COVID-19 Why do some people get sicker than others from COVID-19? Who is more likely to get this disease? How can I avoid getting this disease? How can we treat this virus? These are questions that we are all asking ourselves. We are learning more every day about COVID-19 and how it is transmitted, how it enters our body and how our immune system responds to this virus. It is useful to divide COVID-19 into four stages: Prevention, Infection, Inflammation and Recovery. The best approach for affected individuals appears to be different for each phase. Prevention entails limiting your exposure to the virus through social distancing, hand hygiene, and the use of masks, where appropriate. The infective stage of COVID-19 involves the entry and replication of the virus. The body’s response to the infection triggers an inflammatory state, which results in tissue damage. Recovery fromCOVID-19 will vary depending on how sick you become from the disease. The typical time to recover is two to six weeks. It is longer for those who require ventilatory assistance. While all groups are affected by the COVID-19 pandemic, the elderly and those with underlyingmedical conditions are at the greatest risk. These are the individuals who typically have issues with their immune systems. While we can’t prevent aging, we can adhere to healthy living strategies that mitigate the effect of age and thereby enhance our immunity. Hypertension, diabetes and coronary disease are common conditions associated with an increased risk of COVID-19 infection and severe lung injury with worse outcomes. In one report, there was a 30% incidence of hypertension in COVID-affected patients. Diabetes is known to affect innate immunity. Innate immunity is the body’s first line of defence against infections, including COVID-19. Even short-term elevations of blood sugar have been shown to compromise innate immunity. Diabetes is also associated with an increased inflammatory response, which is part of the body’s later response to the infection. Regular physical activity throughout the day and moderate physical activity of 150 minutes per week have been shown to improve blood pressure control. Diabetes, sugar and lipid metabolism are also better controlled with regular, low-intensity activity. Sedentary lifestyles approximately double the risk for coronary heart disease.The medical conditions most commonly associated with COVID-19 can all be improved through physical activity. Obesity also appears to increase the severity of COVID-19 disease in affected individuals. Fat cells in obesity secrete pro-inflammatory substances, generating tissue damage as COVID-19 progresses from infection into the inflammatory stage. Any underlying medical condition associated with chronic inflammation can worsen the outcome of a COVID-19 infection. COVID-19 gains access to the body through the ACE 2 (angiotension converting enzyme 2) receptor, which appears to be a “docking station” for this virus. The ACE 2 receptor is present in both the heart and lungs and also plays an important role in the immune system. The role of ACE 2 is complicated, however, since the presence of ACE 2 is felt to be protective against lung injury despite it being an entry point for COVID-19. There is still much research being conducted to understand the role of ACE 2 in this disease. Can you reduce your COVID-19 risk by changing your health? by Dr. Susan Reicheld 36 | www.snowbirds.org
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