Why Are Elderly At More Risk For Coronavirus Or COVID-19?

The COVID-19 outbreak, caused by the novel coronavirus, remains rampant across the world. However, it is being seen that older people are especially susceptible to severe illness from this virus. While this is still a new disease and research is ongoing on this novel virus. Nevertheless, research shows that adults who are 60 years and older are more likely to have a severe, usually deadly, coronavirus infection as compared to the other age groups. Let us take a look at why the elderly are at risk for coronavirus or COVID-19.

Why are Elderly At More Risk for Coronavirus or COVID-19?

Why are Elderly At More Risk for Coronavirus or COVID-19?

An extensive study of the positive COVID-19 cases from two of the worst-hit countries, China and Italy, has revealed that there is a particular pattern to the spread of COVID-19 infection. This emerging trend is that this novel virus tends to target older adults more and avoids the younger ones.

Older people, especially those who have pre-existing health conditions like heart disease, lung disease, and diabetes, are being severely affected by the novel coronavirus.

Many of the symptoms of the COVID-19 are similar to those of the seasonal flu. According to the US Centers for Disease Control and Prevention (CDC), nearly 70-85 percent of general flu-related deaths, as well as 50-70 percent of all flu-related hospitalizations, have been seen to occur in people who are 65 years and over.(1)

Similar to the seasonal flu, older people, especially those with pre-existing chronic health problems, are at a higher risk of being infected by the novel coronavirus. All the data collected so far shows that older people with multiple comorbid conditions are being affected severely.(2)

A recent study published in the Journal of the American Medical Association (JAMA) one of the biggest study done so far on COVID-19, found that the fatality rate of the infection was nearly 15 percent in patients who are over the age of 80, as compared to the overall fatality rate of 2.3 percent.(3)

The study also found that children who are ten years old and under made up for only one percent of all the COVID-19 cases to date. Those between the ages of 30 to 79 made up almost 90 percent of all cases.

Research by the World Health Organization (WHO) also found that the mortality rate increased with a person’s age.(4) The highest mortality was found to be in people over 80 years of age and in those who had underlying chronic health conditions.

According to the National Center for Immunization and Respiratory Diseases (NCIRD), serious illness occurs in 16 percent of cases. Older people, along with people with a pre-existing health condition such as diabetes, lung disease, kidney disease, and heart disease, were found to be twice as likely to develop a severe outcome as compared to younger and healthier people.(5)

The elderly population and people who are taking medications for managing chronic health conditions such as diabetes and high blood pressure were also advised to take necessary precautions and also keep adequate essential supplies on hand as the pandemic continues to rise.(6)

In Italy, for example, a country that has one of the oldest populations in the world, the country’s National Health Institute discovered that out of 105 total patients who had died as of March 4, 2020, from the novel coronavirus, the average age was 81.(7) The National Health Institute that there was a full 20-year gap between the average age of the patients who died and those who tested positive for COVID-19 infection. In fact, the institute said that there were only two deaths of people who were under the age of 50.(8)

These findings from Italy were also in line with the data from China’s Center for Disease Control.(9) Researchers from China analyzed the first 72,314 patients who had confirmed or suspected COVID-19 infection and found that there was a huge gap age-wise in the mortality rate. The disease appears to be more severe in people with each passing decade of age.(9)

Why Does This Happen?

One of the most likely reasons why coronavirus or Covid-19 affects older people in a more severe manner is because immune function starts declining as we age. This makes the elderly more susceptible to more severe illnesses, especially if they are already battling a chronic health condition.

The immune system, which is the body’s defense mechanism, starts wearing down with age. So not only does the body begin to have a tougher time in fighting off new infections such as COVID 19, but the immune system is also more impacted by any chronic underlying disease. This makes the immune system weaker and further reduces its ability to fight against any new virus.

In older adults, the total number of white blood cells that are responsible for finding and eliminating any infections, start to decline. These cells also become less capable of identifying new pathogens to protect against. In the particular case of COVID-19, the novel virus also causes damage to the immune cells that might otherwise be able to overcome the virus. So not only were there fewer of these infection-fighting cells in older people, but they are also weaker than what they once used to be in their youth. This is why a novel infection like the COVID-19 ends up doing more damage in older adults than it does in younger people.

Apart from decreased immune response, older people also have a much higher prevalence of chronic diseases such as diabetes, heart disease, and lung disease. Along with an already weakened immune system, these types of chronic underlying diseases make it extra difficult for the body to fight off infections.

In fact, out of the 105 patients who died in Italy as of March 4, 2020, nearly two-thirds were found to have three or more pre-existing health conditions.(10) The most common condition was found to be hypertension or high blood pressure, following by heart disease and diabetes. These chronic diseases are known to cause severe degradation of the organs, thus leaving the body susceptible to infections. Additionally, the treatments for these health conditions are also known to suppress the immune system, again leaving the body more vulnerable and exposed to pathogens.

How To Lower The Risk Of COVID-19?

Older people who are living in high-risk areas, which are experiencing a sharp prevalence of COVID-19 cases, should actively follow certain strategies for reducing their risk of catching the infection.

One of the most important strategies to avoid the infection, of course, is social distancing. Staying home, avoiding large public gatherings, and avoiding anyone who has the symptoms of the disease, should be followed strictly.

According to the Centers for Disease Control and Prevention (CDC), the best way of protecting yourself from COVID-19 infection is to avoid getting exposed to the virus.(11) The agency recommends the following tips to prevent infection:

    Stay home if you feel sick.

  • Avoid coming into close contact with people who are sick and show symptoms of the disease.
  • Avoid touching your nose, eyes, and mouth.
  • Cough or sneeze into a tissue or your elbow. If you are using a tissue, then make sure to dispose of it in the trash.
  • Disinfect and clean regularly touched surfaces and items. Regular household cleaning wipes and sprays can be used.

Conclusion

COVID-19 will not lead to severe symptoms of fatality in a majority of people who contract the disease. However, the elderly, especially those who have pre-existing health conditions such as heart disease, lung disease, and diabetes, are most at risk. Older people who are taking medications to manage these chronic health conditions need to ensure that they have their medications regularly. They should also follow the recommendations of experts when it comes to taking proper precautions to remain safe.

References:

  1. Cdc.gov. 2020. People 65 Years And Older & Influenza | CDC. [online] Available at: <https://www.cdc.gov/flu/highrisk/65over.htm#:~:text=> [Accessed 13 April 2020].
  2. Lloyd-Sherlock, P., Ebrahim, S., Geffen, L. and McKee, M., 2020. Bearing the brunt of covid-19: older people in low and middle income countries.
  3. Wu, Z. and McGoogan, J.M., 2020. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. Jama.
  4. Who.int. 2020. [online] Available at: <https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf> [Accessed 13 April 2020].
  5. Centers for Disease Control and Prevention. 2020. Director, NCIRD. [online] Available at: <https://www.cdc.gov/about/leadership/leaders/ncird.html> [Accessed 13 April 2020].
  6. Centers for Disease Control and Prevention. 2020. Coronavirus Disease 2019. [online] Available at: <https://www.cdc.gov/media/releases/2020/t0303-COVID-19-update.html> [Accessed 13 April 2020].
  7. Business Insider. 2020. Italy, Now Under Lockdown, Has Been Hit Hard By The Coronavirus Outbreak. It Also Has One Of The World’s Oldest Populations With 60% Over Age 40.. [online] Available at: <https://www.businessinsider.com/italy-coronavirus-old-population-cases-death-rate-2020-3?r=DE&IR=T> [Accessed 13 April 2020].
  8. Iss.it. 2020. Istituto Superiore Di Sanità (ISS) – ISS. [online] Available at: <https://www.iss.it/> [Accessed 13 April 2020].
  9. GitHub. 2020. Cmrivers/Ncov. [online] Available at: <https://github.com/cmrivers/ncov/blob/master/COVID-19.pdf> [Accessed 13 April 2020].
  10. Iss.it. 2020. CS N° 15/2020 – Studio ISS Su 105 Deceduti Con Covid-2019, Età Media 81 Anni E Patologie Preesistenti In Due Terzi Dei Casi – ISS.
  11. Cdc.gov. 2020. [online] Available at: <https://www.cdc.gov/coronavirus/2019-ncov/prepare/prevention.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fabout%2Fprevention.html> [Accessed 13 April 2020].

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