Certain physical or mental pathologies are aggravating factors of Covid-19. What are they ?
[Mis à jour le 10 avril à 17h36] A certain number of so-called “at risk” people are more prone to the consequent complications of the new coronavirus, which has already killed more than 12,000 people in France. According to statistics from Public Health France published this Friday, April 10, 2020 a profile is emerging: 73% of patients in intensive care are men and 55% are over 65 years. For many, the patients suffer from comorbidity: 23% of diabetes, 19% of cardiac pathology, 17% of arterial hypertension and 16% of pulmonary pathology. The president of the Scientific Council, Jean-François Delfraissy, based on a report by this group of scientists charged with advising the executive on the health crisis, estimated on FranceInfo that this population was around 17 million in France. “Containment must persist for several weeks from now,” he recommended to protect these particularly fragile populations.
One of the most “at risk” public according to statistics established by Santé publique France on the coronavirus epidemic is the population over 60 years of age. The 4166 deaths recorded in nursing homes since the beginning of March attest to this. According to the epidemiological point published on April 10 by Santé publique France, between April 16 and April 5, 55% of intensive care patients were over the age of 65. In addition, deaths without co-morbidity, in other words without other pathology, concerned almost all people over 70 years of age. The median age of victims is 83 years.
The chronically ill are considered “at risk” by the government. The latest epidemiological assessment shows that 62% of Covid + in intensive care have indeed comorbidities. An Italian study confirms these French figures: out of 1,290 coronavirus-related deaths, 61.9% had more than three co-morbidities. The most common condition is high blood pressure (73% of subjects). Followed by type 2 diabetes (31.5%) and ischemic heart disease (28.1%).
“All resuscitation in France finds a very large proportion of overweight or obese patients,” said Dr Matthieu Schmidt, from the Pitié-Salpêtrière hospital in Paris, to AFP. According to information from Le Monde, 83% of patients hospitalized for intensive care coronavirus are overweight. It is also reported that the average weight of deceased people is 80 kilos. Olivier Ziegler, endocrinologist and nutritionist at the CHRU in Nancy indicated on RMC: “There is a dose effect. The more the corpulence increases, the more the risk of being intubated and ventilated increases”. This fragility is explained by the restricted respiratory capacities of people suffering from obesity. Obese people lose their breath more quickly, so their lungs are weakened and their immune system is weakened. De facto, their organizations find it more difficult to fight Covid-19.
According to Covid-19 statistics, the disease killed 38.5% of women compared to 61.5% of men. Professor Pialoux reported on BFMTV that the ratio of people hospitalized in intensive care was 7 men for 3 women. He hypothesized: “There is probably an enzyme whose gene on the X chromosome is used to get the virus into the cells.” Professor Pierre Delobel, head of the infectious diseases department at the Toulouse University Hospital, said: “Innate immunity is better in women, especially before menopause.”
A study published in the medical journal News England Journal of Medicine, stated that the risk for smokers to develop a severe form of the coronavirus is increased by 50% and the risk of death increases by 130% compared to non-smokers. However, the caregivers are surprised at the reality on the ground. “There is something very special about tobacco. We have found that the vast majority of serious cases are not smokers, as if […] tobacco protected against this virus, via nicotine, “said Professor Delfraissy.
However, the National Committee against smoking (CNTC) has warned: “smokers are at increased risk of contracting [le coronavirus] and develop a severe form. “The organization recalled that” smoking outdoors is essential “to avoid passive smoking” a risk factor for acute and chronic respiratory infections in children.
The blood group
A Chinese study reported that our blood group could be a determining factor in the transmission of the virus. The study, published on the MedRxiv site, relates to 2,100 people affected by the virus and hospitalized in 3 hospitals in Wuhan and Shenzhen. It indicates that people in the O blood group are 33% less likely to be infected with the coronavirus. Conversely, groups A are more vulnerable, with 20% more risk of being contaminated. Group B would also be more affected than the average, but the authors consider that the sample is too small to establish it statistically. The study makes the link between blood groups and antibodies, ensuring that people in group O would be better equipped to deal with the coronavirus. However, the authors called for caution and encouraged further studies.
In a column published in Le Parisien, a hundred psychiatrists worried about the fate of the 12 million people suffering from mental disorders. Indeed, this audience is fragile. “They are exposed to a more serious Covid because they are twice as carriers of the chronic diseases we talk about all the time, diabetes, cardiovascular disease, obesity,” explained on FranceInfo Marion Leboyer, professor of psychiatry at Paris-Est Créteil University.