ICMR answers common questions regarding comorbidity and COVID-19 infection

Experts have always stated that the prevalence of comorbidities in the COVID-19 patients has been one of the major risk factors for them and is capable of developing life-threatening situations. The comorbid individuals must adopt the vigilant preventive measure and require scrupulous management. The Indian Council of Medical Research, the apex body in India for the formulation, coordination and promotion of biomedical research, has answered some of the common questions regarding comorbidities and Covid-19 infection.

Some of the answers are as follows:

Are patients with heart disease, diabetes or hypertension at increased risk to get coronavirus infection? 

No, people with hypertension, diabetes or heart diseases are at no greater risk of getting the infection than anyone else. 

Among people with the above diseases is there an increased risk of severe illness or complications once infected? 

The majority (80%) of people diagnosed with COVID-19 will have mild symptoms of a respiratory infection (fever, sore throat, cough) and make full recovery. Some of the people with diabetes, hypertension and heart diseases including Heart Failure (weak heart) may develop more severe symptoms and complications. Therefore, extra care is advised for these patients. 

Are people with diabetes more prone to COVID-19? 

In general, you know that people with uncontrolled diabetes are at increased risk of all infections. People with diabetes are not at higher risk for acquiring the infection, but some individuals are prone to more severe disease and poorer outcomes once infected. Hence, follow your diet and exercise routine (to the extent possible), take your medications regularly and test your sugar levels frequently so as to keep your diabetes under control. When diabetic patients become sick, they may require frequent monitoring of blood glucose and adjustment of drugs including insulin, small frequent meals and adequate fluids.

What about reports of BP medications increasing the severity of COVID-19? 

After review of available information, the consensus of various scientific societies and expert group of cardiologists is that currently there is no evidence that the two group of drugs- ACE inhibitors (eg. Ramipril, Enalapril and so on ) and angiotensin receptor blockers (ARBs) (eg. Losartan, Telmisartan and so on) increase the susceptibility or severity of COVID-19. These drugs are very effective for heart failure by supporting your heart function and controlling high blood pressure. It may be harmful to stop these medications by yourself. This can worsen your heart condition.

What can I take for pain or fever? 

Some types of painkillers (called NSAIDs) like Ibuprofen are found to worsen the COVID-19. Such drugs are known to be harmful to heart failure patients and may increase your risk of kidney damage. Avoid NSAIDs or take them only when prescribed by your doctor. Paracetamol is one of the safest pain killers to use if needed.

What should I do if I get symptoms suggestive of COVID-19? 

  1. If you have symptoms suggestive of COVID-19, call your doctor and seek advice on the phone. 
  2. Contact nearby COVID-19 testing laboratories and arrange for testing
  3. While awaiting test results, stay at home and avoid close contact with family members, maintain hand hygiene, and correctly wear a medical mask
  4. If you test positive for COVID-19, isolate yourself at home as per the guidelines issued by the Ministry of Health and Family Welfare, India 
  5. If there is worsening of your symptoms, contact your doctor for further advice 

What should you do to prevent COVID19? 

Covid-19 is spread by coughs and sneezes, through what are called droplets ( tiny amount saliva or other secretions expressed through cough/sneezing or even after a hearty laugh) and through touch. When you touch an object that has virus particles on it, the virus may get onto your hands and when you touch your face, you may get infected. Virus particles can persist up to 3 days and therefore it is important to maintain the hygiene of your surroundings. Wash the rooms, tables and other surfaces with floor cleaners or even a simple soap solution and sanitize your hands with hand sanitisers or by washing when you touch unknown or suspicious surfaces.

What are the important steps you can do to prevent acquiring or spreading infection?

  1. Wear a mask – most important for the protection of healthy people and to prevent transmission 
  • Wear a medical mask in crowded areas and in poorly ventilated rooms. Make it a routine part of being around other people 
  • The mask should cover your nose, mouth and chin 
  • Avoid touching the mask frequently 
  • Maintain a physical distance of at least 1 metre even while wearing a mask 
  • Wear a mask if a visitor comes to your home who is not a member of your household 
  • Clean your hands before and after using a mask, and before touching it while still in use 
  • Change the mask if it is soiled or wet, and dispose of properly in a trash bin 
  1. Social distancing
  • Avoid contact with someone who shows symptoms of possible COVID-19 – anyone having a cold or cough or fever 
  • Avoid non-essential travel and use of public transport 
  • Avoid public places, crowds and large family get-togethers. Keep in touch with friends and relatives using phone, the internet, and social media 
  • Avoid routine visits to hospitals / Labs. For minor problems, contact the hospital or HF clinic by phone if possible. If you are regularly checking INR and adjusting blood-thinning medicines, please contact the doctor over the phone if possible and try and avoid a hospital as much as possible

3. Hand hygiene 

  • Avoid handshakes and touching face with hands 
  • Wash your hands with soap and water frequently – do this for at least 20-30 seconds and systematically clean all parts of the hand 
  • Alcohol-based hand-sanitisers are also useful 
  • Avoid touching possibly contaminated areas/objects – Public toilet doors, door handles etc

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