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COVID 2019 Comorbidity with Diabetes

HSSS said:
https://www.ons.gov.uk/releases/analysisofdeathsinvolvingcovid19 Lots of stats on March deaths released today. (@bulkbiker for your new obsession.)

Things that are striking me so far

The definition of pre existing condition is based on death certificate mention. “We define a pre-existing condition as any health condition mentioned on the death certificate that either came before the coronavirus (COVID-19) or was an independent contributory factor in the death. Where only COVID-19 was recorded on the death certificate, or COVID-19 and subsequent conditions caused by COVID-19 were recorded, we refer to these deaths as having “No pre-existing conditions”.” The average number of more existing conditions was 2.7!!

So if the declaring dr doesn’t believe our pre existing diabetes played any role it wouldn’t be mention thus we would be in the no preexisting conditions group statistically speaking?? So those well controlled with no complications or other conditions don’t fall into the higher risk groups?? Or is my interpretation wishful thinking?



View attachment 40442

the “usual “ causes are deaths are mostly lowered so there appears to be people who died with covid and for whom it is being attributed to that rather than their underlying condition(s) that statistically would still died. View attachment 40444
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Surely the reason that the diabetes chart at the bottom of fig 8 is just a reflection of the total numbers of PWD in the population being less than the numbers without any pre-condition. It gives no indication of risk per 100,000 etc.
 
zand said:
it's 45 days since I was infected
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That's really not very long for such a serious response as you had. Modern times we think we should be back and up right away but we need time to recover. Not in any way an attempt to minimise your fears or a substitute for a qualified medic but just, hopefully, reassurance that it's not unreasonable to give yourself more time, understanding and care.
 
copilost said:
That's really not very long for such a serious response as you had. Modern times we think we should be back and up right away but we need time to recover. Not in any way an attempt to minimise your fears or a substitute for a qualified medic but just, hopefully, reassurance that it's not unreasonable to give yourself more time, understanding and care.
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Thank you. Yes as the illness lasted 36 days then it will probably take at least as long as that to heal all the affected parts. I had expected to feel well once the dry cough had gone. Not very likely really was it?
 
copilost said:
My reading is that 'no pre-existing condition' is the 5th most common 'pre-existing' condition, so people with no pre-existing condition are at a higher risk than people with diabetes alone - the 6th most common pre-existing condition! This tells me that these numbers aren't terribly helpful for predicting one's own risk. As 2.7 pre-existing conditions was the norm, presenting numbers by a single condition doesn't really tell us very much. Also, as you, say this is only things listed on the death cert where pre-existing conditions 'usually' aren't listed if they weren't seen as a contributing cause.
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I read it this way at first too. But when you consider how many in the population are diagnosed diabetic and how many are without any diagnosis of pre existing conditions you would indeed expect the numbers to be the way round they are. If fewer people have diabetes then there should be a correspondingly smaller number having it mentioned on the death certificate if it wasn’t a factor in the death. The numbers are by 100000 population not by people with that condition (or lack of).
 
HSSS said:
having it mentioned on the death certificate if it wasn’t a factor in the death
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Now I'm confused (not unusual). I thought it wasn't mentioned on the cert if it wasn't a factor in death? Although that could have changed with covid reporting.
 
zand said:
Thank you. Yes as the illness lasted 36 days then it will probably take at least as long as that to heal all the affected parts. I had expected to feel well once the dry cough had gone. Not very likely really was it?
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It took me 3months to properly get over pneumonia each time. There is a reason why convalescent was important in Victorian times. You have had an illness which your body has had to deal with unsupported by modern medicine. You need an old fashioned convalescence to recover.
 
HSSS said:
We define a pre-existing condition as any health condition mentioned on the death certificate
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HSSS said:
If fewer people have diabetes then there should be a correspondingly smaller number having it mentioned on the death certificate if it wasn’t a factor in the death.
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The numbers in the graph comparing comorbidities are for those that they believe covid was a factor yes. But people that don’t have comorbidities are a far bigger % of the population so you would expect their overall% of deaths to be higher.

sorry I think I’m explaining it badly.

this might help https://www.ons.gov.uk/peoplepopula...hcertificationdeathsinvolvingcovid19march2020

“A pre-existing condition is defined as any condition that either preceded the disease of interest (for example, COVID-19) in the sequence of events leading to death, or was a contributory factor in the death but was not part of the causal sequence.”

“The cause of death information is set out in two parts. Part 1 gives the condition or sequence of conditions leading directly to death, while Part 2 gives the details of any associated conditions that contributed to the death but are not part of the causal sequence.”
 
It to be hoped the drug from Gilead, originally developed for Sars as an antiviral, proves to be as effective as is claimed from some countries.
If it is as good as some suggest it could be a game changer, but we need to be careful with a lot of these claims that prove to be less than promised.

D.
 
Hi All,

Anyone able to unpick the mathematics below? My poor wee brain simply isn't up to grasping it, so if anyone can do a Maths Translation for Dummies, I would be very grateful!

Aseem Malhotra referenced a study in this article https://www.europeanscientist.com/en/article-of-the-week/covid-19-and-the-elephant-in-the-room/
He made the statement that
Public Health England have said now is the best time to quit smoking, citing research from China concluding that smokers were 14 times more likely to get severe disease after contracting COVID-19. (13)

So I followed his reference to here:
https://journals.lww.com/cmj/Abstra...f_factors_associated_with_disease.99363.aspx#
and found this:
Seventy-eight patients with COVID-19-induced pneumonia met the inclusion criteria and were included in this study. Efficacy evaluation at 2 weeks after hospitalization indicated that 11 patients (14.1%) had deteriorated, and 67 patients (85.9%) had improved/stabilized. The patients in the progression group were significantly older than those in the disease improvement/stabilization group (66 [51, 70] vs. 37 [32, 41] years, U = 4.932, P = 0.001). The progression group had a significantly higher proportion of patients with a history of smoking than the improvement/stabilization group (27.3% vs. 3.0%, χ2 = 9.291, P = 0.018). For all the 78 patients, fever was the most common initial symptom, and the maximum body temperature at admission was significantly higher in the progression group than in the improvement/stabilization group (38.2 [37.8, 38.6] vs. 37.5 [37.0, 38.4]°C, U = 2.057, P = 0.027). Moreover, the proportion of patients with respiratory failure (54.5% vs. 20.9%, χ2 = 5.611, P = 0.028) and respiratory rate (34 [18, 48] vs. 24 [16, 60] breaths/min, U = 4.030, P = 0.004) were significantly higher in the progression group than in the improvement/stabilization group. C-reactive protein was significantly elevated in the progression group compared to the improvement/stabilization group (38.9 [14.3, 64.8] vs. 10.6 [1.9, 33.1] mg/L, U = 1.315, P = 0.024). Albumin was significantly lower in the progression group than in the improvement/stabilization group (36.62 ± 6.60 vs. 41.27 ± 4.55 g/L, U = 2.843, P = 0.006). Patients in the progression group were more likely to receive high-level respiratory support than in the improvement/stabilization group (χ2 = 16.01, P = 0.001). Multivariate logistic analysis indicated that age (odds ratio [OR], 8.546; 95% confidence interval [CI]: 1.628–44.864; P = 0.011), history of smoking (OR, 14.285; 95% CI: 1.577–25.000; P = 0.018), maximum body temperature at admission (OR, 8.999; 95% CI: 1.036–78.147, P = 0.046), respiratory failure (OR, 8.772, 95% CI: 1.942–40.000; P = 0.016), albumin (OR, 7.353, 95% CI: 1.098–50.000; P = 0.003), and C-reactive protein (OR, 10.530; 95% CI: 1.224−34.701, P = 0.028) were risk factors for disease progression.

So, is Malhotra's statement that that smokers were 14 times more likely to get severe disease after contracting COVID-19
bourne out by the mathematical hieroglyphs quoted above?

I do, of course, appreciate that there is a lot of other stuff going on too - CRP, albumin, degree of temperature, age and all the other co-morbidities we are familiar with discussing regarding COVID-19.
 
It should be remembered that the 14x number is obviously a relative risk, and we already know that relative risks can be very misleading in any context. I'm twice as likely to win the lottery if I buy two tickets, but I think I'll hold off sending in my resignation letter until after the numbers come in :shifty:
 
There is also the 'minor' detail that PHE are quoted as saying that the numbers refer to 'smokers' (implying current smokers) while the study's words are 'people with a history of smoking'. Such minor details can have huge implications!

However, it is the numbers that interest me. The P Thing has always sent my brain dribbling out of my ears.

I have never smoked, thankfully. But various family members have, for decades. Hence my interest in unpicking this.
 
Brunneria said:
Hi All,

Anyone able to unpick the mathematics below? My poor wee brain simply isn't up to grasping it, so if anyone can do a Maths Translation for Dummies, I would be very grateful!

Aseem Malhotra referenced a study in this article https://www.europeanscientist.com/en/article-of-the-week/covid-19-and-the-elephant-in-the-room/
He made the statement that
Public Health England have said now is the best time to quit smoking, citing research from China concluding that smokers were 14 times more likely to get severe disease after contracting COVID-19. (13)

So I followed his reference to here:
https://journals.lww.com/cmj/Abstra...f_factors_associated_with_disease.99363.aspx#
and found this:
Seventy-eight patients with COVID-19-induced pneumonia met the inclusion criteria and were included in this study. Efficacy evaluation at 2 weeks after hospitalization indicated that 11 patients (14.1%) had deteriorated, and 67 patients (85.9%) had improved/stabilized. The patients in the progression group were significantly older than those in the disease improvement/stabilization group (66 [51, 70] vs. 37 [32, 41] years, U = 4.932, P = 0.001). The progression group had a significantly higher proportion of patients with a history of smoking than the improvement/stabilization group (27.3% vs. 3.0%, χ2 = 9.291, P = 0.018). For all the 78 patients, fever was the most common initial symptom, and the maximum body temperature at admission was significantly higher in the progression group than in the improvement/stabilization group (38.2 [37.8, 38.6] vs. 37.5 [37.0, 38.4]°C, U = 2.057, P = 0.027). Moreover, the proportion of patients with respiratory failure (54.5% vs. 20.9%, χ2 = 5.611, P = 0.028) and respiratory rate (34 [18, 48] vs. 24 [16, 60] breaths/min, U = 4.030, P = 0.004) were significantly higher in the progression group than in the improvement/stabilization group. C-reactive protein was significantly elevated in the progression group compared to the improvement/stabilization group (38.9 [14.3, 64.8] vs. 10.6 [1.9, 33.1] mg/L, U = 1.315, P = 0.024). Albumin was significantly lower in the progression group than in the improvement/stabilization group (36.62 ± 6.60 vs. 41.27 ± 4.55 g/L, U = 2.843, P = 0.006). Patients in the progression group were more likely to receive high-level respiratory support than in the improvement/stabilization group (χ2 = 16.01, P = 0.001). Multivariate logistic analysis indicated that age (odds ratio [OR], 8.546; 95% confidence interval [CI]: 1.628–44.864; P = 0.011), history of smoking (OR, 14.285; 95% CI: 1.577–25.000; P = 0.018), maximum body temperature at admission (OR, 8.999; 95% CI: 1.036–78.147, P = 0.046), respiratory failure (OR, 8.772, 95% CI: 1.942–40.000; P = 0.016), albumin (OR, 7.353, 95% CI: 1.098–50.000; P = 0.003), and C-reactive protein (OR, 10.530; 95% CI: 1.224−34.701, P = 0.028) were risk factors for disease progression.

So, is Malhotra's statement that that smokers were 14 times more likely to get severe disease after contracting COVID-19
bourne out by the mathematical hieroglyphs quoted above?

I do, of course, appreciate that there is a lot of other stuff going on too - CRP, albumin, degree of temperature, age and all the other co-morbidities we are familiar with discussing regarding COVID-19.
Click to expand...

Sounds odd as I'm sure I read somewhere that smokers were less likely to die from COVID..
And that their symptoms were less severe.. chance of me finding that again (probably twitter) are slim but I'll have a go..

Edit to add.. looks like the jury is out (hardly surprising) and please excuse the source..

https://www.dailymail.co.uk/news/article-8152597/Does-smoking-greater-risk-coronavirus.html
 
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Thanks both.
Fascinating stuff!!!

So, smokers are less likely to be hospitalised, but if they get to the point of having severe respiratory issues, they are much worse... according to a lot of jumbled interpretation by journalists who avoid number crunching as much as they can. lol.

I did rather like The Express' comment that
University College London Professor Brown told MailOnline: "It's difficult to assess how well smoking status has been recorded in an emerging epidemic.
"Lots of these people have been too sick to answer or have not replied totally honestly."
A former NHS doctor, and medicine lecturer at the University of East Anglia, agreed.
He said: "One interpretation is that smokers are less likely to end up in hospital.
"But, actually, it's more of an indication that when you've got doctors who are unbelievably busy they don't complete all of the questioning they would normally do."
 
urbanracer said:
So doctors advising the WHO now state that there's no evidence for the presence of antibodies after having had Covid-19.

Maybe explains why the antibody tests are reportedly not working very well.

Rather alarming if we can catch it again straight away or at anytime in the near future. There goes the herd immunity concept.
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If there are no antibodies how do you get better? Maybe there is just no evidence of antibodies?
 
Brunneria said:
"But, actually, it's more of an indication that when you've got doctors who are unbelievably busy they don't complete all of the questioning they would normally do."
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In the UK the doctors treating Covid patients will have full access to the person's GP medical records (I assume). Smokers will have their smoking details on these medical records. We are asked about smoking when we have health check ups. It is one of the tick box checks, and used when they do the Q-Risk scores. Of course, not everyone tells the truth. :)
 
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