People living with non-communicable diseases (PLWNCDs) are as susceptible as the general population to infection with SARS-CoV-2 (official name of the novel coronavirus). However, trends in case series and other observational data show more severe COVID-19 (official name of the disease caused by SARS-CoV-2) disease in persons with poorly controlled pre-existing non-communicable diseases (NCDs) including hypertension, diabetes, heart failure etc. Even NCD risk factors such as tobacco use and obesity have been linked to increased susceptibility to infection. The underlying mechanisms responsible for this have not been fully described but theimpact of NCDs and their risk factors on the strength of the immune system may play a role.
The COVID-19 pandemic has stretched even the most advanced health care systems to breaking point, such that more focus is being placed on emergency care, perhaps, to the detriment of routine care services. There is real danger in “neglecting” routine NCD care, because, patients who were heretofore well-controlled, may relapse, thus increasing their risk of manifesting severe disease, and dying, if infected. There are suggestions to extend the follow-up durations for NCD patients. This may sound like common sense, but this decision needs to be taken on a patient-by-patient basis, considering levels of disease control, presence/absence of co-morbid disease(s), and the need to balance infection risks.
Further, social distancing and other infection control measures which are absolutely necessary in context, to curb the spread of COVID-19, may be restrictive to the extent of predisposing apparently healthy persons, to NCDs or worsening pre-existing NCDs. Decreased physical activity levels linked to the stay at home, and limited social interactions may negatively impact mental health.
Thus, the need to adopt healthier lifestyles, to moderate our individual and collective NCD risks has never been more urgent, as is the need for innovation in risk factor modification strategies. This must be seen as an investment in the body’s immune health.