The CDC just released data on COVID deaths in the US over the past year, and the results are both surprising, and not surprising. For this report, they looked at millions of patients hospitalized with COVID, analyzed the data and analyzed who really got sick, who died, and why. There were a few surprises that were rather unexpected, for which we don’t have a clear explanation, and some data that may provide some signals on what to look for to determine if a particular COVID case or phenotype was going to have a worse outcome.
The study was published in the policy journal Preventing chronic diseases, and is titled ‘Underlying Medical Conditions and Severe Illness Among 540,667 Adults Hospitalized With COVID-19 March 2020-March 2021.”
Among 4,899,447 hospitalized patients in PHD-SR, 540,667 (11.0%) were patients with COVID-19, of whom 94.9% had at least 1 documented underlying medical condition. Essential hypertension (50.4%), disorders of lipid metabolism (49.4%), and obesity (33.0%) were the most common. The strongest risk factors for death were obesity (adjusted risk ratio [aRR] = 1.30; 95% CI, 1.27-1.33), anxiety and fear-related disorders (aRR = 1.28; 95% CI, 1.25-1.31), and diabetes with complication (aRR = 1.26; 95% CI, 1.24-1.28), as well as the total number of conditions, with ARRs of death ranging from 1.53 (95% CI, 1.41-1.67) for patients with 1 condition to 3.82 (95% CI, 3.45-4.23) for patients with more than 10 conditions (compared with patients with no conditions).
If you were obese, you had a 30 percent higher risk of a negative outcome (meaning death). Next was anxiety and fear-related disorders accounting for a 28 percent increased chance of of death. This may come across as a bit strange, but critically ill patients often times must be given medication to address the anxiety and depression that inevitably accompanies a patient who has multiple comorbidities, and a high chance of mortality. It is said that if a patient has nine medical issues, the tenth will be anxiety or depression. So a medical code was created to capture this information, and is most likely what is responsible for this result. Diabetes was third with a 26 percent increased chance of death. The data also showed that besides these individual conditions and their impact on mortality, patients who had at least one condition had a 53 percent higher chance of dying than patients without any underlying conditions. However, those patients who had more than 10 conditions were almost four times more likely of dying. The table below shows the worst comorbidities in descending order of aRR.
Keep in mind that these conditions do not take into account the fact that if patients suddenly need to receive invasive mechanical ventilation (that is, go on a ventilator), that adds a 50 percent chance of mortality. What is somewhat surprising is the list of comorbidities that had a lower risk or a non-significant risk of death, IMV or ICU admission.
Diabetes without complication is a bit surprising, as is essential hypertension, which is basically a disruption in your vascular system (and COVID is largely a vascular disease in many respects). So, if you happen to have any of these lower risk conditions in the table above, you can breathe a bit easier. For those who may have some of the higher risk conditions, exercise more caution about contracting COVID in the first place. Post infection, doctors need to pay closer attention to cases with these signals for worse outcomes.
The table above shows an important data point: out of almost 5 million hospitalized patients considered in the study, only 740 (0.4 percent) died with no comorbidities. This means that patients could have been 80 years old with no comorbidities, and would have survived COVID. Moreover, a number of these 740 patients could have died of gunshot wounds, car accidents, etc. since anyone who dies within 28 days of a positive COVID test is classified as a COVID death. Yes, you read that right!
Continuing on, 2.6 percent of patients had one comorbidity, 32 percent had two to five morbidities, and 39 percent had six to ten comorbidities. A full two-thirds of all patients who died from COVID in this study had six or more comorbidities. In other words, these were fundamentally unhealthy people. That is a big takeaway – COVID kills the least healthy people.
Interestingly enough, 58.9 percent of patients who died were males. This was noted in China in the early days of the pandemic, and seems to be corroborated by the data here. There has been some studies done in Brazil using a drug called Proxolutamide, which is a male androgen blocking substance that inhibits the male testosterone pathway. It now seems Proxolutamide has a very strong protective effect in both men and women.
Again, the data here is suggesting that the more obese a patient is, the the worse the outcome with COVID. So, it seems natural that this should be a public health issue, as much as getting people vaccinated is. If you have a healthier, less obese population, with strong natural immunity, COVID mortality will be reduced significantly, according to the data. Unfortunately, obesity is currently being normalized in American fashion magazines and media, with the catchphrase being “obese, but healthy.” Not when it comes to COVID.
The next point of note is that there is an exponentially increasing chance of dying from COVID based on your age. For every 4.82 years (or 5.48 based on newer data) older you are, the chance of dying from COVID doubles. If you are under the age of 40, your chance of dying here is about 0.2 percent. If you are 85 years of age, and you have a case of COVID, your chance of dying around 30 percent.
In conclusion, the data collected here tells us that if we really cared about public health, the first thing we should do is to reduce obesity and improve overall health by reducing chronic diseases. You don’t want people with six, ten or more comorbidities if you can help it. Obesity levels have exploded in the past 30 years, and underlying chronic conditions like diabetes and diabetes with complications have steadily increased for several decades. This is a public health emergency! Our public health authorities should be beating the drum on the importance of healthy living, addressing obesity and combating other chronic diseases. They should be focusing on promoting proper nutrition and vitamin supplementation to boost natural immunity (such as vitamins C, D and Zinc), not just for the COVID pandemic, but for the next health crisis that is sure to come. Then we could ensure that vaccine risk benefit calculations are actually favorable and we use vaccines, and use them appropriately. They should be used in the most vulnerable populations where the risk-benefit analysis works. They should not be used in population where the risk-benefit analysis does not work, or in populations that have had a prior anaphylactic reaction to a vaccine, and would be harmed by an additional immune challenge. Simply put, the question of whether to vaccinate or not has never been a simple, clear-cut black and white issue. Medicine and human physiology varies. We know this. Risk factors are different, comorbidity sets are different. Outcomes are different. Let’s not be dogmatic automatons. Let’s look at the data responsibly and realize the data is always changing, and we have to adapt our strategies and understanding in a responsible manner.
Analysis by Dr. Chris Martenson