Hypertension, diabetes, cancer 

Having comorbidities can make COVID-19 worse
Post-lockdown, those with underlying medical conditions must be extra careful

India’s burden of non-communicable diseases poses a major hurdle in the fight against COVID-19. The country has 257 million people with hypertension and 73 million with diabetes.
When social distancing measures are relaxed, individuals with underlying medical conditions may still have to be particularly careful as they are more at risk of developing serious illness from COVID 19, says Dr. M. Shafi Kuchay, senior consultant, division of endocrinology and diabetes, Medanta-The Medicity, Gurugram.
“In general, patients with diabetes—especially those with uncontrolled disease—can be more susceptible to viral infections, such as influenza. This is because high blood glucose levels dampen immunity,” he explains. “A critical factor for any infection control in patients with diabetes is whether or not their blood glucose levels are optimally controlled.”
A study conducted by the US Centre for Disease Control (CDC) throws light on the link between COVID-19 infections and pre-existing medical conditions. It analysed the data of around 7,000 COVID19 patients and found that 71 per cent of those who were hospitalised with the infection and 78 per cent of those who were admitted to ICUs had underlying medical conditions. Data from a 191-patient study published in The Lancet found that 30 per cent of patients had hypertension, 19 per cent had diabetes, and 15 per cent had heart disease as underlying medical conditions.
One in three Indians suffers from hypertension, according to a study conducted by All India Institute of Medical Sciences, New Delhi, Fortis Escorts Health Institute, New Delhi, and Mother Hospital, Kerala. Maintaining healthy blood pressure levels is important for reducing the severity of the infection. Initially there were apprehensions that two of the blood pressure lowering medicines could increase one’s risk of contracting COVID-19. However, the American Heart Association and the American College of Cardiology have issued guidelines stating that antihypertensives do not increase the risk for the infection and hence they should not be discontinued.
People with cancer are at a higher risk for infections including COVID-19. Many of them are on immunosuppressive treatments which make them vulnerable to viral infections, says Dr Prasad Narayanan, senior consultant and director, Medical Oncology(solid tumours), Cytecare Hospitals, Bengaluru. “Cancer patients that contract the Covid virus, and have pre-existing co-morbidities like cardiovascular issues or diabetes may have serious infections that can, in some cases, even lead to death.”
There should be open and transparent conversations between patients and their doctors/oncologists, says Narayanan. “It is important to balance the benefits of cancer-related care with the risks related to COVID-19,” he adds.

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