Just when we thought things here on Planet Contagion couldn't get any more chaotic, President Donald Trump has tested positive to the dreaded virus. As a doctor, I of course wish a speedy recovery for anyone infected with COVID-19—Trump is said to have only "mild symptoms," like a cold—just as I worry about those at high risk. And Trump is at high risk. Read on to find why his diagnosis might be bad news for his health, and to get through this pandemic at your healthiest, don't miss these Sure Signs You've Already Had Coronavirus.
Many studies have reported males are more at risk of a poor COVID outcome than females—the risk for males is around twice the risk for females. The infection fatality ratio (IFR) for men over 80 is 11.6%, compared to 4.6% for women, according to Nature. This seems to be due to biological differences in the male and female immune system.
The 64-74-year old age group are five times more likely to be admitted to hospital with COVID infection, and 90 times more likely to die, than those aged 18-29, per the CDC. For every 1,000 people admitted to hospital with COVID in their mid-70s, 116 will die, per Nature.
A recent review of the medical literature in Obesity Reviews, which included 1,733 studies and 399,461 participants, concluded that people who are obese, are 113% more likely than those of normal weight, to be admitted to hospital with COVID, 74% more likely to end up in ITU, and 48% more likely to die.
There are many reasons why obesity increases the risk of a poor COVID outcome.
Obesity causes chronic inflammation, impairs the immune response, and increases the risk of a cytokine storm—the cause of adult respiratory distress syndrome (ARDS).
Obesity is associated with impaired glucose tolerance, insulin resistance and type-diabetes.
Excess fat sits under the diaphragm and in the chest wall, making it more difficult to breathe in and out.
Too much fat is "lipotoxic"—fat literally poisons other organs such as the heart, kidneys, and liver.
Obesity increases the risk of venous thromboembolism.
America and Brazil have the highest death rates from COVID across the globe.
A recent statistical reanalysis of data concluded that deaths in Europe were, in fact, 28% lower than those in America. Economists believe that if this excess mortality had been prevented, 57,800 American lives could have been saved. The authors point out that the U.S. has 4% of the world's population but is responsible for 21% of global COVID infections and deaths.
Trump Has a Stressful Job
Trump finds himself in an unprecedented situation, infected with COVID-19, and only three weeks away from the American election. No doubt his stress levels are high.
Chronic stress seems to be a risk factor for a poor outcome from COVID infection. Stress results in increased levels of the hormone cortisol. This then triggers certain responses from the cardiovascular and immune systems.
In a recent paper in Endocrine Today, researchers compared the cortisol levels of 533 people admitted to hospital with COVID infection. They found that a doubling in the cortisol level on admission increased the risk of death by 42%. High cortisol levels on admission were found in the sickest patients and predicted the worst outcomes.
Final Thoughts from the Doctor
Trump has medical risk factors which he cannot change right now. And if even the president can become infected, so could you. Do everything you can to prevent getting—and spreading—COVID-19: Wear your face mask, get tested if you think you have coronavirus, avoid crowds (and bars, and house parties), practice social distancing, only run essential errands, wash your hands regularly, disinfect frequently touched surfaces, and to get through this pandemic at your healthiest, don't miss these 35 Places You're Most Likely to Catch COVID.
Dr. Deborah Lee is a medical writer at Dr Fox Online Pharmacy