of co-morbid conditions made up a significantly lower percentage of Covid-19 hospital admissions. We saw a 10 to 15 percent absolute reduction in patients with diabetes or cardiovascular disease comorbidities, compared to other comorbidities,” Dr Snyman recently pointed out during Agility Health’s Quarterly Review.
Mutation of the virus does not change the profile of the disease, so this is not likely to be a major factor. Analysis of claims data provided a probable explanation, as we found that more members were having preventative health screenings, and many were proactively managing their health better than in the first wave.
“For the third wave and beyond, it is highly advisable for members of the public to have their regular preventative screenings and closely adhere to their treatment plan. Find out if you are at risk, especially from the ‘silent killers’ and take ownership of your health because these diseases do not have obvious symptoms but can put one at much greater risk from Covid-19 as well as future serious health problems.”
