SARS-CoV-2 is still a new virus, but we’re learning more about it every day. In this post, we look at two studies that examine risk factors for poor outcomes in COVID-19 patients – and there are some surprises.

Increased age, male gender, elevated BMI, diabetes, and heart disease are now commonly understood to be risk factors for more severe outcomes, hospitalizations and deaths related to COVID-19. However, in a  study at NYU Langone medical center of over 5000 patients with COVID-19, these factors were significant but not the strongest predictors for severe illness. Instead, it was the clinical presentations observed and laboratory markers of inflammation that were the strongest indicators of patient deterioration. In these patients, hypoxia or low blood oxygen was the clinical marker that showed the highest likelihood of progression to critical illness. On lab results, the elevation of three inflammatory markers in the blood (C-reactive protein, ferritin, and D-dimer) were common in the hospitalized patients requiring critical care. 

Other research out of NYU Langone studied the risk factors for strokes in COVID-19 patients. They found that in all the patients positive for COVID-19 who had suffered from a stroke, the stroke origins were more likely to be unknown (or “cryptogenic”) compared to stroke patients who had not tested positive for COVID-19. In other words, the COVID-19 positive patients with stroke were less likely to have the usual common risk factors of hypertension and a history of prior stroke. The COVID-19 positive stroke patients were also more likely to be younger men with elevated inflammatory and clotting markers such as D-dimer, ESR (erythrocyte sedimentation rate), and troponin. These subjects also had higher mortality rates than   COVID-19 negative stroke patients. 

While age and comorbidities have been shown to be predictors of negative outcomes with COVID-19, these studies show that inflammatory and clotting markers and clinical presentation may be even more predictive in determining the severity of disease progression. NYU implemented a therapeutic anticoagulation protocol for some COVID-19 patients in early April, with more research currently being conducted on the efficacy of these treatments. Research such as this is exciting and promising as it will continue to help us learn how to prevent severe outcomes sooner and more effectively.

ACTIONS YOU CAN TAKE:

  • Yet again, here is more evidence that age alone is not a predictive/protective factor. Do not allow yourself to be complacent about your COVID-19 risk simply because you are not elderly.
  • Similarly, surviving COVID-19 infection is not return to “normal life” for everyone – this infection has severe effects in some people, including stroke. This is not a risk for anyone to take lightly.
  • If you are diagnosed with or suspect you have been infected with SARS-CoV-2, monitor your blood oxygen levels. You may be able to get a pulse oximeter from your healthcare provider or online so you can measure your blood oxygenation at home, and seek medical support early if needed.

SARS-CoV-2 is still a new virus, but we’re learning more about it every day. In this post, we look at two studies that examine risk factors for poor outcomes in COVID-19 patients – and there are some surprises.

Increased age, male gender, elevated BMI, diabetes, and heart disease are now commonly understood to be risk factors for more severe outcomes, hospitalizations and deaths related to COVID-19. However, in a  study at NYU Langone medical center of over 5000 patients with COVID-19, these factors were significant but not the strongest predictors for severe illness. Instead, it was the clinical presentations observed and laboratory markers of inflammation that were the strongest indicators of patient deterioration. In these patients, hypoxia or low blood oxygen was the clinical marker that showed the highest likelihood of progression to critical illness. On lab results, the elevation of three inflammatory markers in the blood (C-reactive protein, ferritin, and D-dimer) were common in the hospitalized patients requiring critical care. 

Other research out of NYU Langone studied the risk factors for strokes in COVID-19 patients. They found that in all the patients positive for COVID-19 who had suffered from a stroke, the stroke origins were more likely to be unknown (or “cryptogenic”) compared to stroke patients who had not tested positive for COVID-19. In other words, the COVID-19 positive patients with stroke were less likely to have the usual common risk factors of hypertension and a history of prior stroke. The COVID-19 positive stroke patients were also more likely to be younger men with elevated inflammatory and clotting markers such as D-dimer, ESR (erythrocyte sedimentation rate), and troponin. These subjects also had higher mortality rates than   COVID-19 negative stroke patients. 

While age and comorbidities have been shown to be predictors of negative outcomes with COVID-19, these studies show that inflammatory and clotting markers and clinical presentation may be even more predictive in determining the severity of disease progression. NYU implemented a therapeutic anticoagulation protocol for some COVID-19 patients in early April, with more research currently being conducted on the efficacy of these treatments. Research such as this is exciting and promising as it will continue to help us learn how to prevent severe outcomes sooner and more effectively.

ACTIONS YOU CAN TAKE:

  • Yet again, here is more evidence that age alone is not a predictive/protective factor. Do not allow yourself to be complacent about your COVID-19 risk simply because you are not elderly.
  • Similarly, surviving COVID-19 infection is not return to “normal life” for everyone – this infection has severe effects in some people, including stroke. This is not a risk for anyone to take lightly.
  • If you are diagnosed with or suspect you have been infected with SARS-CoV-2, monitor your blood oxygen levels. You may be able to get a pulse oximeter from your healthcare provider or online so you can measure your blood oxygenation at home, and seek medical support early if needed.

BLOG POST AUTHOR

Amanda Lucero, ND lives and practices in Salt Lake City, UT. She is a founding member of the Naturopathic Alliance.