New Delhi: Recent studies on coronavirus indicate that the burden of the case and deaths based on age-sex specific Covid-19 case fatality rate (CFR) of COVID-19 infections is high among male (66%) than females (34%), however, experts and doctors opine that the infection is more or less evenly distributed in elderly age group irrespective of male or female.
Speaking in this context, Dr Rajesh Kumar Pandey, Senior Director & HOD Critical Care at BLK super speciality hospital, Delhi said, "People who are 64 years of age and above have almost one and the half times the mortality compare to those who are 63 years and younger. The age beyond 64 -65 years is one risk factor. Presence of COPD, diabetes, cancer, hypertension, coronary artery disease, COPD, chronic kidney, kidney liver disease is another high-risk factors and are unmodifiable and we cannot change it".
"Another aspect is the clinical parameters -if the patients have refractory hypoxemia, lungs are showing bilateral pneumonia, failing lungs, oxygen requirement is 100 %, and requires to be intubated and put on mechanical ventilation, are the highest risk factors. Ventilated patients those who have severe Acute Respiratory Distress Syndrome (ARDS), the mortality tunes to 60-90 per cent. The data doesn't show that females are more susceptible but it is more or less equal. There is no gender bias", he told ETV Bharat.
The study, published in the Journal of Global Health Science, presented age and sex-specific view of mortality form the disease using the measure of CFR, which is the ratio of confirmed deaths in total confirmed cases.
According to the study, the CFR among males is 2.9 %, while for females it is 3.3% in India.
"CFR depends on the denominator, if the denominator in COVID positive patients is small, obviously the CFR is going to be high. So, the denominator is a big factor. Globally, the CFR from May to June has been creeping high. In Italy and the U.S, it is touching about 13-14 % and in India, it is more than 3%", Dr Pandey adds.
"Most of the female and male patients are elderly with the comorbid condition, OBs which is again challenging. X-ray is conducted every day but it is very difficult to see changes. Most of their oxygen requirement is very high. So, the severe form of COVID-19, pneumonia or ARDs is almost non-responsive to the usual therapy", he points out.
Globally, data reveals that everybody is likely to be affected equally or become COVID-19 but the morbidity mortality is much higher in elderly people as compared to younger ones. Most of the younger people are asymptomatic or mildly symptomatic barring a few exceptions.
As further informed, BLK hospital is modifying COVID-19 emergency areas and putting up a gas pipeline in order to ventilate patients.
Moreover, a lot of government facilities are still vacant like the Hindu Rao hospital which should be made available for the treatment of COVID-19 patients as the coming two months are going to be very challenging. More emphasis should be perhaps laid on the hospital front.
Dr Pandey further points out, "China in New England Journal paper has published a data based on the experience of 70,000 people under age-sex COVID-19 CFR, which reveals that in terms of children there are no mortality cases. However, as age increases, the CFR also increases".
"We have female patients but there is no indication that they are more prone to corona. The death rate as we go above 60 years, it increases exponentially, at the age of 40-50 years, the death rate is 1%, 50-60 is slightly higher to 2% and for above 80 years of age, the death rate is 20 %. Age has clear cut relation with death rate. There is 90-95 % recovery rate. Death occurs in the case of aged patients or patients with COVID who develops severe respiratory distress. Fatality risk is equal between elderly males and females", said Dr Pankaj Kumar, Additional Director, critical care at Fortis Hospital.
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