Nearly one in every five patients, or 17.9% of the people, with so-called comorbidities who contract the coronavirus disease (Covid-19) in India, succumb to the viral disease, according to the Union health ministry data. For patients with no underlying medical conditions, the corresponding proportion is 1.2%.
This means that people with comorbidities are 15 times more likely to die if infected by Sars-CoV-2, the virus that causes Covid-19, than those with no underlying conditions.
Comorbidity refers to the existence of multiple medical conditions in the same person. In the case of Covid-19, having conditions such hypertension, diabetes, heart, liver or kidney disease increases the risk of a patient developing a more severe form of the disease and of dying.
Although the findings about the higher case fatality rate (CFR) – the proportion of cases that end up in death – for people with comorbidities are largely in line with what scientists around the world have observed, this is the first time the government has released data showing the correlation between fatality and comorbidities in India.
In the US, the only country with more confirmed Covid-19 infections than India, a study by country’s federal agency Centers for Disease Control and Prevention (CDC) published in June showed that 19.5% people with underlying diseases died compared to 1.6% of those who were healthy — proportions that are strikingly similar to India’s.
The largest variance in the two groups (those with and without comorbidities) in India was reported among people above the age of 60 years where nearly a quarter (24.6%) of those with underlying conditions died against one in 20 patients (4.8%) with none. For those between 45 and 60 years of age, the CFR was 13.9% for patients with comorbidities against 1.5% for those without. Patients under the age of 45 years had the best CFR for both categories – 8.8% for those with underlying diseases and 0.2% for healthy individuals, the health ministry said during Tuesday’s weekly Covid-19 briefing.
Experts said comorbidities can heavily impede the recovery in Covid-19 patients. “Comorbid conditions such as heart, kidney or liver diseases or diabetes etc. majorly impede the recovery process in serious Covid-19 patients. It also takes longer for Covid-19 patients with underlying medical conditions to recover, especially those with uncontrolled disease,” said Dr Vikas Maurya, head of respiratory medicine and interventional pulmonology at Fortis Hospital.
The health ministry also provided fresh data on age- and gender-specific breakup of fatalities in the country. About 88% of Covid-19 deaths have been among those aged above 45 years, with those above 60 making up the biggest share of fatalities (53%). About 70% deaths have been of male patients, the health ministry added.