Comorbid and COVID, you don’t want them together

Dr Richard Maurer, working from
Medical office / Home office / Outside office

Do you have a dangerous comorbidity of COVID-19?

Way back on February 25th, it was clear to public health officials that type 2 diabetes, separate of cardiovascular disease, resulted in more severe COVID-19 infection. []

But why? What is it about having type 2 diabetes and prediabetes that causes this novel coronavirus to become more deadly? Scientific inquiry in many countries has not answered this question, but I’ll share what I have learned about the underlying conditions that raise the risk of more problematic COVID disease.

Like some of you, I read about COVID-19 at least a couple hours daily. BBC, WEBMD, CDC, WHO—it becomes a blur after a while, especially given all we don’t know. How contagious are the people without symptoms and for how long? How many have developed immunity? How do we understand who is at higher risk of severe illness?

COVID-19 trajectory

Today, April 3rd, the US CDC states there are 239,279 cases of COVID-19 and 5,443 deaths.

Let’s not get caught up with the % death rate—1.4% overall from a Lancet report on April 1st, but again, the publication relied upon terribly variable testing data. Every country tests differently so the denominator varies. Is the death rate 0.5% or 9%?

Here is what we all agree upon – COVID is more deadly than the seasonal flu perhaps by four times or more given data from two countries that did the most testing (Germany and South Korea). More thorough testing of prior exposures might lower that percentage. What should sober us up about COVID-19 is the rate of spread for this illness. When people congregate, this virus spreads incredibly well which creates a strain on our crucial healthcare system due to the time axis. Substantial social distancing measures are effectively slowing the rate of infections to one that is more medically manageable. For how long? We don’t know whether this virus will wane with a summer season in the northern hemisphere or recede when a crucial percentage of a population carries immunity but let’s just agree, it’s for awhile.

Interestingly, COVID-19 is far less deadly to children. Rather, it causes serious illness in those with other conditions, aka “comorbidities”. Headlines state age as the risk factor, but it is not older age as much as the accumulation of comorbid diseases. In the US, 40-60 year olds are showing up in the hospital with serious COVID-19 illness and it should not alarm us as we in America, lead the Western world in some of the COVID co-conspirators such as high blood pressure, excess body fat and high blood sugars. With each added comorbidity, illness worsens.

Conditions, per the U.S. CDC, that raise your risk of serious COVID-19 illness

  • Severe obesity (body mass index [BMI] of 40 or higher)
  • Diabetes
  • Smoking
  • High Blood Pressure
  • Chronic lung disease or moderate to severe asthma (especially when managed with immunosuppressant medication like steroids)
  • A serious heart conditions – eg. congestive heart failure and prior heart attack
  • People who are immunocompromised
    • Eg. post-chemotherapy, organ transplantation with subsequent anti-rejection meds, prolonged use of corticosteroids
  • Chronic kidney disease (undergoing dialysis) and chronic liver diseases

Let’s be attentive to the top half of this list—the modifiables. Furthermore, if one has anything from the lower half of the list, make sure the top half of the list is corrected.

THREE of the top four in the list define the syndrome we refer to as Metabolic Syndrome: weight gain – high blood sugar – high blood pressure. If you have all three, you have it. But if you are not sure, I remember some book that covers this, The Blood Code is still in print I know. []

When our blood testing facilities are less challenged with distancing rules, you can get a proper panel done to look for the condition at ULTA lab tests []

[Read this next section like it’s from the Men In Black]

Co-Morbidity Management Plan SHORT TERM:

If you have one of these conditions: too much body fat, high blood sugar, smoking…NOW is the time. Don’t wait. The virus is present and we must be strong to pull through. Don’t eat Sh*#. Really. All the flour, sugar and chocolate chips were sold out of the supermarket yesterday, but there was full racks of eggs, fish and fresh produce. Limit sugar these days. We must maintain a body that behaves like that of a younger individual. Maintain fitness. Every day, especially while home-bound, exercise to the point of breathing heavily. Practice heart rate recovery with your workouts—”Go until you can’t and rest until you can” I wrote more on this here… – RM

Provide a message to your body to become more insulin sensitive, leaner, and fitter.  And don’t forget a good night’s sleep.

CO-Morbidity Elimination Plan LONG TERM:

Run some tests on yourself. Typically, medicine works to manage disease, but not help you find an unusually healthy life. Work to remove any modifiable diagnosis from your comorbid list.

I personally used to be high blood sugar / prediabetic and have since dialed in an even better diet for me and I work out differently than I ever had in my first 40 years, including more weight lifting. I supplement with a simple and short list of nutrients that work for me. I use labs to measure my progress over time to tweak my behavior and lifestyle. The most recent lab I have done on myself is this Cardiovascular Risk Assessment Deep Dive Here is the link, and go ahead and share with your friends what you learn.[]

Knowing that this COVID virus is not going away, I approach the coming months and year with a confidence that my body could face this hot new virus without an underlying metabolic condition adding to the fire. If you have a metabolic health challenge that needs correction on your end…now is the time.