The race is on to find a cure for COVID-19, the novel coronavirus leaving a path of destruction behind it. In addition to killing thousands around the World, the economic destruction it’s left behind is shocking.

But that’s not the only shocking thing about COVID-19. It’s humble beginnings in Wuhan, China seemed innocent enough. Being an infection of the lower respiratory tract, it originally targeted older men. And in that area, a lot of older men smoke.

Unfortunately, the death rate in China seems high at 2.3%. It seems high because we have no idea of the prevalence of the disease. As a result, the numbers may be fuzzy.

Many believe asymptomatic carriers may be the primary mode of spread, and these people have no idea they even have it. Therefore, the prevalence may be higher making the death rate much, much lower.

Then it hit Italy, and spread like wildfire. Consequently, it completely incapacitated their healthcare system. As a result, they make tough decisions every day on who gets treatment and who doesn’t. The death rate in Italy is much higher at 7.2%. Again, this may be much lower.

Then, late last week they released some statistics on who was dying. And that data may be the most shocking thing of all.

COVID-19: What’s killing people?

The age spread in Italy really isn’t surprising at all. Because they have an older population, the disease hit them harder. The average age of those infected with COVID-19 is 63 years old. The average age of those who died: 80 years old. Below is the prevalence of death from COVID-19 by age group:

This isn’t surprising. But let’s take a look at those who are dying. Is anything other than age contributing to the problem? Do they have other diseases or conditions that make them more likely to die from COVID-19?

Looking at this data, a clear picture emerges. Of those who died from COVID-19 infection, 98.8% had at least one comorbidity. Nearly half had 3 or more, while 75% had 2 or more.

But let’s look at those comorbidities in order from most prevalent to least:

• Hypertension 73.8%
• Diabetes 33.9%
• Ischemic heart disease 30.1%
• Atrial fibrillation 22.0%
• Chronic renal failure 20.2%
• Active Cancer in the past 5 yrs 19.5%
• COPD 13.7%
• Dementia 11.9%
• Stroke 11.2%
• Chronic liver disease 3.7%

I bolded the one that should immediately grab your attention: COPD. Chronic Obstructive Pulmonary Disease(COPD) is a group of chronic and progressive inflammatory lung diseases that include emphysema and chronic bronchitis. Smoking is the leading cause of COPD.

How can COPD be the 7th leading comorbidity? It’s a chronic inflammatory lung condition, wouldn’t it be first since COVID-19 attacks the lungs.

Instead, hypertension leads the way(5.5x higher risk) followed by diabetes(2.5x greater risk) and cardiovascular disease(2x risk). And in China it was pretty much the same.

Are chronic systemic inflammatory conditions worse for COVID-19 outcomes than lung damage caused by smoking? Smoking does increase your risk for those conditions as well.

Metabolic syndrome would be downright scary, and the biggest threat to Americans from the virus.

COVID-19 in the land of the free, home of the Metabolic Syndrome

Metabolic Syndrome is a group of symptoms that cluster together to increase the risk of cardiovascular disease, type 2 diabetes and stroke. They include:

• Hypertension
• Central adiposity
• Fasting glucose >100mg/dL
• Triglycerides >150mg/dL
• HDL cholesterol <40mg/dL

People have metabolic syndrome when they have 3 or more of these symptoms. As you can tell, it’s essentially a carbon copy of the comorbidities list from Italy. Most noteworthy, multiple comorbidities drove up the risk in Italy.

A recent study found that only 12% of Americans have none of these problems. Furthermore, only 49.6% met the blood pressure criteria, meaning that more than 50% are walking around with hypertension.

Due to poor metabolic health, Americans may be in for a rude awakening Unfortunately, this is not reported in the press. Americans and the press hyper-focus on age as the only risk factor. As a result, the young initially ignored it.

But metabolic dysfunction doesn’t discriminate based on age. Young people get hypertension too, and obesity and type 2 diabetes prevalence is exploding as well. Consequently, we will see younger people with more severe cases.

While Italy has us beat on age, the US has cornered the market on obesity, type 2 diabetes, and cardiovascular disease.

Your best weapons in the battle against COVID-19

Looking at the data from Italy, it’s clear that irrespective of age, poor metabolic health is what’s likely to kill you. Only 1.2% of the people who died of COVID-19 had 0 comorbidities. Because we can’t change our age, that’s fantastic news.

Therefore, it’s crucial that the focus goes towards improving overall health. Every one of those conditions is driven in large part by poor lifestyle. Thus, good lifestyle habits decrease the risk of severe outcomes from COVID-19 by decreasing metabolic dysfunction.

This means you should:

• Optimize circadian rhythms (Circadian disruption causes metabolic syndrome)
• Maintain a healthy weight
• Go for walks, be physically active
• Exercise
• Go outdoors (UVA light from the Sun lowers blood pressure)
• Eat a healthy diet
• Prioritize sleep/have good sleep hygiene
• Manage stress

Make these habits a part of your daily life and you’ll not only reduce your risk for severe COVID-19 infection, you’ll feel great too.

Conclusion

COVID-19 is highly contagious and can be deadly for some. Because of it’s early prevalence primarily in older people, young people felt mostly spared. Unfortunately, the data coming out of both China and Italy tell a different story.

Rather than being discriminatory based on age, it appears COVID-19 targets the metabolically unhealthy. While older people are at a higher risk for fitting that criteria, the poor metabolic health of Americans young and old should be a wake up call.

Luckily there’s a lot people can do. Whether people are willing to do it is another story. For most, it requires completely changing their lifestyle and the way they approach health. But if you’re willing to put in the work, it’s well within your grasp.