FIGHT BACK. Chauncey W. Crandall

strokes and tested positive for COVID-19. The strokes occurred in the brain and were very unusual in people under the age of fifty. This has led doctors in New York to suspect that COVID-19 is causing a clotting problem that is leading to the strokes.

      The paper also noted that in China, there was an approximate 5 percent incidence of strokes seen in COVID-19 patients, and strokes were also associated with the 2004 Singapore outbreak of severe acute respiratory syndrome (SARS), which is caused by a related type of coronavirus.

      An article in The New York Times titled “Coronavirus May Pose a New Risk to Younger Patients: Strokes” (May 14, 2020) underscores this connection to COVID-19.

      COVID-19 in Children and Teens

      When COVID-19 first appeared in the United States, it was assumed that although children could contract and also spread the virus, they did not become seriously ill. But there are recent reports of children and teenagers becoming very sick with an inflammatory syndrome that may be linked to the virus. This new condition, considered rare, is called pediatric multisystem inflammatory syndrome, and it resembles Kawasaki disease, an acute illness in children.

      This syndrome is considered very rare, and children with it have been hospitalized but have generally recovered.

      While no link has been firmly established yet between this illness and COVID-19, it is being reported in areas where there have been large outbreaks of the virus, including in the United States, the United Kingdom, and other European countries.

      A definitive list of symptoms is being compiled, but Kawasaki disease produces a persistent fever (102.2° Fahrenheit or higher), swollen neck glands, cracked lips, swelling in the hands and feet, and reddened eyes.

       Chapter 2

       Who Is at Risk?

      Everyone is at risk of getting sick from COVID-19 because we have no built-in immunity to it. However, there are some groups within the population who are at even higher risk of developing serious complications from COVID-19. But remember, no one is immune from COVID-19.

      That said, if you are in one of these categories, you are at high risk for developing complications from COVID-19 or even dying. Note that what many of these conditions have in common is a suppressed immune system. Having a strong immune system can help reduce your risk of infection from many viruses, including COVID-19.

       Remember, if you are at risk for COVID-19, always talk to your doctor first to make sure the recommendations in this book are right for you.

      Who Is at Highest Risk for Severe Complications for COVID-19

      This list of risk factors is a long one, but a new British study called the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) that surveyed seventeen thousand hospitalized coronavirus patients gives us the best understanding of who is actually at high risk.

      The study, which analyzed patient data from February 2020 through April 2020, showed that the virus is virulent and quite often deadly. The study also found that certain preexisting conditions raise the risk of both complications and death.

      Mortality rates for those hospitalized were high, with 33 percent of those admitted to a hospital for the virus dying. The mortality rates rose as patients developed complications, with 45 percent placed in intensive care units (ICUs) dying. Similarly, the study found that 53 percent of ICU patients placed on ventilators also died.

      The study found the risk factors that raised the likelihood of dying were dementia (39 percent), obesity (37 percent), and heart disease (31 percent).

      Metabolic Syndrome

      The ISARIC study noted that patients who were hospitalized had certain preexisting conditions, including obesity, heart disease, and diabetes. Such conditions are often associated with the “metabolic syndrome” that afflicts one-third of adult Americans.

      In fact, metabolic syndrome conditions skyrocket your risk of COVID-19 complications significantly more than if each condition was added singly. People with metabolic syndrome have two or more of the following conditions: obesity, high blood pressure, diabetes, high triglycerides, and low HDL cholesterol, the “good” cholesterol.

      The ISARIC study found that of those hospitalized for the virus, 29 percent suffered from chronic heart disease, 19 percent had diabetes, 19 percent had pulmonary disease (not including asthma), and 14 percent had asthma.

      Researchers who did a meta-analysis on studies in China involving 46,246 patients noted that, historically, they have fared worse in the viral pandemics preceding this one, mainly severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS).

      And COVID-19 is not shaping up to be an exception according to a study done in India, which found a death rate of nearly 50 percent for patients that had high blood pressure, diabetes, and heart disease.

      Metabolic syndrome is seen as a disease largely caused by lifestyle, particularly eating too much and exercising too little. The good news is that you can take steps to reduce the severity of metabolic syndrome in your life, thereby reducing the risk due to exposure to the virus.

      It is also important to remember that most of the conditions included in metabolic syndrome will weaken your immune system, so boosting your immune system is critically important to put you in the best position to fight back against COVID-19.

      Now let’s take a closer look at the risk factors that are more likely to make COVID-19 worse and also what steps to take to reduce these risks.

      Risk Factors for COVID-19

       • being age sixty-five and over

       • high blood pressure

       • obesity

       • diabetes

       • chronic lung diseases (chronic obstructive pulmonary disease [COPD] and asthma)

       • cardiovascular disease, including heart disease and atrial fibrillation

       • kidney disease

       • immunosuppression

       • cancer and being a cancer survivor

      Age Sixty-Five and Over

      Since the coronavirus was first identified, one fact has stood out consistently: those people who become most seriously ill have been age sixty-five and older. If you’re in this age group, protecting against COVID-19 becomes extra important. If you’re age eighty-five and older, you have the highest risk of dying of the disease.

      Recommendations:

       • Follow the recommendations on wearing a mask and social distancing outlined elsewhere in this book.

       • If you work, ask your employer whether you can work from home.

       • During the pandemic, restaurants were closed. When you go to them after they’ve reopened, give yourself some distance in seating and steer clear of any buffets to minimize the possibility of contamination.

       • Make use of the special “Senior Hours” at supermarkets and other stores, both for those age sixty-five and older and for those at risk with other health conditions outlined here.

       • At times when the virus is spreading, steer clear of crowds, including those at “senior” events, especially if people are not wearing masks or taking precautions.