COVID-19 symptoms: Why some cases are worse than others – who’s most at risk?

The vast majority of confirmed COVID-19 cases are considered mild, involving mostly cold-like symptoms to mild pneumonia. However, some COVID-19 patients suffer far worse symptoms with some needing hospitalisation and the use of a ventilator. Why are some COVID-19 cases worse than others?

Studies have reported that 14 percent of confirmed cases have been “severe,” involving serious pneumonia and shortness of breath.

Another 5 percent of patients confirmed to have the disease developed respiratory failure, septic shock, and/or multi-organ failure and are known as “critical cases” potentially resulting in death.

Roughly 2.3 percent of confirmed cases did result in death.

Scientists are working to understand why some people suffer more from the virus than others.

New studies are looking at how a person’s genetic makeup may influence how badly they are affected by the virus, if at all, said Dr Anthony Cardillo.

He continued: “Researchers have already mapped the human genome.

“And now studies are finding that those who develop more severe symptoms have more mutations in the area of the genome that controls the immune response.

“So, if scientists can determine in advance which people may be more vulnerable to the virus, it may help improve their protection.”

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Who’s most at risk

The latest data from China stem from an analysis of nearly 45,000 confirmed cases, and on the whole suggest that the people most likely to develop severe forms of COVID-19 are those with pre-existing illnesses and the elderly.

While less than 1 percent of people who were otherwise healthy died from the disease, the fatality rate for people with cardiovascular disease was 10.5 percent.

That figure was 7.3 percent for diabetes patients and around 6 percent for those with chronic respiratory disease, hypertension, or cancer.

Investigators are relating age-related COVID-risk to the way the immune system changes over the years.

An example includes the male-female differences in immune responses.

Some scientists are probing for genetic variations that might raise susceptibility.

Others are highlighting the social, environmental and economic factors that elevate risk, including racism.

In a study published in Nature, factors associated with COVID-19-related death was further investigated.

The study noted: “Working on behalf of NHS England, we created OpenSAFELY—a secure health analytics platform that covers 40 percent of all patients in England and holds patient data within the existing data centre of a major vendor of primary care electronic health records.

“COVID-19-related death was associated with being male greater age and deprivation (both with a strong gradient); diabetes; severe asthma; and various other medical conditions.

“Compared with people of white ethnicity, Black and South Asian people were at higher risk, even after adjustment for other factors.

“Age and gender are well-established risk factors for severe COVID-19 outcomes: over 90 percent of the COVID-19-related deaths in the UK have been in people over 60, and 60 percent in men.” 

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