Coronavirus disease, commonly known as COVID-19, is an infectious disease caused by a newly discovered virus called coronavirus or officially called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by the World Health Organization (WHO). According to the latest COVID -19 statistics, the number of confirmed cases worldwide as of November 15, 2020, was 53,766,728, including 1,308,975 confirmed deaths (WHO Coronavirus Disease (COVID-19) Dashboard, 2020). The WHO has already declared coronavirus a pandemic because of its extensive and widespread scale of the outbreak. The United Nations, on the other hand, has categorized COVID-19 as the “worst global crisis” since World War II. The US, India, and Brazil are leading the tally of most infected countries. The US accounted for the world’s highest number of cases and deaths at 10,641,431 and 242,542 respectively according to WHO.
The COVID-19 pandemic is still unfolding and there is much that remains a mystery. With its growth, the emergence of scientific publications trying to analyze the magnitude and impact of the pandemic is also on the upsurge. There are many unsolved twisters and teasers related to COVID-19 that are baffling the physicians and public health research scientists across the globe. In this league of solving the unknown tracks of COVID-19, the researchers have found “poor health choices” to be one of the factors associated with a higher risk of COVID complications among Americans. The COVID-19 pandemic has cast a glaring light on lifestyle risk factors that may make a person more susceptible to the contracting coronavirus and its complications. Smoking, lack of physical activity, obesity, and excessive alcohol intake are a few lifestyle risk factors that are likely to increase the chances of getting COVID-19 (1,2,3).
Smoking is damaging to one’s health and is already known to be a risk factor for many respiratory infections and diseases, including cold, influenza, pneumonia, and tuberculosis. Smoking is found to be associated with increased growth of acute respiratory distress syndrome (ARDS), the major complication found in severe cases of COVID-19 among people with acute respiratory infections. Few of the known studies have found that people having cardiovascular and respiratory conditions that might be caused by smoking tobacco or otherwise, are much prone to developing chronic COVID-19 symptoms (3,4). According to WHO, the lung function in smokers is impaired, thus increasing the probability and risk of developing a lung infection. COVID-19 aggressively attacks the lungs, making the condition worse or can even result in fatality. Compared to non-smokers, patients who are avid smokers tend to require more intensive care and ventilation. Additionally, it is found that people with chronic respiratory diseases, cardiovascular problems, and other comorbidities (more than one disease/condition present in a person) directly linked to smoking, have higher fatality rates due to COVID-19.
It is found that coronavirus usually starts with invasion and infection of lungs and respiratory tract tissue; but in acute and severe cases, almost all the major organs in the body are now known to be negatively impacted. Unfortunately, as of now, we have no effective and known treatment/medicine for this disease. Thus, strict hygienic rules, isolation, social distancing, and quarantine are considered as few of the effective measures aimed at containing the coronavirus disease. Many countries worldwide have or are implementing full or partial lockdown measures as a preventive measure to COVID-19. The immobilization due to isolation and quarantine measures leads to a reduction in physical activity. The reduction in exercise and physical activity can reduce or suppress the capacity of organs /body systems to resist viral infection and increases the risk of damage to the immune, respiratory, cardiovascular systems (5,6). It is recommended to exercise regularly at home to avoid the airborne coronavirus and maintain fitness levels. Research also revealed that COVID-19 has detrimental social and psychological impacts such as emotional distress, depression, high levels of anxiety, stress, and low mood. Regular exercise, including low-intensity physical activities, meditation, yoga, walking, relaxing with family, and being in nature, are all measures, not only effective in avoiding coronavirus, but are also considered as an effective stress management and physiological upliftment tool (5, 7).
It is said that if two pandemics meet, the result could be very deadly. Obesity and COVID-19 are two such pandemics that have engulfed the whole globe. According to a recent study containing the meta-analysis of 75 international studies, obesity is found to be a significant risk factor for illness and death due to COVID-19 (8). Looking at the statistics, it is found that obese people are two times more likely to be hospitalized and among those who are hospitalized, approximately 75% are more likely to be admitted to the intensive care unit (ICU) and nearly 50% are more likely to die of COVID-19.
Obesity upsurges the risk of chronic inflammation and impaired immune function thus making it difficult for the body to fight the COVID-19 infection. Excessive bad cholesterol can also make it tougher for a person to take a deep breath, a vital consideration for an illness that impairs lung function.
Additionally, obese people are also more likely to have diabetes, heart problems, and high blood pressure, which on their own are the leading risk factors for severe COVID-19. Surprisingly, obesity is found to be more common in Black, Latin, and Native Americans, who are more likely to get infected and die from COVID-19 than White Americans. According to washingtonpost.com, Black Americans have higher rates of underlying health conditions including higher rates of hypertension, heart disease, diabetes, and lung disease, and having less access to care. In addition to that, Black Americans hold many ‘essential’ jobs that put them at more risk and make social distancing more difficult. Racial disparities in housing are found to be another reason that causes black lives to get infected and die from COVID-19. The doctors worldwide suggest that if someone is obese (having a body mass index, or BMI, of 30 or higher), should stay very vigilant towards protecting themselves from infection and should maintain all the measures including physical distance, avoiding crowds when possible, wearing masks, and washing hands to lower the risk of getting infected in the first place.
With the widespread social isolation and support and limited access to medical care, alcohol consumption was found to be a coping and mitigating strategy to stress and anxiety related to COVID-19. Ironically, this is not the first time alcohol consumption has increased in the United States following catastrophic events, such as terrorist attacks and large-scale natural disasters (9). The question arises of how excessive alcohol intake and severity of COVID-19 are related. According to the National Institute on Alcohol Abuse and Alcoholism, excessive alcohol intake activates the immune system and increases the risk of chronic inflammation, which interferes with the body’s immune response to viral infection. In the lungs, there are epithelial cells that line the lung surface, and excessive alcohol damages this lining and leads to acute respiratory distress syndrome. The impaired immune system function and an augmented susceptibility to respiratory illness thus increase the severity of COVID-19 and greater risk of mortality.
In addition to the above-mentioned lifestyle risk factors, there are certain underlying conditions that lead to an increase in the risk of COVID-19. US Centers for Disease Control and Prevention (CDC), has released a study stating the facts and figures related to these certain underlying conditions and provides guidance on how everyone can protect themselves and their families and communities from COVID-19.
Stay tuned to our next blog to learn about certain underlying medical conditions that may upsurge the severity of COVID-19 and how one can protect himself or herself from COVID-19.
Written by Dr. Shikha Sharma, Reviewed by Dr. Harshi Dhingra