factor for serious complications of COVID-19, no matter what age the person is.
A person whose body mass index, or BMI, is thirty or more is considered obese. BMI is based on a formula that divides a person’s weight in kilograms by their height in meters.
According to the Centers for Disease Control and Prevention (CDC), nearly half (48.3 percent) of adults hospitalized in the United States with COVID-19 were obese and were also most likely to require intensive care or die. Although these figures were based on people age sixty-five and older, other studies have found this to be true for younger people as well.
Exactly why obesity raises risk is unknown, but one possible explanation is that abdominal obesity, the pattern found mostly in men, may compress the diaphragm, lungs, and chest area. This makes breathing more difficult, especially when these individuals are sick.
Recommendations:
• Use COVID-19 as extra motivation to lose weight.
• See the chapter on what to eat (chapter 17) as well as the chapters on sleep (chapter 16), exercise (chapter 19), and stress reduction (chapter 20), as people under stress or those who are sleep deprived tend to eat more and gain weight.
Chronic Obstructive Pulmonary Disease
Chronic obstructive pulmonary disease, or COPD, is the umbrella term used to encompass the serious lung conditions of emphysema and chronic bronchitis. Studies find that people with COPD are at a fivefold risk for being hospitalized with severe COVID-19 and are also at greater risk of dying.
Recommendations:
• Make sure you have a thirty-day supply of your medication.
• If you use oxygen, contact your supplier to find out what to do in the event there is a COVID-19 outbreak in your area.
• People with COPD are at increased risk for severe complications from seasonal flu and pneumonia, so contact your physician if you are having symptoms of an upper respiratory infection.
• Ask about using telemedicine for follow-up visits.
Asthma
Early research on COVID-19 assumed that people with asthma would be at risk for complications because this disease constricts the airwaves, making it difficult to breathe. Later research finds that people with mild asthma are not at higher risk, but there is still a concern about those with moderate and severe asthmatic conditions.
Recommendations
• Follow your usual plan to keep your asthma under control.
• Make sure you have a thirty-day supply of your medication.
• Continue your current medications, including any with steroids. Although steroids can suppress the immune system, don’t stop taking them without your doctor’s approval.
• Avoid your asthma triggers. Also, asthma can be triggered by anxiety, and certainly the COVID-19 pandemic has caused anxiety, as are likely any reoccurrences of virus spread. Take care of your emotional health.
• Ask about using telemedicine for follow-up visits.
Heart Disease
People with heart disease are at an increased risk of serious complications from COVID-19 and also are more likely to die from it; they are at 10.5 percent increased risk of dying compared to 2.3 percent for people who do not have underlying health conditions, Chinese researchers say.
People with the following heart conditions are at highest risk, the European Society of Cardiology says:
• Heart failure, a condition in which the heart becomes weakened and doesn’t pump blood effectively.
• 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.
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