Impact of COVID-19 and comorbidities on health and economics: Focus on developing countries and India

Abstract

Background and aims Presence of comorbidities in patients with Coronavirus disease 2019 (COVID-19) have often been associated with increased in-hospital complications and mortality. Intriguingly, several developed countries with a higher quality of life have relatively higher mortality with COVID-19, compared to the middle- or low-income countries. Moreover, certain ethnic groups have shown a higher predilection to contract COVID-19, with heightened mortality. We sought to review the available literature with regards to impact of COVID-19 and comorbidities on the health and economics, especially in context to the developing countries including India. Methods A Boolean search was carried out in PubMed, MedRxiv and Google Scholar databases up till August 23, 2020 using the specific keywords, to find the prevalence of comorbidities and its outcome in patients with COVID-19. Results All available evidence consistently suggests that presence of comorbidities is associated with a poor outcome in patients with COVID-19. Diabetes prevalence is highest in Indian COVID-19 patients, compared to other countries. Majority of the patients with COVID-19 are asymptomatic ranging from 26 to 76%. Conclusions Universal masking is the need of hour during unlock period. Low-income countries such as India, Brazil and Africa with less resources and an average socio-economic background, must adopt a strict policy for an affordable testing programs to trace, test, identify and home quarantine of asymptomatic cases. Despite the huge number of COVID-19 patients, India still has low volume research at the moment.

Relationship between physical and mental health comorbidities and COVID-19 positivity, hospitalization, and mortality

“…For example, in a retrospective cohort study in China, individuals with kidney and cardiovascular disease were shown to have worse prognoses for their COVID-19 infections compared to those without pre-existing conditions ( Zhou et al., 2020 ). In Brazil, individuals with pre-existing conditions who screened positive for COVID-19, had 8.9 times higher risk for mortality compared to those without pre-existing conditions ( Sousa et al., 2020 ) with similar findings shown in the US ( Harrison et al., 2020 ) and across other countries ( Singh and Misra, 2020 ).…”

Perspectives About Modulating Host Immune System in Targeting SARS-CoV-2 in India

“…Sporadic studies from different Indian states/cities such as West Bengal and Jaipur revealed association of one or more co-morbid conditions with deaths in COVID-19 patients. Computational analysis based on Boolean search highlighted diabetes as the most prevalent co-morbidity in Indian COVID-19 patients, followed by hypertension ( Singh and Misra, 2020 ). Co-morbidities in COVID-19 patients result in increased medical complications, incidence of hospitalization and high mortality rate.…”

Application of Telemedicine in Diabetes Care: The Time is Now

“…People with diabetes, specifically those with poor glycemic control [ 1 ], have been identified as a risk cohort that needs to be particularly protected from infectious diseases such as seasonal flu and COVID19. Data provided by NHS England reveal that one-third of the COVID19 deaths in the United Kingdom are associated with diabetes, that patients with type 1 and type 2 diabetes have a 3.5-fold and twofold higher risk of dying from COVID19, respectively, and that this enhanced risk can be attributed to diabetes-related vascular comorbidities [ 2 , 3 ].…”