Covid deaths: Diabetes, hypertension top co-morbidities in Mumbai

Sixty per cent patients who succumbed due to Covid-19 in Mumbai had diabetes and hypertension as underlying co-morbid conditions.

Sixty per cent patients who succumbed due to Covid-19 in Mumbai had diabetes and hypertension as underlying co-morbid conditions. Data obtained from the civic body on 16,149 deaths recorded till October 10 also showed that 36% patients did not have any underlying disease, while the remaining 4% deceased had conditions like tuberculosis, chronic kidney disease, ischemic heart disease, among others.

Data obtained from the civic body on 16,149 deaths recorded till October 10 also showed that 36% patients did not have any underlying disease, while the remaining 4% deceased had conditions like tuberculosis, chronic kidney disease, ischemic heart disease, among others. (VIJAY BATE/HT)

According to the data, 6,336 or 39.2% deceased had diabetes, 3,311 or 20.5% had hypertension and 5,862 or 36.3% had no co-morbidity. “Not just Covid-19, diabetes and hypertension have been the leading co-morbidities when it comes to the worsening impact of other diseases as well,” said critical care specialist Dr Kedar Toraskar from Wockhardt Hospital, who is also a member of Maharashtra’s Covid-19 task force. “Covid-19 infection affects the pancreas. In addition to this, the treatment required for some patients may include steroids that are known to elevate blood sugar levels. All these factors together contribute to higher complications among patients,” he said.

The pancreas is an organ that regulates blood sugar. Experts say Sars-CoV-2 either damages the pancreas through direct injury or through inflammation of the pancreas. Due to such injury, the organ’s ability to regulate blood sugar is impacted.

Similarly, Covid-19 patients may have severe outcomes when they have high blood pressure, which is one of the leading causes of cardiovascular diseases. Medical experts say that hypertensive patients are more prone to suffer from a severe form of Covid-19, longer hospitalisation and Intensive Care Unit (ICU) admission. A scientific brief published by the World Health Organization this June stated that the available evidence is consistent overall in suggesting that hypertension increases the risk of Covid-19, admission to intensive care units, severe disease and mortality. “Whether these increased risks were independent of other risk factors, however, has not been fully elucidated,” it said.

Medical experts said that obesity was also among the factors of concern, even as the civic body does not list it as a co-morbidity while analysing the deaths. “In most cases, the Body Mass Index (BMI) of the patients is not captured which is a problem,” said Toraskar. “We have seen overweight and obese patients at more risk of severe Covid-19,” he said. He said that some patients with obesity may have been counted under the 36% patients with no co-morbidities, as they may not have any known underlying conditions.

“Most patients without co-morbidities who have succumbed had developed the severe disease,” said Dr Avinash Supe, who heads the Covid-19 death audit committee. “It will be right to say that the disease killed them. Many of them went into a cytokine storm,” he said. Cytokine storm is a severe immune reaction that leads to organ damage.

While experts say that some patients may have undiagnosed underlying diseases, some deaths may also be due to failure or inadequate health infrastructure at some level. An analysis by the death audit committee shown that nearly 60% patients have died within five days of hospitalisation, suggesting either delayed treatment or hospitalisation or rapid progress to severe disease.