FIGHT BACK. Chauncey W. Crandall

Dilated cardiomyopathy, a disorder in which the heart’s chambers become enlarged and cannot pump blood effectively.

       • Advanced forms of arrhythmogenic right ventricular cardiomyopathy.

       • Congenital cyanotic heart disease, which are types of heart problems that occur before birth and result in low blood oxygen levels.

       • Obstructive hypertrophic cardiomyopathy.

       • People who have undergone heart transplants are put on immunosuppressive drugs to keep their bodies from rejecting their new organs. This makes them more vulnerable to infections, including COVID-19.

      Recommendations:

       • Make sure all your vaccinations are up to date, including your pneumonia shot.

       • Make sure you have a thirty-day supply of your medication.

       • Ask about using telemedicine for follow-up visits.

       • Review the information on ACE inhibitors and ARBs covered in the section in this chapter on high blood pressure and discuss with your doctor if you are taking any of these medications.

       • Even during a COVID-19 outbreak, if you are experiencing any symptoms that can be heart-related, call 911. Such symptoms include the following:◊ chest pain or discomfort◊ difficulty breathing◊ weakness◊ shortness of breath◊ fainting◊ confusion

      People with Weakened Immune Systems

      Conditions that suppress the immune system include AIDS, HIV, and immune deficiency. People who have undergone bone marrow or organ transplants have weakened immune systems as well. The prolonged use of corticosteroids and TNF inhibitors, like adalimumab (Humira) and infliximab (Remicade), also weaken the immune system.

      Recommendations:

       • Discuss your condition with your doctor.

       • Ask about using telemedicine for follow-up visits.

      Kidney Disease

      Serious kidney disease weakens the immune system, putting people at risk for infections, and this is even more true for those on dialysis. People with a kidney transplant need to take antirejection drugs, which work by suppressing the immune system.

      Recommendations:

       • If you have moderate or severe chronic kidney disease (stages 3–5), you should practice social distancing but also ask your doctor if you need to isolate yourself during times of COVID-19 spread. The more advanced your kidney disease, the stricter you need to be about avoiding interaction with others.

       • If you’re on dialysis, discuss your schedule with your treatment team. You also may be advised by your physician to isolate yourself from others to avoid getting infected.

       • Ask about using telemedicine for follow-up visits.

      Cancer and Cancer Survivors

      Cancer patients—especially those with blood and lung cancers or malignancies that have spread throughout the body—have three times the risk of death or severe complications from COVID-19 compared to people who don’t have cancer, a large, multihospital study in China finds. Also, many cancer treatments suppress the immune system, which makes contracting infections, including COVID-19, more likely. These treatments include chemotherapy, radiation, and CART cell therapy, which suppress the body’s immune system.

      Recommendations:

       • Make sure you have a thirty-day supply of your medications on hand.

       • Contact your doctor several days before a scheduled appointment to make sure the office is open.

       • Ask about using telemedicine for follow-up visits.