Abstract
The different presentations, comorbidities, and outcomes of COVID-19 highlight the importance of early identification and proper triage of patients. High-risk patients can be divided into patients with common comorbidities and patients with special categories. Common comorbidities include, but are not limited to, Cardiovascular Disease (CVD), Diabetes Mellitus (DM), immunosuppression, underlying respiratory disease, and obesity. Certain categories of COVID-19 patients are also at increased risk, including neonates and pregnant women. In the present article, we delineate the reported risk factors for acquisition of infection, and for increased severity of the clinical disease. We also comparatively analyze those risk factors associated with COVID-19 and with the antecedent human acute respiratory syndrome-causing viruses, SARS-CoV-1 and MERS-CoV. We hypothesize that the structural similarities of the three viruses predict a similarity in the profile of high-risk patients. Several pathophysiological patterns have been detected to support this theory.
Highlights
A century has passed since the dramatic Spanish Influenza pandemic, which resulted in a global crisis and nearly 50 million deaths
It was followed by the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in 2012, and the Severe Acute Respiratory Syndrome Coronavirus2(SARS-CoV-2), which began in December 2019 and was declared a pandemic by March 11, 2020 [1,2,3]
Both SARS-CoV-1 and SARS-CoV-2 infect host cells by the binding of their viral spike protein to angiotensin-converting enzyme 2 (ACE2) receptors which are highly expressed in the lungs and the heart [4]
Summary
A century has passed since the dramatic Spanish Influenza pandemic, which resulted in a global crisis and nearly 50 million deaths. The coronavirus outbreak of December 2019 may be on a trajectory to rival, in human cost, the influenza crisis of 1918, with estimates of almost 135 million confirmed cases worldwide and three million deaths at the time of this writing [1]. The first epidemic was caused by the Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-1) in 2003. It was followed by the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in 2012 (ongoing), and the Severe Acute Respiratory Syndrome Coronavirus2(SARS-CoV-2), which began in December 2019 (the first case reported on December 12) and was declared a pandemic by March 11, 2020 [1,2,3]. Coronaviruses have become the main pathogens of emerging respiratory disease outbreaks
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