‘10 in every 100 Covid patients above 50 years in Mumbai succumbed’

Among those over 50, highest case fatality rate in 80-89 age group

Ten in every 100 Covid-19 patients above the age of 50 years in Mumbai have succumbed to the infection, according to data from the Brihanmumbai Municipal Corporation (BMC). The case fatality rate in patients above 50 years is 10.64%, higher than Mumbai’s average of 5.4%, shows the data available for 132,221 cases and age-wise break-up for 7,419 deaths.

HT Image

Among those over 50 years, the 80-89 age group has the highest case fatality rate of 21.2% – 664 of the 3,131 who tested positive died. While 9,463 patients in the 70-79 age group tested positive, 1,496 died, with a case fatality rate of 15.81%. The highest number of deaths was recorded in the 60-69 age group – 2,122 deaths from among 18,454 patients, and a case fatality rate of 11.49%. The case fatality rate is lowest in children below 9 years (0.49%), with 12 deaths out of 2,439 cases.

Doctors have attributed the higher fatality rate in older patients to a ‘compromised’ or ‘exhausted’ immune system, along with co-morbidity.

Dr Shashank Joshi, a senior city-based doctor who was part of the Maharashtra government’s task force set up in April to reduce mortality in the state, said, “Senior citizens are more vulnerable because they have weaker immunity and their immune surveillance mechanism fails. There is something called as immunological aging. The body’s ability to mount a robust response becomes weak with age. Senior citizens also have higher incidence of co-morbidity such as hypertension, diabetes, heart diseases.”

According to Dr Joshi, patients with co-morbidity are a vulnerable group, as they have a higher chance of getting a more severe infection. He said, “The Covid-19 virus docks in the ACE2 receptor, so there is local activation of some chemicals. It is an angiotensin converting receptor, which means it has a direct link to heart and diabetes, and the body’s metabolism. That is why they have a higher chance of getting a more severe disease, and the more severe the disease, the higher the chance of a patient passing away.”

Children, on the other hand, have an organ called thymus which makes T lymphocytes, and is the main organ which fights respiratory viral infection. “Children are born with protection to clear the virus,” Dr Joshi said.

Dr Om Shrivastav, a senior city-based consultant for infectious diseases, who was also part of Maharashtra government’s task force to formed in April to reduce the case fatality rate in the state, said, “The obvious reason is that as you get older, your immune system grows weaker, and that is the reason why you are not able to fight Covid. Immune systems in older patients behave in a more exhausted way. It is also due to co-morbidity and poor lifestyle. But it is not simply a matter of age and immunity, because there are younger people who have weak immune systems and older people who have strong immune systems.”

A senior civic official said, “Testing on time and reporting symptoms like cough or breathlessness on time is crucial, especially in older patients. BMC is doing door-to-door surveys to locate senior citizens with co-morbidity and low oxygen saturation, so they can be made aware about the risk they have from the illness, and receive medical help on time.”

So far, BMC has screened 874,275 senior citizens, and found 3,097 of them to have oxygen saturation less than 95. Of these, 5,036 senior citizens live in containment zones and five were found to have oxygen saturation less than 95.

Mumbai on Thursday recorded 1,350 new cases, and 30 deaths due to Covid-19. The total number of cases has gone up to 140,888 and the toll is 7,535. There are 19,463 active Covid-19 cases.

The case fatality ratio for Mumbai is 5.3%, and the discharge rate is 80%. Until August 25, Mumbai has done 725,519 tests, with a positivity of 18.9%.