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labs:coronavirus_covid19_health

Coronavirus (COVID-19) Health Information and Risks

For live tracking/statistics, see the Coronavirus (COVID-19) Live Tracker.

Health Risks Associated with COVID-19

What are the key risk groups for the novel coronavirus SARS-CoV-2 that causes COVID-19? See a data breakdown below.

There are several primary sources for risk information about COVID-19. The first, is the World Health Organization (WHO). WHO produced one of the first reports regarding the differential disease severity of COVID-19, and the data produced by them has so far held up in other countries outside of China. While the true number of confirmed cases of COVID-19 in China during the initial phases of the epidemic are likely to remain uncertain, the clinical information provided by the WHO about the severity of the disease continues to relatively accurate. Of course, as more countries had become engaged in a global pandemic, these statistics have varied from region to region based on region-specific demographics.

Figure 5. Pattern of disease progression for COVID-19 in China

“WHO Figure 5.” One of the most critical pieces of data published by the WHO. From this, we can tell that a large percentage of COVID-19 cases become critical or severe, and that around 50% of these critical cases result in death. The combination of high critical rate, and high conversion of critical into fatality, is what has been driving the high case fatality rate seen in COVID-19.

The WHO descriptions of each grade of disease severity can be seen below.

“Most people infected with COVID-19 virus have mild disease and recover. Approximately 80% of laboratory confirmed patients have had mild to moderate disease, which includes non-pneumonia and pneumonia cases, 13.8% have severe disease (dyspnea, respiratory frequency ≥30/minute, blood oxygen saturation ≤93%, PaO2/FiO2 ratio <300, and/or lung infiltrates >50% of the lung field within 24-48 hours) and 6.1% are critical (respiratory failure, septic shock, and/or multiple organ dysfunction/failure). Asymptomatic infection has been reported, but the majority of the relatively rare cases who are asymptomatic on the date of identification/report went on to develop disease. The proportion of truly asymptomatic infections is unclear but appears to be relatively rare and does not appear to be a major driver of transmission.”

As noted by the WHO at this time, the proportion of asymptomatic cases was unknown at the time. Today, we have estimates of asymptomatic case rates as high as 50%. From this data, we can see the four levels of disease severity as classified here:

1. Mild to moderate disease - most recover, non-pneumonia and pneumonia cases.
2. Sever disease - dyspnea (difficult or labored breathing), hypoxia (lack of oxygen in body tissues), and lung infiltrates (e.g., Ground-glass opacity (GGO)).
3. Critical disease - respiratory failure, septic shock, multiple organ failure, mechanical ventilation required.

An archived copy of the WHO report is available from IIRESS servers here: WHO Final Report on China


Who is most at risk?

From the WHO Joint Final Report on China, we can see that the highest risk group for COVID-19 is the elderly.

Age
80+ 14.8%
70-79 8.0%
60-69 3.6%
50-59 1.3%
40-49 0.4%
30-39 0.2%
20-29 0.2%
10-19 0.2%
0-9 no fatalities*†

*† US now reports several fatalities in the age 0-9 category: US COVID-19 death toll grows to 3 for children in New York

Men are slightly more likely to die from COVID-19 than women.

Sex Case Fatality Rate (CFR)
Male 2.8%
Female 1.7%

And finally, people with comorbidities are also at much higher risk.

Pre-Existing Condition Case Fatality Rate (CFR)
Cardiovascular disease 10.5%
Diabetes 7.3%
Chronic Respiratory Disease 6.3%
Hypertension 6.0%
Cancer 5.6%
No pre-existing conditions 0.9%

Source: Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19)

Much of this data has recently been corroborated by the CDC as US clinical cases have begun to resolve.

CDC Stats for COVID-19 Risk:

Estimated percent requiring hospitalization

  • 31-70% of adults 85 years old and older
  • 31-59% of adults 65-84 years old

Estimated percent requiring admission to intensive care unit

  • 6-29% of adults 85 years old and older
  • 11-31% of adults 65-84 years old

Estimated percent who died

  • 10-27% of adults 85 years old and older
  • 4-11% of adults 65-84 years old

Source: CDC Risks, Older Adults

US CDC list of high risk individuals:

  • People 65 years and older
  • People who live in a nursing home or long-term care facility

People of all ages with underlying medical conditions including:

  • Chronic lung disease or moderate to severe asthma
  • Serious heart conditions
  • Conditions that can cause a person to be immunocompromised, including cancer treatment, smoking, bone marrow or organ transplantation, immune deficiencies, poorly controlled HIV or AIDS, and prolonged use of corticosteroids and other immune weakening medications.
  • Severe obesity (body mass index [BMI] of 40 or higher)
  • Diabetes
  • Chronic kidney disease and who are undergoing dialysis
  • Liver disease

US CDC also notes that individuals with Asthma are at significantly higher risk than others and offers specific guidance to this group as seen below. This risk is also extended to immunocompromised or HIV positive/AIDS individuals.
US CDC - People with Moderate to Severe Asthma
US CDC - People with HIV

Recent articles on risk & comorbidities


Tobacco Use and COVID-19

News and Publications About Tobacco use and COVID-19

  • “A review of studies by public health experts convened by WHO on 29 April 2020 found that smokers are more likely to develop severe disease with COVID-19, compared to non-smokers.”

Signs and Symptoms

CDC Signs and Symptoms of Coronavirus disease 2019 (COVID-19)

  • Fever
  • Cough
  • Shortness of breath or difficulty breathing
  • Chills
  • Repeated shaking with chills
  • Muscle pain
  • Headache
  • Sore Throat
  • New loss of taste or smell

US CDC Coronavirus Disease 2019 (COVID-19) Signs & Symptoms

Oregon Health Authority Weekly Report, Signs & Symptoms, Infection Risk, and Underlying Conditions 04/28/2020

Figure 1. provides information on signs and symptoms from all COVID-19 cases. Of all 2,345 cases, 87.4% (n=2,049) reported having signs and symptoms of COVID-19. The two most commonly reported symptoms are cough (n=1,617, 69.0%) and fever (n=1,149, 49.0%). Figure 2 provides information on risk factors from all COVID-19 cases. The two most common risk factors are having underlying medical conditions (n=1,033, 44.1%) and contact with a known COVID-19 case prior to symptom onset (n=809, 34.5%). It is important to note that each person may report more than one sign/symptom or risk factor. Figure 3 shows the sex distribution of all COVID-19 cases.

*Congregate living situations include, but are not limited to, long-term care facilities, group homes, prisons, shelters, etc. Data include people with confirmed cases who live or work in congregate living situations. Direct patient care is only asked if a case is a healthcare worker or volunteer. The denominator is the number of healthcare workers or volunteers. *Underlying medical conditions include cardiovascular disease, chronic liver disease, chronic lung disease, chronic renal disease, current or former smoker, diabetes mellitus, immunocompromised condition, neurologic/neurodevelopmental condition, obesity, or other chronic diseases.

Oregon Health Authority (OHA) COVID-19 Weekly Report, 4/28/2020

Oregon Health Authority (OHA) COVID-19 Weekly Report, 4/7/2020

Scientific Articles Focusing on Rare Warning Signs and Symptoms of COVID-19


What can you do?

Be aware of the symptoms

  • Symptoms of COVID-19 can range from mild symptoms to severe illness and death.
  • Symptoms may appear 2-14 days after exposure.
  • Watch for fever, cough, and shortness of breath.

CDC Recommendations for reducing exposure risk of COVID-19:

  • Stay at home - avoid non-essential travel
  • Wash your hands often.
  • Avoid close contact (6 feet, which is about two arm lengths) with people who are sick.
  • Clean and disinfect frequently touched services.
  • Avoid all cruise travel and non-essential air travel.
  • Call your healthcare professional if you have concerns about COVID-19 and your underlying condition or if you are sick.
  • Wear a cloth face covering in public (CDC Recommendation as of 04/03/2020)

Manage Anxiety and Stress

  • Take breaks from watching, reading, or listening to news stories and social media. Hearing about the pandemic repeatedly can be upsetting.
  • Take care of your body. Take deep breaths, stretch, or meditate. Try to eat healthy, well-balanced meals, exercise regularly, get plenty of sleep, and avoid alcohol and drugs.
  • Make time to unwind. Try to do some other activities you enjoy.
  • Connect with others. Talk with people you trust about your concerns and how you are feeling.
  • Call your healthcare provider if stress gets in the way of your daily activities for several days in a row.
  • If you, or someone you care about, are feeling overwhelmed with emotions like sadness, depression, or anxiety, or feel like you want to harm yourself or others call 911.
  • Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) Disaster Distress Helpline: 1-800-985-5990 or text TalkWithUs to 66746. (TTY 1-800-846-8517)

*Note: The information contained in this website does not constitute medical advice. If you are having a medical emergency please contact your local healthcare provider or dial 911. If you are concerned about your health risks related to Coronavirus, please consult a medical professional.


Non-clinical Mask Usage

Sexual Health During the Pandemic

Guides and resources to best sexual health practices

Is COVID-19 Sexually Transmitted?

Best Sexual Health Practices Guidelines During the Pandemic, from Mayo Clinic If you are sexually active with someone outside of your household, consider these precautions to reduce your risk of getting the COVID-19 virus:

  • Minimize the number of sexual partners you have.
  • Avoid sex partners who have symptoms of COVID-19.
  • Avoid kissing.
  • Avoid sexual behaviors that have a risk of fecal-oral transmission or that involve semen or urine.
  • Use condoms and dental dams during oral and anal sex.
  • Wear a mask during sexual activity.
  • Wash your hands and shower before and after sexual activity.
  • Wash sex toys before and after using them.
  • Use soap or alcohol wipes to clean the area where you have sexual activity.

https://www.mayoclinic.org/diseases-conditions/coronavirus/expert-answers/sex-and-coronavirus/faq-20486572


Sources

labs/coronavirus_covid19_health.txt · Last modified: 2020/07/10 18:00 by bpwhite