841
edits
Changes
no edit summary
Another part of these differences is linked to risk factors or pathologies of the affected person (comorbidities), which determine the possible severity of the infection and, therefore, the need for healthcare resources. It shall always be borne in mind that advanced age and being male are the two main demographic factors linked to the severity and lethality of infection by this virus. However, the scientific community is unanimous in identifying the comorbidities included in this section as additional risk factors.
<li style="display: inline-block">
COPD
[[File:Logo Monografía.jpg|left|thumb|300px|Map: Reportered of COPD in the population over 15 years of age. 2017. Spain [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_Prevalencia-de-obesidad-en-la-poblacion-mayor-de-18-anos_2017_mapa_17861_spa.pdf PDF]. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_Prevalencia-de-obesidad-en-la-poblacion-mayor-de-18-anos_2017_mapa_17861_spa.zip Data]. [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=r_122_t.r_122_t&s=Total&t=A02&view=map10 Versión interactiva. ]]]
Chronic Obstructive Pulmonary Disease (COPD) does not appear to be a predisposing factor for SARS-CoV-2 infection. However, once infection occurs and the disease develops, there is an increased risk of hospital admission, admission to intensive care unit (ICU) and death. Furthermore, the respiratory symptoms of COVID-19 may sometimes be confused with COPD exacerbations, which may delay diagnosis and affect the clinical course. The underlying pathophysiological mechanism would be an increased expression of ACE2 receptors (to which the virus binds to penetrate the cell) in the bronchial epithelium, amongst others.
The SEMI-COVID-19 registry of the Spanish Society of Internal Medicine provides clinical data on patients from hospitals across the country, including a history of COPD in 7% of those patients.
The map shows clear differences in reported prevalence between territories. Galicia, Asturias, Extremadura, Aragón and Castile and León (Castilla y León) stand out, with prevalences of around 5%, compared to regions such as the Balearic Islands (Illes Balears) and the Canary Islands (Canarias), with less than 3%. In relation to gender, it is interesting to note that the prevalence in women is higher or equal to that of men in some regions even though COPD is associated with smoking.
There are two major limitations to the data shown. The first is that they are based on self-reported data, which may constitute a reporting bias. The second is that the data are not age- or sex-adjusted, so the differences shown in prevalence may be explained by a different population structure. COPD is an age-associated disease; the regions with the highest prevalence are those with a large elderly population.
</li>
HYPERTENSION
Hypertension is an important risk factor that has been discovered in 19% of patients with COVID-19 in Spain. The biological concept is based on its effect on the renin-angiotensin-aldosterone system and on angiotensin-converting enzyme 2 (ACE-2) overexpression.
Two facts stand out in the data shown: on the one hand, the reported prevalence shows figures of 20-25% in all regions, except for the Balearic Islands (Illes Balears) that registers around 10%; on the other hand, the similarity of figures between men and women, except in the cases of Navarre (Navarra) and Melilla. However, the interpretation of the data has the same limitations as in the case of COPD.
