Why Underlying or Comorbid Conditions are Very Important in COVID-19

It is well-known that older adults are at greater risk of getting serious complications from COVID-19, but few people realize that the majority of people that require hospitalization in the US [1] (and presumably the data is similar in Canada) have very common underlying medical conditions (known as “comorbid” conditions), including high blood pressure (hypertension), obesity, diabetes and cardiovascular disease and chronic lung disease [1]. With a vaccine for COVID-19 coronovirus more than a year a way, current efforts to reduce the risk of contracting the virus focus on physical and social distancing measures, personal hygiene including proper hand-washing techniques and avoiding touching one’s face, as well as wearing face coverings in public places but there is more we can do to reduce the risk of getting serious complications or dying from complications from the virus — and that is addressing dietary and lifestyle changes that are documented to put comorbid conditions such as high blood pressure, type 2 diabetes and obesity into remission.

Early release of a research study on April 8, 2020 [1] reported that between March 1-30, 2020, hospitalization rate in 99 counties of 14 US states was 4.6 people per 100,000 population, and rates were highest amongst those who were ≥65 years of age and those with underlying medical conditions. Among almost 1500 laboratory-confirmed COVID-19–associated hospitalizations, almost 25% were between the ages of 5–17 years, almost 25% were aged 18–49 years, ~30% were aged 50–64 years and 43% were aged ≥65 years. Among those patients with data on underlying medical conditions, almost 90% had one or more comorbid conditions — with almost 50% of patients having hypertension (high blood pressure) or obesity and almost 30% having diabetes or cardiovascular disease. This is huge.

“These findings suggest that older adults have elevated rates of COVID-19–associated hospitalization and the majority of persons hospitalized with COVID-19 have underlying medical conditions.”[1]

Underlying comorbid conditions among US adults with COVID-19

Changing What’s in Our Control to Change

Many of us feel somewhat powerless during this COVID-19 outbreak and while the internet is full of recommendations for dietary supplements, many overlook the most obvious way to lower risk of serious complications by lowering any known comorbid conditions we may have. We can achieve and maintain a normal body weight and waist circumference, normalize blood pressure and blood sugar, and lipid markers such as improving HDL cholesterol and lowering triglycerides.

As covered in an earlier article, a study published in November 2018 reported that 88% of Americans are already metabolically unhealthy[2]; that is, only 12% have metabolic health defined as [2];

  1. Waist Circumference: < 102 cm (40 inches) for men and 88 cm (34.5 inches) in women
  2. Systolic Blood Pressure: < 120 mmHG
  3. Diastolic Blood Pressure: < 80 mmHG
  4. Glucose: < 5.5 mmol/L (100 mg/dL)
  5. HbA1c: < 5.7%
  6. Triglycerides: < 1.7 mmol/l (< 150 mg/dL)
  7. HDL cholesterol: ≥ 1.00 mmol/L (≥40 mg/dL) in men and ≥ 1.30 mmol/L (50 mg/dl) in women

When considering only waist circumference, blood glucose levels and blood pressure levels~50% of Americans were considered metabolically unhealthy [3].  Given the slightly lower rates of obesity in Canada as in the United States, there is likely a slightly lower percentage of Canadians who are metabolically unhealthy, but the similarity of our diets may make that difference insignificant.

While we obviously can’t reduce our age or the presence of chronic lung conditions such as asthma or COPD, we can lower our risk of having severe outcomes should we contract the virus;

  • If we are overweight, we can lose weight.
  • If we have high blood pressure we can make safe and effective dietary changes to lower that, and by adding other lifestyle changes, achieving normal blood pressure without the need for medication is possible.
  • If we have higher than normal blood sugar, we can normalize that through dietary and lifestyle changes. Type 2 diabetes need not be a “chronic progressive disease”! It can be put into remission.
  • If we have abnormal lipid panel (cholesterol), we can change the way we eat to lower triglyceride levels, as well as increase HDL (“good”) cholesterol levels.

Final Thoughts…

There is much about the current situation we can’t change. Physical (social) distancing measures will likely be in place for some time. The need for consistent hand hygiene and avoiding touching our face will likely be come second nature for most of us, as may be the wearing of face coverings in public for many.

But with all of us eating at home almost all of time, now is an ideal time to find out how to eat in such a way to improve our metabolic health and lower our risk of serious outcomes should we contract the virus.

More Info?

If you would like more information about how I can help you and your family eat better, or how I can help you lose weight, lower blood pressure or blood sugar or lower cardiovascular risk, please reach out to me. While all my services are now provided via Distance Consultation, I have more than a decade of experience providing virtual nutrition support.

You can find more about the details of the different packages I offer by looking under the Services tab, or in the Shop and if you have any service-related questions, please feel free to send me a note using the Contact Me form above, and I will reply as soon as I can.

To your good health!


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  1. Garg S, Kim L, Whitaker M, et al. Hospitalization Rates and Characteristics of Patients Hospitalized with Laboratory-Confirmed Coronavirus Disease 2019 — COVID-NET, 14 States, March 1–30, 2020. MMWR Morb Mortal Wkly Rep. ePub: 8 April 2020. DOI: http://dx.doi.org/10.15585/mmwr.mm6915e3
  2. Araújo J, Cai J, Stevens J. Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009–2016. Metabolic Syndrome and Related Disorders Vol 20, No. 20, pg 1-7, DOI: 10.1089/met.2018.0105

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