People with these diseases have a higher death rate from coronavirus

People with heart disease seem to be at higher risk of developing serious illness from coronavirus. But there are practical steps they can take to reduce the risk.

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A leading Prince of Wales Hospital cardiologist Professor Nigel Jepson is warning people with heart conditions to take extra precautions during the COVID-19 pandemic because they are at greater risk of death from the virus.

More than one in four (26 per cent) of those aged 75 and over have heart, stroke and vascular disease and over one million Australians suffer from heart conditions.

Professor Jepson said people with heart problems, high blood pressure, chronic respiratory disease and diabetes, are at elevated risk of developing complications if they contract COVID-19.

During the outbreak in Wuhan in China patients with an underlying heart condition developed complications including breathing problems, abnormal heart rhythms or, ultimately, heart failure, more often than others, he said.

“This increased risk of death for people with CVD is estimated to be nearly 10 per cent higher than a ‘healthy’ patient,” he said.

“We don’t want to create fear or panic but I don’t think we’re really getting the message across that, while for most of us COVID-19 would be an innocuous disease to get, we need to adopt caution and care to slow the rate of spread as much as possible, in order to protect those who could be more seriously affected,” he said.

People who had no chronic health conditions had a death rate of 1.4 per cent but those with heart disease had a death rate of 13.2 per cent, experts from the World Health Organisation (WHO) found.

The team looked at deaths among the more than 55,000 cases of COVID-19 in China.

Patients with COVID-19 who had diabetes had a death rate of 9.2 per cent, high blood pressure 8.4 per cent, chronic respiratory disease 8 per cent and cancer 7.6 per cent.

And being male also carried a higher risk of death with the death rate among men with COVID-19 4.7 per cent compared to females is 2.8 per cent.

Doctors don’t know why people with heart disease are more vulnerable to COVID-19. Picture: istock

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The Heart Foundation’s chief medical adviser Professor Gary Jennings said it was not yet clear why people with heart disease were more at risk of dying from coronavirus.

“We see it with the flu as well so it is similar, what we don’t know is why,” he said.

“They’ve got less reserves because they are struggling with heart disease and then something else comes along and overwhelms them.

“It’s a respiratory illness and they already have fluid build-up in their lungs from heart disease.”

New research looking at deaths among 191 Chinese coronavirus patients published in The Lancet journal found the average time to death from the virus was 18 days.

Patients who died were more likely to develop sepsis, have blood clots, lower white blood cell count, elevated levels of a biomarker for inflammation and chronic disease, indicators they had suffered a heart attack.

Medical staff take samples from people at a building where 46 people were confirmed to have the coronavirus in Seoul, South Korea. Picture: Getty Images

Almost all those who died suffered respiratory failure, and sepsis and half of them developed secondary infections.

Meanwhile virologists have claimed an overly aggressive immune response to coronavirus that destroys healthy tissue in airways – needed to keep out bacteria – could be the reason some people die from coronavirus.

US National Institutes of Health flu expert Jeffrey Tauubenberger who sequenced the genome of the deadly 1918 influenza virus said COVID-19 starts in the nose and if it’s contained in the upper airway usually results in a less severe disease.

However, if the virus moves into the lungs it can trigger a more severe phase.

“You have no ability to keep stuff out of the lower respiratory tract,” he told Bloomberg.

This left the lungs vulnerable to an invasive secondary bacterial infection, he said.

The WHO team found it took about two weeks to recover from a mild cases of the virus, 3-6 weeks for patients with severe or critical disease.

It took around one week for the virus to progress from a mild case to severe disease and patients who died did so between two to eight weeks after they got the infection, the report found.

10 WAYS PEOPLE WITH HEART ISSUES CAN REDUCE COVID-19 RISK

1. Avoid large gatherings (even contexts with fewer than 500 people) e.g. theatres, cinemas, concerts and shopping centres

2. Exercise caution when using public transport – avoid busy times and routes in known outbreak areas; make alternative travel arrangements

3. Do not travel unnecessarily – avoid airports, train stations and bus terminals

4. Go shopping at quiet times – or take advantage of major supermarkets’ timeslots for older people only

5. Have your prescriptions for heart medicines filled now – ask your pharmacist and GP to assist as shortages are occurring in some areas

6. Postpone non-urgent medical appointments or procedures – or consult your healthcare professional by phone or ‘telehealth’ instead

7. Stock up on groceries (within reason) – you’re going to be at home more, so organise for online deliveries (friends and family can help)

8. Get vaccinated – stick to plans to be vaccinated for influenza and pneumonia, and others as your doctor advises, to avoid developing other conditions that can be confused with coronavirus (such as flu)

9. Stay healthy – eat well, get enough sleep and follow exercise regimens as advised by your healthcare professionals

10. Keep calm and carry on – if you live alone, think about low-risk activities you can do to socialise, such as meeting a friend outdoors for a walk

Originally published as People with these diseases have a higher death rate from coronavirus