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What is comorbidity — the factor that likely led to 3 COVID-19 deaths in India

All three Indians who have died of COVID-19 had underlying health conditions that are believed to have compromised their fight against the disease.

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New Delhi: The three Indian COVID-19 patients who have lost their lives so far had one thing in common — they all had underlying conditions that are believed to have compromised their body’s fight against the pandemic. 

The 64-year-old man who died in Maharashtra was reportedly suffering from multiple health issues while the 68-year-old West Delhi woman, the second COVID-19 death in India, had diabetes and hypertension. 

The first patient who died, on 12 March, a 76-year-old man from Karnataka, was suffered from hypertension and asthma. 

The simultaneous presence of more than one health disorder in a person is known as comorbidity. These disorders may exist independent of each other, or may be interlinked due to the same underlying causes.

For example, a person with obesity often suffers from heart disease and/or diabetes. 

According to a study published in The Lancet medical journal and several other experts, COVID-19 is more likely to be fatal in people who already have hypertension, diabetes or heart disease. 

The struggle against the COVID-19 pandemic and the need for social distancing thus takes on deeper urgency in India because the country is estimated to have over 8 crore hypertension patients, and around 72.96 crore diabetes cases among adults.

Also Read: What patients of diabetes, asthma need to do to stay safe from COVID-19

A compromised response

The term comorbidity was first coined by Alvan R. Feinstein, a researcher at Yale University, US, in a research paper published in 1970. He explained that not taking comorbid diseases into account skewed medical statistics, creating misleading data in mortality rates for a general population, and in fatality rates for an individual disease. 

It was also important to understand the impact of comorbidity while deciding how to treat patients, he said. 

Today, comorbidity is widely recognised even in the field of mental health. For example, it is not uncommon for people diagnosed with anxiety disorders to also suffer from depression. 

While these conditions are usually manageable with regular medicines and appropriate medical attention, the development of another infection puts a patient at risk of death. 

In healthy adults, the body’s immune system is able develop antibodies that fight off viral infections. However, in patients of diabetes and heart diseases, the immune system’s response is compromised.

“When people with diabetes develop a viral infection, it is often difficult to treat them due to fluctuations in their blood glucose levels and the presence of diabetes complications. Their immune system is compromised,” Dr Mahesh DM, a consultant for endocrinology at Bengaluru’s Aster CMI Hospital, told ThePrint in an earlier interview. 

Similarly, people who have a stent implanted in their arteries may be more vulnerable to COVID-19 infection, as the virus can cause tears in a patient’s blood vessels. 

“Influenza virus is already known as a propellant for heart attacks. The patients who are on blood-thinning medications, their chances of bleeding from lungs become high in case of coughing, such as in the case of coronavirus infection,” Yugal Kishore Mishra, head of cardiac sciences at Manipal Hospital in Delhi, said. 

Also Read: Bengal’s first COVID-19 patient evaded test for 2 days while IAS mother met top officials


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