Age, race and underlying conditions: What makes you more susceptible to coronavirus? – cleveland.com

CLEVELAND, Ohio -- Based on the data gathered by the state, it seems that black Ohioans and people older than 50 are disproportionally affected by coronavirus.

About 19% of confirmed coronavirus patients are black, even though the states population is about 13% black. About 58% of cases are in patients over 50, and about 38% are over 60. About 17.1% of the population is 65 and over, according to most recent U.S. Census numbers.

The Centers for Disease Control and Prevention currently advises that people over 65 and people who live at nursing homes are at high risk for severe illness from COVID-19. CDC officials also warn that people of all ages with underlying medical conditions are at higher risk for severe illness.

But experts dont have the same kind of data for underlying conditions -- like diabetes, smoking and cardiovascular disease. Most information now is based on how certain conditions affect the immune system or from preliminary research, often from overseas and not yet peer-reviewed.

The state and federal government want more information, too.

How does the government get information on underlying conditions?

Ohio is not tracking underlying conditions in coronavirus cases.

Our primary focus during this pandemic has been to identify those who are positive so that local health departments could start contact tracing and monitoring others who might be at risk, Ohio Department of Health spokeswoman Melanie Amato wrote in an email.

As the COVID-19 response has developed, so too has the data we have available to understand how the illness is progressing. Our data experts have been working to analyze the data and share as quickly as possible. Today, we are sharing race and ethnicity data. That is the most current data breakdown we have at this time.

The state is collecting demographics. But Ohio Department of Health Director Dr. Amy Acton said that 40% of the cases, forms did not include the patients ethnic background.

Where officials know the racial background, 25% of cases are in black patients.

The intake forms are also what provide information on underlying conditions. When a patient becomes a person for investigation for coronavirus, a form is filled out and submitted to the CDC.

That form -- sent without any identifying information -- will lend more insight into the conditions that might make a patient more vulnerable, like age, heart disease, lung disease, cardiovascular disease, pregnancy and smoking status.

For the people that we have interviewed so far, we do not yet have enough data to allow us to release this information in aggregate, Cuyahoga County Board of Health spokesman Kevin Brennan wrote in an email. If/when that time comes, we will take a look at making it public.

Cuyahoga County is the hardest-hit in the state of Ohio, with 911 cases.

The CDC studied 122,653 coronavirus cases confirmed from Feb. 12 to March 28, 2020. Of those cases, 67,277 had missing or unknown status for underlying conditions that were part of the report, with about 5 percent of cases having complete information.

This analysis was limited by small numbers and missing data because of the burden placed on reporting health departments with rapidly rising case counts, and these findings might change as additional data become available, researchers wrote, also noting limitations in testing.

What did the CDC find so far?

Of the 7,162 cases studied, 37.6% had one or more underlying conditions. These conditions included:

Diabetes: 10.9% (no clarification between Type I and Type II)

Chronic lung disease: 9.2%

Cardiovascular disease: 9.0%

Immunocompromised condition: 3.7%

Other chronic disease: 16.5%

Former smoker: 2.3%

Current smoker: 1.3%

What other research is there?

Studies breaking down underlying conditions are often based on Chinese data, where governments are on the other side of the COVID-19 peak.

A Chinese Medical Journal study found that 25.6% of patients studied had comorbidities, meaning there are two conditions or illnesses present, with hypertension being the most common. In patients where the illness became more severe, 27.3% had a history of smoking, opposed to 3.0% in a group that improved or stabilized.

Researchers withdrew a different commonly referenced study summarizing underlying factors to update it with more data, though the authors claimed the conclusions shared in the study were still true. The study shared an observation that men died more frequently from coronavirus than women, which some health professionals inferred could be related to that men in China are more likely to be heavy smokers.

A study published in the Journal of the American Medical Association -- Cardiology last month showed patients with cardiovascular diseases composed about 4.2% of more than 44,000 confirmed cases in China, yet made up 22.7% of all deaths, with a case fatality rate of 10.5%.

Preliminary research led the American Heart Association to urge caution for elderly people with coronary heart disease or hypertension.

In the case of smoking, the CDC recommends that smokers to be wary because research has shown that the chemicals in cigarettes can change the bodys immune response.

Smokers are grouped in CDC recommendations with other underlying conditions that can compromise the immune system, including cancer treatment, immune deficiencies, poorly controlled HIV or AIDS, and prolonged use of corticosteroids and other immune weakening medications.

And other underlying conditions are known to threaten the immune system. Diabetes is an autoimmune disease. As patients age, the immune system can become unbalanced, prompting a more severe response which can cause severe symptoms.

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Age, race and underlying conditions: What makes you more susceptible to coronavirus? - cleveland.com