As many as 85% of those who died in the State due to COVID-19 had diabetes or hypertension or both, making their recovery difficult. Medical experts said these two conditions form an ideal background for pathogens like the SARS-CoV-2 to cause lethal damage.
According to data provided by State health officials till April 5, and analysed by The Hindu, of the 45 people who died, 38 had diabetes, hypertension or both. At least six victims also had heart disease.
Mumbai-based endocrinologist and diabetologist Dr. Shashank Joshi said, “Our body has humoral mediated immunity, which helps in the formation of antibodies, and cellular mediated immunity, which is the body’s own defence mechanism. In patients with diabetes, these immune systems are weak.”
This means they are immunocompromised, Dr. Joshi explained. He added, “When a virus like the SARS-CoV-2 infects them, it causes a cytokine storm (an overproduction of immune cells and their activating compounds known as cytokines). This often leads to tremendous leaks into the lungs, which is why the patients require ventilators.” Blood sugar and blood pressure parameters should be kept in control, he emphasised.
The International Diabetes Federation states that when people with diabetes develop a viral infection, it can be harder to treat due to fluctuations in blood glucose levels and, possibly, the presence of diabetes complications. “There appear to be two reasons for this. Firstly, the immune system is compromised, making it harder to fight the virus and likely leading to a longer recovery period. Secondly, the virus may thrive in an environment of elevated blood glucose,” the IDF states.
State officials also observed that the mortality rate was high among senior citizens. It was 19% in the 60-80 age group, and nearly 22% in the 80-90 age group. “High blood pressure is common among the elderly. Age and other underlying ailments make them more vulnerable,” said senior physician Dr Altaf Patel.
Physician and intensivist Dr. Pravin Amin said data from China and Italy also show a similar trend. “Diabetes and hypertension alter the defence system and when a patient is affected by COVID-19, a network of reactions take place which become difficult to manage,” said Dr. Amin adding that 80% of COVID-19 patients have very mild disease and with proper management, those with co-morbid conditions also show recovery. “I have discharged a woman with diabetes on Sunday. The key is to have these diseases under control,” said Dr. Amin who practices at Bombay Hosptal and Breach Candy Hospital.