Reports and studies evaluating the Covid-19 outbreak data show that individuals with non-communicable diseases (NCDs), particularly cardiovascular diseases, cancer, diabetes, and chronic lung diseases, are at higher risk of Covid-19 infections and complications. Meanwhile, the burden of these four particular NCDs has been rapidly rising among low-income countries.
Several studies with evidence explain the link between Covid-19 and co-morbidities, most of which are NCDs and the associated mortality. Much of it is attributed to weaker immune system, caused either by old age, chronic diseases or drugs used to treat Covid-19 such as renin–angiotensin system blockers. In India, out of the total deaths, 70-80 per cent of deaths occurred in patients who were above the age of 60 years and were suffering from any chronic NCDs. Expounding on the same, the World NCD Federation has released a special issue of its official publication, International Journal of Non-Communicable Diseases (IJNCD), ‘Covid-19 and NCDs.’
The publication’s special issue includes an article highlighting the strategies required to address the co-morbidity of Covid-19 and NCDs. An article titled ‘Covid-19 and Non-Communicable Diseases: Impact and the strategic approaches’ by Professor J S Thakur of PGIMER elaborates on strategies including integration and convergence of the existing communicable and NCD programs, strengthening primary health care for universal health coverage, updating guidelines, enhancing surge capacity, and multi-sectoral participation.
A report by former WHO Executive Director Dr Jacob Kumaresan quoted that data indicate that people with NCDs are extremely susceptible to Covid-19 and its complications including death. His artcle, ‘Is the COVID-19 pandemic an opportunity to advance the global NCD agenda?’ emphasised that the focus on controlling the pandemic has led to delays in diagnosis, treatment, and management of NCDs. It stated that the pandemic has exposed the weaknesses of the health-care systems, exacerbated the inequalities within societies, and disproportionately affected the vulnerable groups.
An article by Dr Shanthi Mendis from Geneva Learning Foundation, Switzerland, described that cardiovascular manifestations of Covid-19 are complex. The article, ‘Managing diabetes and Covid-19: A national strategic framework’ by Dr V Mohan concluded that in people with both diabetes and Covid-19, the morbidity is greater and those older in age or with co-morbidities have significantly increased risk of mortality.
Among other reports, the article, ‘Problems of management of non-corona re spiratory diseases in the era of Covid-19’ by Professor SK Jindal of PGI and Head of Jindal Clinics, concluded that the management of respiratory diseases has suffered the most because of the clinical similarities between Covid-19 and non-Covid flu, respiratory allergies, pneumonias, and respiratory failure. Due to similarities, some patients tend to avoid seeking treatment lest they are diagnosed with Covid-19 infection. Meanwhile, diagnostic tests such as spirometry and invasive investigations (bronchoscopies and thoracostomies) are avoided by physicians for the fear of spread of infection. Moreover, patients with acute worsening of asthma and chronic obstructive pulmonary disease requiring nebulisation therapy are not even attended by medical facilities.
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