some of the organ damage is caused by the virus’s invasion, along with the inflammation that results, the deadliest cases are those in which the immune system, sensing its widespread damage, suddenly goes into abnormal chaotic overdrive, creating a condition called a cytokine storm, which is much like aggressive friendly fire in the heat of battle.
When this happens, the body releases immune cells and proteins into the bloodstream, which then attack healthy tissues in the body. While such a response only occurs in a small percentage of cases, it can lead to organ shutdown and death.
The Lungs
When the coronavirus targets the lungs, it causes shortness of breath, which sometimes rapidly develops into acute respiratory distress syndrome, or ARDS. This condition causes massive fluid buildup in the lungs, preventing oxygen from getting to the rest of the body. This lack of oxygen can damage the body’s other organ systems, causing them to shut down, and resulting in death.
The Heart
Research out of China shows not only that the virus damaged the lungs but that nearly 20 percent of people hospitalized with COVID-19 also suffered serious cardiac injury and were at higher risk of dying.
Such cardiac problems included sudden heart attacks, a serious heart condition known as myocarditis, and irregular heartbeat rhythms.
Initially, doctors chalked these problems up to the inflammatory effects of the virus, along with respiratory distress caused by pneumonia and ARDS, but they are now seeing other types of heart damage as well, leading them to believe the virus may injure the heart directly.
The Brain
Researchers are also concerned about mounting evidence that the coronavirus may attack the brain, causing neurological damage and even strokes.
In China, doctors reported a study that 30 percent of COVID-19 patients developed a wide array of neurological problems, including headache; dizziness; impaired consciousness; acute cerebrovascular disease, including epilepsy; and peripheral symptoms, including decreased appetite, taste, and smell.
In New York, doctors reported in the New England Journal of Medicine on a small number of apparently healthy younger people, who had suffered 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.
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
