Four key risk factors accounting for two-thirds of coronavirus hospital admissions have been revealed by a new study.
The majority of Covid-19 hospital cases are attributable to at least one of these four pre-existing conditions: obesity, high blood pressure, diabetes and heart failure.
Age and race, to the surprise of researchers, were not included amongst the four main factors, the Mirror reports.
The findings are based on research conducted on the total 906,849 coronavirus hospital cases that had occurred in the US by November 18 last year.
They found that 30 per cent were attributable to obesity, 26 per cent to high blood pressure, 21 per cent to diabetes and 12 per cent to heart failure.
The model suggests that these four conditions were also responsible for big differences in Covid hospitalisations when it comes to age and race or ethnicity.
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When figures for the four conditions were combined, the model suggests 64 per cent of Covid hospitalisations might have been prevented.
Study lead author Professor Dariush Mozaffarian, Dean of the Friedman School, said: “While newly authorised Covid-19 vaccines will eventually reduce infections, we have a long way to go to get to that point.
“Our findings call for interventions to determine whether improving cardiometabolic health will reduce hospitalisations, morbidity, and health care strains from Covid.
“We know that changes in diet quality alone, even without weight loss, rapidly improve metabolic health within just six to eight weeks.
“It’s crucial to test such lifestyle approaches for reducing severe Covid-19 infections, both for this pandemic and future pandemics likely to come.”
Researchers estimated the number and proportion of national Covid-19 hospitalisations that could have been prevented if Americans did not suffer from obesity, high blood pressure, diabetes or heart failure.
Other studies also strongly link these conditions to a higher risk of poor outcomes among Covid-19 patients.
In the new study, researchers estimated that age and race or ethnicity resulted in disparities in Covid hospitalisations due to these four conditions too.
Their model estimates around eight per cent of Covid hospitalisations among the under 50s were due to diabetes compared to around 29 per cent of hospitalisations among people aged 65 and over.
Plus obesity had an equally detrimental impact on Covid hospitalisations despite a person’s age.
At any age, Covid hospitalisations attributable to all four conditions were higher in black adults than in white adults and generally higher for diabetes and obesity in Hispanic adults than in white adults.
For example, among people age 65 and older, diabetes was estimated to cause about a quarter per cent of Covid hospitalisations among white adults, versus almost a third, or 32 per cent, among black adults, and about 34 per cent among Hispanic adults.
When the four conditions were considered combined, the proportion of attributable hospitalisations was highest in black adults of all ages, followed by Hispanics.
For example, among 18 to 49-year-olds, the four conditions jointly were estimated to cause about 39 per cent of Covid hospitalisations among white adults, versus half among black adults.
Prof Mozaffarian said: “National data show that black and Hispanic Americans are suffering the worst outcomes from Covid-19.
“Our findings lend support to the need for prioritising vaccine distribution, good nutrition, and other preventive measures to people with cardiometabolic conditions, particularly among groups most affected by health disparities.
“Policies aimed at reducing the prevalence of these four cardiometabolic conditions among black and Hispanic Americans must be part of any state or national policy discussion aimed at reducing health disparities from Covid-19.”
In epidemiological terms, the attributable proportion represents the percentage of Covid hospitalisations that could have been prevented in the absence of the four conditions.
In other words, the study found the people might still have been infected but may not have had a severe enough clinical course to require hospitalisation.
A 10 per cent reduction in national prevalence of each condition, when combined, could prevent about 11 per cent of all Covid hospitalisations, according to the model.
The four conditions were chosen based on other published research from around the world showing each is an independent predictor of severe outcomes, including hospitalisation, among people infected with Covid.
Lead study author Meghan O’Hearn, a doctoral candidate at the Friedman School, said: “Medical providers should educate patients who may be at risk for severe Covid-19 and consider promoting preventive lifestyle measures, such as improved dietary quality and physical activity, to improve overall cardiometabolic health.
“It’s also important for providers to be aware of the health disparities people with these conditions often face.”
The specific risk estimates for each condition were from a published multivariable model involving more than 5,000 Covid patients diagnosed in New York City earlier in the pandemic.
The researchers used other national data to model the number of Covid hospitalisations nationally – the distributions of these hospitalisations by age, sex, and race; and the estimated distribution of the underlying comorbidities among adults infected with Covid.
They then estimated the proportions and numbers of Covid-19 cases that became severe enough to require hospitalisation owing to the presence of one or more of the conditions.
The findings were published in the Journal of the American Heart Association.
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