25% to 50% of people who reported to hospitals in China with coronavirus in December 2019, had hypertension or other comorbidities like diabetes, cancer, or heart conditions. In Italy, 75% of COVID-related deaths included hypertensives. Hypertension and severe COVID symptoms have a genetic connection. But how interlinked are they? Read on to find out more!
Introduction
The clinical and epidemiological features of COVID-19 have been under constant study and several research studies have been published about it over the last several weeks.
A lot of focus is on the comorbidities that have an association with COVID, in particular.
The most common comorbidities in one report were hypertension (30%), diabetes (19%), and coronary heart disease (8%).
ACE inhibitors, which are used to treat hypertension, have been researched to increase the ACE2 receptor expression, to which the coronavirus binds to.
But, it is important to note that none of these can be declared as a 'cause' of COVID since these are more prevalent in the elders, who appear to be at an increased risk for COVID.
However, blood pressure control is extremely important to reduce the impact of COVID in your body.
Genetics and COVID
The coronavirus appears to affect any individual despite factors like their age or gender.
However, recent research reveals that some people tend to have more severe symptoms, in comparison to others who may experience mild symptoms or be completely asymptomatic.
Some genetic factors tend to influence how the virus enters your body, and consequently, how the virus affects you as well.
Hypertension - A risk factor for COVID?
There is a wide acceptance amongst the scientific community that there is a genetic risk factor that causes severe symptoms in some individuals, while rendering other asymptomatic.
One such disease that scientists have researched is hypertension.
The limited studies on this reveal that the novel coronavirus latches on to the human protein ACE2 receptors and gains entry into the lungs.
Hypertensive individuals are prescribed Angiotensin-Converting Enzyme(ACE) inhibitors, and some studies have shown that these medications increase the number of ACE receptors, thereby increasing the portals for entry of the virus.
There are, however, opposing theories with a few groups of scientists saying that the ACE2 can actually protect the lungs from a very severe infection of 2019- nCov.
Genetics’ play in hypertension
A very common health condition that is prevalent today is hypertension or abnormally high blood pressure.
A blood pressure level of 120/80mm Hg is considered normal, and having blood pressure equal to or higher than 130/80 mm Hg is called hypertension, in an otherwise healthy individual.
Though a common condition today, hypertension runs in families, and therefore, genetics and heredity may play a major role in determining the disease risk.
Individuals who have hypertensive parents tend to have an increased risk of developing the condition. However, how the exact inheritance of this condition is still unknown.
Many Genome-Wide studies have been conducted to study the influence of genes on the development of hypertension.
Around 280 genetic variants have been found that are said to increase the risk of hypertension and other associated conditions such as coronary artery disease.
Hypertension and COVID: Reducing your risk using 23andMe DNA data
Some genes that have a significant role to play in the development of hypertension are –
- ACE
- ADD1
- CYP1 1B2
With the currently available studies, it has been observed that there are many genes that play a role in the pathophysiology of hypertension. It is highly unlikely that just one or two will emerge as the leading genes associated with the condition.
Now it is as simple as just following 3 simple steps to identify your risk for hypertension using your DNA raw data.
Signs to look out for to check for COVID when you have hypertension
So far, it is quite evident that hypertension is high-risk comorbidity that results in severe symptoms if affected by COVID.
Pneumonia is one of the most common complications in severe cases.
In a hypertensive individual, high blood pressure damages the blood vessels and arteries. Therefore, it results in reduced blood flow to the heart.
As a result, your heart needs to work extra hard to pump blood, so it reaches all parts of your body.
When this happens over a period of time, it results in the weakening of the heart muscles.
The same effect can occur when there is hypercholesterinemia occurs together with hypertension.
Most common symptoms to look out for if you suspect a COVID infection include:
- Fever
- Dry cough
- Tiredness
- Breathing difficulty and shortness of breath
- Chest pain
- Restlessness
- Decreased immunity
- Reduced kidney function
Tips for managing your blood pressure to reduce your risk for COVID
As a hypertensive individual, you need to take extra care to reduce your chances of contracting COVID. Here are some guidelines that you need to follow:
- Stay indoors as much as possible and avoid crowded places
- Maintain social distancing
- Limit or avoid contact with sick individuals
- Avoid touching your eyes, nose, and face
- Wash your hands with soap and water for at least 20 seconds when you return home from outdoors
- Always use a facemask when amongst people
- DO NOT STOP taking your hypertension medications
- Avoid non-essential travel and short trips
- Monitor your blood pressure levels daily
- Eat a healthy diet
- Reduce your stress levels by practicing yoga or other forms of indoor physical activity
- Clean and disinfect surfaces like doorknobs, countertops, etc.
- Stock-up on essential medications like those for hypertension, fever, cough and any other prescription medications
References
https://www.cebm.net/covid-19/coronaviruses-a-general-introduction/
https://academic.oup.com/eurheartj/article/38/29/2309/3852720
https://jasn.asnjournals.org/content/13/suppl_3/S155
https://academic.oup.com/ajh/article/33/5/373/5816609
https://pubmed.ncbi.nlm.nih.gov/24842388/
Do you have your DNA raw data file from 23andMe, AncestryDNA, FTDNA, LivingDNA, etc.?
Upload your DNA raw data to Xcode Life to know your genetic predisposition to hypertension.
Published on 29, June 2020
Diabetes is a chronic disorder wherein the body no longer responds to insulin. The disease could reduce the efficiency of the body’s immune system. As such, diabetes is a common comorbidity of COVID-19, with up to 20% of patients requiring intensive medical care. With lockdowns and social restrictions in place across the globe, here are some ways in which you can protect yourself from the novel coronavirus.
Introduction
The current COVID-19 pandemic has affected all our lives in one way or another. The cases report a range of symptoms from mild or asymptomatic cases to severe forms of pneumonia that could lead to the patient’s death.
With newer evidence released on a daily and monthly basis, researchers worldwide are trying to deduce the infection pattern, characteristic symptoms, potential treatment patterns, and drugs.
COVID-19 is an infection of a new coronavirus called the SARS-CoV-2 that emerged in the Wuhan region in China. This disease was so widely spread, that the World Health Organisation declared a global pandemic in March 2020.
The SARS-CoV-2 is a type of coronavirus, which falls under the same family as SARS and MERS. Some experiments have hypothesized that the virus has some affinity to angiotensin-converting enzyme receptor 2 (ACE2), which acts as the gateway to the human body.
Genetics and COVID-19
As many scientists rush to find the cure for the disease, a pressing question remains- why is there such a disparity between patients of COVID-19? How are there some individuals showing absolutely no symptoms, and on the other hand, why are some patients exhibiting severe pneumonia-like symptoms?
The known factors, like age and previous medical history, makes an individual more susceptible to showing severe symptoms.
However, there are cases of perfectly healthy young people showing severe symptoms as well. Some underlying genetic factors can be responsible for this.
As mentioned above, one hypothesized path that the virus takes to the body is through latching onto the ACE2 receptor.
Scientists have found variants of the gene that codes for ACE2, which could influence how the protein functions or impact the structure. This, in turn, affects how the virus could infect a person.
Another factor that could influence how the virus infects an individual could be the person’s blood group.
The ABO gene determines the blood type of a person and could shine a light on how susceptible a person is to the virus.
Both these genes are from preliminary studies, and this needs more validation and a larger group of volunteers to conclude any observation.
Is diabetes a risk factor for COVID-19?
Diabetes is a condition in which there is an impairment in the body’s ability to produce or respond to insulin.
This results in abnormal levels of carbohydrates and elevated levels of glucose in the blood.
People with diabetes are at an increased risk, as they have an impaired immune response to infection.
This applies to both cytokine profiles and activation of T-cells and macrophages.
The impact of having an impaired response to insulin affects the body’s response to viral infection and potential secondary infection in the lungs.
A study compared hospitalization rates of COVID-19 patients and the underlying medical conditions.
Of all the volunteers in the study, 7% were hospitalized and admitted in the ICU, and 77% were not hospitalized. While analyzing the patients with diabetes, up to 20% were hospitalized, and only 45% were not hospitalized.
This data shows that patients with diabetes require extra medical attention if diagnosed with COVID-19.
Patients with type 2 diabetes are also at risk of being obese. This is an additional risk factor for severe infection.
In the case of the 2009 H1N1 epidemic, about twofold more patients diagnosed with the disease, with a history of obesity, ended in ICU, and took longer to recover.
Finally, the most common co-morbidities to COVID-19 are hypertension and diabetes.
These diseases are both treated with ACE2 inhibitors.
This means that a patient with an ACE inhibitor would have an increased expression of ACE2.
Since the novel coronavirus targets ACE2, it could facilitate COVID-19 infection, and place these patients at a high risk of disease and fatality.
Genetics and Diabetes
Genetics plays a role in type 2 diabetes; however, factors like lifestyle choices play a larger role in the manifestation of this disease.
A choice for healthy living can heavily lower the chances of developing type 2 diabetes.
This includes staying healthy by maintaining a healthy weight and choosing healthy foods.
It is possible to test for your genetic predisposition towards diabetes using your 23andMe DNA raw data.
Diabetes and COVID: Reducing your risk using 23andMe DNA data
If you have are a diabetic/ have a predisposition to diabetes, it is important to be prepared. Some measures that you can take are:
- Have emergency contacts ready in case you would need them.
- If you show any influenza-like symptoms, contact a medical professional immediately.
- Regularly check blood glucose levels to avoid complications related to low or high blood pressure.
- Make sure you have access to a sufficient amount of food and water.
- If you have to quarantine yourself, make sure you have the required medications for that period.
- If you need to correct your blood pressure, make sure you have the necessary medications.
- Try to follow a regular schedule and get a good night’s sleep.
- Make movement and exercise a priority, and try to incorporate small exercises throughout the day. Comply with social distancing.
- Avoid unnecessary travel, stay at home as much as possible
- If you do have to step out, wear a face mask, stay 6 feet away, and carry hand sanitizer.
Diet plan for diabetes- COVID-19 version
There are three main pillars of diabetes maintenance, monitoring, exercise, and diet. Measures that you can take with respect to exercise and monitoring are explained above, and the following details a diet plan that you can follow.
- Prioritize following a healthy, well-balanced diet to keep glucose levels up, and to enhance immunity
- In the case of dips in your blood sugar, keep simple carbs like honey, fruit juice or candies
- Stock up on foods that have a low glycaemic index (vegetables and whole wheat pasta/noodles)
- Avoid excess consumption of fast foods or fried foods
- Limit consumption of refined sugars, carbohydrates, and fats
- Incorporate fruits and nuts into your diet
Summary
COVID-19 is caused by a novel coronavirus, SARS-CoV-2. The symptoms and the path of infection are still being studied, with new data being released on a daily basis. Individuals with comorbidities, especially like diabetes and hypertension, must strictly follow social distancing practices. If they do step out, measures of wearing a face mask, carrying a sanitizer, and washing hands thoroughly with soap can help prevent infection.
References
Could genetics play a role in the severity of COVID-19?
COVID-19 Infection in People with Diabetes
Do you have your DNA raw data file from 23andMe, AncestryDNA, FTDNA, LivingDNA, etc.?
Upload your DNA raw data to Xcode Life to know your genetic predisposition to diabetes.
