心脏病和糖尿病患者需要了解的COVID-19风险

你可能听说过慢性疾病会增加你患COVID-19并发症甚至死亡的风险。但这对有这些症状的人来说意味着什么呢？

We talked to the experts to find out why pre-existing conditions up your risk and what exactly you can do to stay safe and healthy.

The three most common underlying health problems associated with more serious complications from COVID-19 were cardiovascular disease,diabetes以及慢性肺病疾病控制和预防中心(CDC). Hospitalizations were six times higher and the risk of death was 12 times higher in people who had these conditions.

Other research has shown a similar relationship. Forty percent of deaths from COVID-19 are related to complications of the cardiovascular system, according to a May 2020 study inCirculation Research. 而且，根据2020年6月的一项研究，糖尿病与不良后果增加2到3倍有关Journal of Diabetes Investigation.

这些数据指出了这些健康状况和与COVID-19相关的更严重后果之间的联系。

“很多这些危险因素和疾病集群together," says杜安平托，医学博士，公共卫生硕士，一位心脏病专家，在贝彻以色列专业医疗中心。“我们真的不知道它是否是那些人之一或所有这些都在一起的东西，这是在一起的阴谋和导致坏结果。”

“先天性疾病不会增加你感染病毒的几率。”

But researchers are starting to tease apart some of the differences.

Panagis Galiatsatos, MD,an assistant professor at Johns Hopkins School of Medicine, recently completed a meta-analysis of 119 previously published reports to examine the relationships between pre-existing conditions and COVID-19 outcomes. The study hasn't been published yet, but it found that pre-existing conditions are an independent risk factor for worse outcomes for COVID-19. "It's not because patients are older. Age is an independent variable and so is having diabetes," Dr. Galiatsatos tells LIVESTRONG.com.

一个健康的人比患有心脏病或糖尿病的人生活得更好并不奇怪。尽管如此，医生们还不清楚为什么会出现这种情况——尽管似乎有三个主要因素在起作用。

Underlying health conditions have always been risk factors for infections and worse symptoms. "This isn't new to COVID-19," Dr. Galiatsatos says.

例如，糖尿病是一种影响身体多个器官和系统的疾病，包括免疫系统,which may contribute to more severe COVID-19 symptoms. Poor blood sugar control, a common symptom of those diagnosed with diabetes, negatively affects the way your immune system functions, increases inflammation and makes it harder for your body to clear viruses from your system, too, per the June 2020Journal of Diabetes Investigation学习。

If you have a pre-existing condition, you might have less reserve to deal with what can be quite a severe illness, Dr. Pinto says. With no pre-existing conditions, you would fight COVID-19 on one front. "But if you have heart disease, kidney disease, a pre-existing lung condition, then you're fighting on three or four fronts at the same time," Dr. Pinto says.

“许多与COVID-19相关的并发症都与血管有关，”尤其是高血压，医学博士，Brigham and Women's Hospital的心血管医学专家、哈佛医学院的mallinkrodt医学教授说。High blood pressureis associated with a greater likelihood of hardening of the arteries.

利比博士说，如果你有正常的动脉为心脏提供氧气和营养，你的心脏就可以很好地处理它。但他说，如果你有潜在的健康状况，比如高血压，你的心脏需要更用力地泵血，以增加输出量，并将血液输送到饥饿的组织中。换言之，你的心血管系统可能不足以对感染作出反应。

而血管内壁受损也会导致免疫系统反应过度活跃，即细胞因子风暴，以及人体凝血机制出现问题，使你更容易出现血栓。

最后，由于获得医疗保健和其他社会经济因素的差异，患有预先存在的条件的患者可能总体而言。“没有良好地获得医疗保健，社会经济地位，糖尿病和过早的心脏病在一起，”Pinto博士说。“他们可能没有能力采取自己。这些是在ICU中可能超越的人。”

If you have a pre-existing condition, the best way to fight the virus that leads to COVID-19 is to avoiding catching it in the first place. "Pre-existing conditions don't raise your chances of catching the virus," Dr. Galiatsatos says. "Your susceptibility depends on how well you re-engineer your lifestyle."

Without a vaccine or anti-viral treatment, strategies that minimize your chances of becoming infected are even more important if you have a pre-existing condition —洗手，保持社会距离and wear a mask.

不需要医用口罩。”Cloth masks或者遮盖物可以在很大程度上保护你可能接触到的人，”利比博士说。

Limit how much you are around others, and avoid going places where it won't be possible to socially distance from others, per the疾病预防控制中心.

"If you're going to a place where face masks are optional, do not go. Face masks are highly effective for an individual only if everyone around them is also wearing a face mask," Dr. Galiatsatos says. "To stay safe, it's going to take changes to your own behavior and a strong reliance on others to do the right thing."

别忘了保持你的病情治疗。对于患有糖尿病的个体，继续监测血糖水平并跟上您的治疗计划。对于具有高血压的人，不要跳过你的药物。

考虑到你的日常活动和采取什么样的预防措施是一个困难的计算，尤其是在没有很多COVID-19感染的地方。与支付账单和照顾家人的具体需要相比，感染的风险更具理论意义。请记住以下因素：

Consider your decision of what to do and not do, Dr. Pinto says, in context of your personal situation — what is your personal risk, what are your chances of contracting the virus and if you were to become infected, what would happen?

“这些预先存在的条件的人应该自我选择他们疾病的严重程度，”Pinto博士说。例如，如果您已经管理了20年的心脏病并进行了先前的心脏病发作，那么与被治疗和治愈心脏病疾病的人相比，您需要更加警惕。

你的医生可以帮助你评估不同活动的风险。

考虑您的社区发生了什么。Pinto博士建议，如果可能的话，延迟差事，约会，直到感染，才会导致衰退。如果感染在您的社区中飙升，只会在胁迫下恢复活动，如果发生紧急情况，因为您的后果可能是如此可怕，“他说。

Assimilating back into public life also means expanding your social circle.

Galiatsatos博士建议您在与他们联系之前与人交谈。“这真的很艰难，但如果你想和朋友一起出去玩，并且知道他或她没有得到指导，你可能想要坚持缩放或面部，”他说。

The same goes for重返工作岗位. 和你的雇主谈谈将采取哪些预防措施。如果你真的要回去工作，那就清洁你的工作空间，并定期洗手。

没有一刀切的答案。告诉你的医生什么预防措施对你有意义，你的生活方式和你的需要。