Some COVID risk factors may surprise you. Why psoriasis and ADHD can boost the threat. – NJ.com

By now, most of us know the major risk factors that increase the odds of a life-threatening case of COVID-19.

Obesity. Lung and heart disease. Being over 65.

And while those factors are among the conditions front-line health care providers have reported seeing in high numbers among intensive care patients during the pandemic, there are many lesser-known threats that make people vulnerable, experts say.

They range from the logical (smoking, including those who quit years earlier) to the curious (stroke, pregnancy and kidney disease) to the surprising (rheumatoid arthritis, psoriasis, Alzheimers and a wide range of mental health conditions).

About four in 10 U.S. adults 92.6 million people have a higher risk of developing serious illness if they become infected with the coronavirus due to a health condition or their age, according to a 2020 Kaiser Family Foundation analysis. More than 41 million alone are at risk due to an underlying medical condition.

Many of them might be taking medication that weakens their immune system, said Dr. Jonathan Shammash, an internal medicine specialist at Hackensack University Medical Centers COVID-19 Recovery Center.

Medications like corticosteroids can create a risk factor, Shammash said. Immune-modulating medicines can target aspects of our immune system. There are so many of these medications.

Patients with chronic illnesses such as rheumatoid arthritis or psoriasis, aside from the medications they may take which may affect the immune system, we also have the issue of the disease itself and how its affecting the immune function.

The Centers for Disease Control and Prevention says the impact of medications such as corticosteroids which include cortisone and prednisone on the immune system depends on the dose and length of time theyre taken.

While the highly contagious omicron variant that swept through New Jersey in December and January was thought of as a milder strain, it was lethal for thousands of residents, especially the immunocompromised and those with multiple underlying comorbidities.

New Jersey reported 2,380 confirmed coronavirus deaths in January, the highest monthly total since May 2020 during the first wave of the pandemic. And through the first 17 days of February, the state has announced another 1,188.

But the Garden States seven-day average for confirmed daily positive tests continues to fall.

Here are some additional risk factors that make a case of COVID-19 even more dangerous.

Pregnant women face an increased risk of severe COVID-19 as well as complications in childbirth, such as preterm deliveries or stillborn babies, according to CDC data released last fall.

Disturbing in its own right, the coronavirus is even a threat to some women after pregnancy.

Nationwide, nearly 160,000 pregnant women have been infected since the onset of the pandemic in early 2020 26,672 have been hospitalized and 259 died, according to the CDC. Deaths reached a peak in August, September and October 2021, when delta was the dominant variant.

During pregnancy, a womans immune system shifts to protect the fetus including preventing the mothers body from rejecting or attacking it. That pivot can make the mother-to-be less able to fight off a virus.

That elevated threat remains even after childbirth, the CDC says. Certain underlying medical conditions and other factors, including age can increase the risk for developing severe COVID-19 illness just following or even weeks after the end of a pregnancy.

One of the more unusual underlying risk factors is the broad umbrella of mental illness.

Examples range from attention-deficit/hyperactivity disorder (ADHD) and mood disorders to schizophrenia, according to the CDC.

Such conditions can make you more likely to get very sick from COVID-19, the national health agency reports.

COVID-19 patients with mental illness were almost two times as likely to die as other coronavirus patients, according to a study last year in JAMA Psychiatry. Those with severe mental illness such as schizophrenia had an even greater chance of dying from COVID-related illness.

One explanation, experts say, is that people with mental illness often have other underlying conditions, perhaps because of their health habits such as a poor diet and lack of exercise as well as difficulty accessing medical care.

Theyre at higher risk of getting infected, higher risk of being hospitalized and higher risk of dying from COVID, said Dr. Annette C. Reboli, an epidemiologist and dean of Cooper Medical School of Rowan University. One of the things about mental illness that lends itself to a higher risk is first and foremost mental illness can change behavior. People may be less likely to protect themselves against infection.

They may be more fearful of getting a vaccine. They may be suspicious of a vaccine. They may be more likely to go out and about without a mask or less likely to pursue other protective measures.

The reasons are as varied as they are complex because of the myriad conditions mental illness covers, Reboli said.

So, if someone has attention deficit disorder, they may just forget to use the mask because they get distracted, Reboli said. There is other data that shows that those who have chronic mental illness have a shortened lifespan compared to the general population, maybe because theres an element of medical neglect, lack of access to health care.

There are also studies that found a relationship between state of mind [and] stress and the bodys ability to fight infection, she noted.

Many studies show that any type of stress affects our immunological response and causes inflammation, Reboli said.

You stopped smoking? Kicked the habit for your health?

Thats great. Just one thing: Even being a former smoker can make you more vulnerable to a severe case of COVID-19, the CDC says.

Health experts say smoking often leads to lung problems and chronic inflammation that affects blood vessels, which in turn increases the likelihood of becoming seriously ill with COVID-19.

Some studies indicate that smoking in and of itself, without an underlying medical condition, is not a risk factor, Reboli said.

Smoking can affect not only the lungs, but also your cardiovascular health, she said. Those smokers are at higher risk for a heart attack and things like that.

Health experts say people with high-risk factors can reduce their odds of severe illness if they get fully vaccinated. Some may need a fourth shot, or second booster, they add.

Its important for those who have these risk factors, even if theres only a moderate association with high risk, to go get the vaccine, Reboli stressed. Really, everybody who is eligible should get the vaccine.

But its especially important if you have a risk factor. The vaccines have been shown to prevent bad outcomes hospitalizations, ICU usage and death.

CDC spokeswoman Kanta Sircar, an epidemiologist, said scientists are trying to understand how different coronavirus variants affect the body, and whether some underlying medical conditions pose higher risks with one variant but not another.

Theres still so much we need to understand about COVID, Sircar said.

People with underlying conditions should talk to their doctor about how to best protect themselves against the coronavirus and avoid serious symptoms.

Your health care provider knows best about your current situation if you have more than one underlying condition and if you take different medications, Sircar said. They can work with you to get your condition under control. Then they can help you or work with you to make sure, if youre a patient whos immunocompromised, that you get not only your regular vaccines, but a booster and an extra booster.

Gov. Phil Murphy says 49% of eligible New Jersey residents still have not received a vaccine booster shot, and announced a new push Wednesday to encourage people to get the extra jab during his latest coronavirus briefing in Trenton.

Murphy said cases of the omicron variant are plummeting. He recently announced plans to lift mask mandates for schools and childcare centers next month.

Our numbers are clearly headed dramatically in the right direction, Murphy said.

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NJ Advance Media staff writers Steven Rodas and Brent Johnson contributed to this report.

Original post:
Some COVID risk factors may surprise you. Why psoriasis and ADHD can boost the threat. - NJ.com