99% of Those Who Died from Virus Had Other Illness, Italy Says | Hacker News Reader

99% of Those Who Died from Virus Had Other Illness, Italy Says

bloomberg.com

88 pointskasperni32 comments

“Other illness” is extremely vague. Apparently having had a high blood pressure reading counts. What about sore knees? Migraines?

Edit: if you scroll down, you find info that is actually meaningful: a chart showing deaths by age. What this shows is that 90+% of people over 60 have had a doctors visit that turned up an issue.

It says in the article:

"More than 75% had high blood pressure, about 35% had diabetes and a third suffered from heart disease"

Which makes sense considering most of them were older people

Heart disease is undiagnosed diabetes

https://www.youtube.com/watch?v=UZoQiDaWnuE

That seems highly improbable to me. Can you give some data to back your assertion?

[Edit: I see you added a Youtube video, with no further information. No, I'm not going to go watch a no-further-information-given Youtube video to find out if your claim has a scientific basis, or if you're a quack. If it's real, it ought to be in text somewhere, with data.]

Diabetes mellitus is highly prevalent amongst patients with heart failure, especially those with heart failure and preserved ejection fraction (HFpEF), and patients with the two conditions have a higher risk of mortality compared with patients without diabetes or heart failure.[1–3] Diabetic patients have an increased risk of developing heart failure because of the abnormal cardiac handling of glucose and free fatty acids (FFAs), and because of the effect of the metabolic derangements of diabetes on the cardiovascular system.

A wealth of epidemiological evidence demonstrates that diabetes mellitus is independently associated with the risk of developing heart failure, with the risk increasing by more than twofold in men and by more than fivefold in women.[1–3,6]

Both population studies and clinical trials have demonstrated that diabetes mellitus significantly increases the risk of recurrent hospitalisations for heart failure and the duration of hospital stay in patients with heart failure, and it is associated with a significantly higher mortality compared with those without diabetes.[11]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5494155/

Cardiovascular disease remains the leading cause of death in women. Both obesity and diabetes mellitus are important independent risk factors for the development of cardiovascular disease. Obesity is the leading risk factor for type 2 diabetes. The Centers for Disease Control and Prevention report that 32% of white and 53% of black women are obese.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3066828/

OK. That's enough for me to buy that diabetes can (and often does) cause heart disease. It's even enough for me to buy that heart disease is often caused by undiagnosed diabetes.

But your initial statement was

> Heart disease is undiagnosed diabetes

What you have shown here is not enough for me to buy your initial statement.

> diabetes mellitus significantly increases the risk of recurrent hospitalisations for heart failure

I hadn't heard this - good to know!

However, the studies you cited do not seem to support your earlier statement:

> Heart disease is undiagnosed diabetes

Perhaps a qualification would fit better: deaths from heart disease may have been caused by undiagnosed diabetes.

I think headlines like these are extremely detrimental to the global fight of this virus.

Whether or not you're at risk (age, health problems, etc), you are a vehicle for transporting the virus and so while there is no need for "panic", it's both respectful and pragmatic to distance so that the virus can be contained.

Why? Shouldn't the truth be known? Wouldn't it be wise to know actual stats vs/ trying to hide the truth in order to propagate undue panic? Then discuss it, and options, as how to move forward with correct information vs/ guesses and/or rumors?

It's sad that this report was downvoted on a site (HN) that is supposed to be so analytical.

In a perfect world where everyone reacts rationally sure. However, the actual reaction to this information is that individuals deem themselves not a risk and go about their daily lives. Unfortunately they are endangering everyone who is at risk in the process.

Yeah, there's so much complexity here that a simple number could lead someone to miss.

So, 99% of those who died had another illness. Almost everyone has illnesses, so what kinds are we talking about?

A patient surviving doesn't mean the patient didn't need intensive medical care.

So you survived, are there any long-term symptoms you'll have to learn to live with?

I've also heard that (at least in some contexts) a "mild" case of COVID-19 is defined as one that didn't need breathing assistance. That's not the colloquial definition of "mild."

The article raising interesting points but there is still not enough information to make an evaluation. I'm more interested in some kind of quantification of how many years of life corona virus is taking from its victims. You could imagine a hypothetical grim reaper virus that kills you a day before you would otherwise die. This virus kills absolutely everybody in the country but it is probably not worth fighting unless it is super cheap to do so.

Exactly. In this study of 207 infected patients, the chief complaint of 99 people during admission to the ER was GI distress. How many people have not sought help because they only have GI issues?

https://journals.lww.com/ajg/Documents/COVID_Digestive_Sympt...

That is an interesting study but your summary isn't accurate. Over half of those digestive symptoms are anorexia not what would usually be called GI distress. 41 of the 99 with digestive symptoms had more specific GI issues, mostly diarrhea. Only 7 of the 99 had no respiratory symptoms and they did not say if any had only digestive symptoms.

Instead of correlating outcomes by age because age is so easy to measure, it would be more useful to correlate them by comorbidity since that seems more relevant. And might provide some slight peace of mind to fit and healthy 65 year olds.

About 90% of the general population have "other" illnesses.

A third of the US population suffers from high blood pressure [1]. More than 100 million U.S. adults are now living with diabetes or prediabetes [2]. About 15 million Americans have cancer of some sort [3]. About 10 million people are immunocompromised or immunosuppressed [4]. So, you're not wrong! The high risk factor cohort is enormous, and the more risk factors you have, the higher your risk of death is (based on data coming out of Italy). A lot of folks are going to die from ailments they had and knew about, or ailments they had but didn't know about.

[1] https://www.cdc.gov/bloodpressure/facts.htm

[2] https://www.cdc.gov/media/releases/2017/p0718-diabetes-repor...

[3] https://seer.cancer.gov/statfacts/html/all.html

[4] https://www.google.com/search?q=americans+immunocompromised

Point being is it is much of the danger can be attributed to being in poorer health to start with. JUST LIKE EVERY OTHER PATHOGEN.

That might be the case, but they are certainly not older than 80.

Most people dying from AIDS die from other illnesses. If something new pulls the bodily systems down across the board by viral replication, dying cells and lack of oxygen there will always be a place that is a weak spot which gives.

With AIDS attacking the immune system, this is an patently bad example.

Multiple reports now mention this "high blood pressure" criteria. What this means more exactly? Elevated (above 120/80) also counts as high?

I also saw a report showing a co-morbidity with tobacco smokers. I'll see if I can find it.

This makes sense seeing that cigarette smoke damages lungs.

I haven’t been able to find a good description, but I suspect it means there is a known history of high bp (which indeed is usually defined as you wrote)

However, there is confounding issue of bp medicine - there was a lancer article about ibuprofen and some kinds of bp medicine causing increased ACE2 expression, which is suspected to increase susceptibility to sarscov2 and worsen covid symptoms.

So, it could be that the blood pressure isn’t actually the risk factor, but treatments for it. Will take time to tell

The official position of the european cardiology association is that claims that BP medicine can increase suceptibility and worsen symptoms is basically FUD: https://www.escardio.org/Councils/Council-on-Hypertension-(C...

It is strongly suggested to keep taking your BP medication.

A bonus also lies in that link: there is evidence from studies in animals suggesting that these medications might be rather protective against serious lung complications in patients with COVID-19 infection, but to date there is no data in humans.

The mechanism of protective action is explained by this comment on HN: https://news.ycombinator.com/item?id=22505537

While the theory of ACE inhibitors/blockers making covid-19 worse is basically based upon the presumption that due to inhibition/blocking of angiotensin receptors, the body upregulates by creating more ACE receptors, to which the virus can bind.

This is not only interesting but also extremely important given th fact that a large part of population has bp higher than normal, and some of these people regularly take ACE inhibitors. So far some doctors ask patients to switch to another type of bp-lowering medicine:

https://www.thelancet.com/pdfs/journals/lanres/PIIS2213-2600...

whereas others do not:

https://www.medscape.com/viewarticle/926838

Many hospitals in China and Italy have already enough data to make a better judgement on this.

This doesn't mean that many of those who were younger and without pre-existing illnesses weren't in a serious condition and in danger of dying, just that, with the help of intensive care, they were able to survive.

If and when heath services become completely overwhelmed and there are no longer enough hospital bed/ventilators/doctors and nurses to provide the assistance they need, then we'll likely see a lot of younger and otherwise healthy people start to die as well.

It's that the opposite of what they are saying. In a situation where you just described when the system in italy was very openly overwhelmed young people not only didn't die there's very little evidence they got sick, to begin with

Hope you are correct!

Was this due to triage where resources were focused on younger people with complications as the medical professionals felt that it was a better use of limited resources?

Same as with influenza.

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