COVID-19 and comorbidities: Deleterious impact on infected patients

Abstract

The pandemic situation with the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from China has endangered human lives. Coronavirus disease 2019 (COVID-19) is presented with asymptomatic, mild, or severe pneumonia-like symptoms. COVID-19 patients with diabetes, chronic obstructive pulmonary disease (COPD), cardiovascular diseases (CVD), hypertension, malignancies, HIV, and other comorbidities could develop a life-threatening situation. SARS-CoV-2 utilizes ACE-2 receptors found at the surface of the host cells to get inside the cell. Certain comorbidities are associated with a strong ACE-2 receptor expression and higher release of proprotein convertase that enhances the viral entry into the host cells. The comorbidities lead to the COVID-19 patient into a vicious infectious circle of life and are substantially associated with significant morbidity and mortality. The comorbid individuals must adopt the vigilant preventive measure and require scrupulous management. In this review, we rigorously focused on the impact of common morbidities in COVID-19 patients and recapitulated the management strategies with recent directions. We found limited resources describing the association of comorbidities in COVID-19; however, our review delineates the broader spectrum of comorbidities with COVID-19 patients.

Co-morbidity and blood group type risk in coronavirus disease 2019 patients: A case–control study

“…Certain co-morbidities were associated with strong angiotensin-converting enzyme 2 (ACE2) receptor expression. ACE2, a cleavable, extracellular enzyme located on the cell surface membrane, mediates entry by SARS-CoV-2 into human cells, leading to significant morbidity and mortality [ 26 ].…”

“…In the current study, diabetes mellitus was identified as the most significant co-morbidity (with a high OR = 9.4) associated with COVID-19 mortality. People with diabetes are susceptible to SARS-CoV-2 infection due to impaired phagocytic cell capabilities, in addition to several risk factors, including elevated ACE2 receptors levels, impaired T-cell function, and increased interleukin-6 concentration, which enhances viral entry into the cells, resulting in an escalation in lung inflammation and poor outcomes [ 26 ]. Although diabetes was independently associated with COVID-19 mortality in the current study, other co-morbidities, including hypertension, CVD, CKD, and obesity, were also linked to COVID-19 deaths, and the synergistic effect of these factors may have contributed to promoting COVID-19 mortality.…”

Severe COVID-19 and Sepsis: Immune Pathogenesis and Laboratory Markers

“…The immune response of patients having comorbidities might be weaker and less effective in containing the virus. Respiratory diseases and cardiovascular diseases, hypertension, diabetes, and diseases affecting the immune system are associated with significant morbidity and mortality [ 24 ]. As COVID-19 progresses, it can lead to hyper-inflammatory responses and cytokine storms [ 25 ].…”

The race to treat COVID-19: Potential therapeutic agents for the prevention and treatment of SARS-CoV-2

“…Furthermore, the current data reveal the SARS-CoV-2 mortality rate between 3% and 5, which is much lower than other Coronaviridae family member’s mortality rate, such as SARS-CoV (9–15%) and MERS-CoV (34–37%) [ [7] , [8] ]. However, tragically, SARS-CoV-2 is considerably transmissible and causes more severe health effect on the elderly people or with comorbidities, which is the existence of more than one chronic disease such as diabetes, obesity, and cardiovascular at the same time, that weaken the immune system of the human body [ [9] , [10] ]. The risk for severe illness from SARS-CoV-2 increases with age; older adults above 65 years of age are at higher risk (23-fold) and account for 80% of hospitalizations [ 10 ].…”