
Coronavirus is most deadly if you are older and male – new data reveal the risks - sohkamyung
https://www.nature.com/articles/d41586-020-02483-2
======
lettergram
From my analysis, it appears all age groups are going to be somewhere between
50%-100% more likely to die in 2020 than any prior year.

[https://austingwalters.com/u-s-covid19-less-tests-more-
death...](https://austingwalters.com/u-s-covid19-less-tests-more-deaths-no-
end-in-sight/)

I think that's a better metric because it puts it in perspective. If you're
30, a 50% increased risk of death is still very very low. But if you're 80+
that risk is pretty substantial.

Note: this is basically extrapolating the New York and New Jersey numbers,
which is assumed had the highest COVID19 penetration in the U.S.

~~~
rubidium
“ this is basically extrapolating the New York and New Jersey numbers”

That’s a poor measure for a number of reasons. Not least of which is we’re
getting a lot better at treating Covid medically.

~~~
lettergram
I don’t think that’s necessarily true. We don’t have enough data to support
that claim, probably won’t for years.

Very few peer reviewed treatments have been socialized. Most evidence is that
things “show promise” then end up being less effective after actual analysis.

~~~
chomp
Peer reviewed treatments, sure. But case studies have been widely shared
between medical teams. Things like tummy time, steroids for people on
ventilators, anti clotting agents, ventilator strategies and remdesivir are
all things we've learned since the outbreak started. These aren't ground
breaking cure all treatments, but they definitely moved the needle.

------
dr_dshiv
Based on these data, can we now calculate the expected impact on life-years
instead of just "deaths?" An 80 year old dying isn't a tragedy in the way a 30
year old is.

~~~
toss1
If you want to go down that path, you must also include long-term impairment
of life function

E.g., a pitcher for the Boston Red Sox is out for the season due to a heart
condition brought on by COVID-19, prognosis unknown. [1]

You don't get any healthier than a professional athlete for a top major sport,
and although this guy likely will not die, he is off the field in in danger of
losing his career.

And yes, I know several 80, and even 100-year olds that are a lot more sharp
and physically active than many 40 year olds. Age is not the mere number you
think it is. Genetics and decades of healthy/unhealthy choices create massive
variations in healthspan and lifespan - you simply do not know that your
"typical" 80-year-old has a near expiration date - (s)he could have decades of
healthy, happy life ahead.

[1] [https://www.si.com/mlb/2020/08/01/eduardo-rodriguez-red-
sox-...](https://www.si.com/mlb/2020/08/01/eduardo-rodriguez-red-sox-out-for-
season-covid-19-heart-issue)

~~~
samatman
You were on a roll in the first half, but you didn't stick the landing.

Sure, plenty of hale and healthy 80 year olds. Also, a majority of 80 year old
Covid patients survive. Are they likely to be the same cohort? That's what I
would bet on.

QALY stands for Quality-Adjusted Life Years. That includes long-term
impairment of life function, in the definition.

And you're spot-on, we don't even have preliminary data on that, yet. If it
were a really big and obvious effect, like 20% of all patients suffer a 20%
downward adjustment that will never get better, I wager we'd have a preprint
to that effect.

It's a terrible thing for those affected, of course it is. But how many? How
badly? We just don't know yet.

~~~
toss1
Indeed, we have no strong data on that, because it literally can not yet
exist, and will not for many years

But the initial reports of both serious effects to blood, circulatory, lung,
organ, and peripheral & central nervous system are real cause for concern, as
are teh sufficient numbers of extended illnesses, enough that it already has a
name - "Covid long haulers", and support forums.

~~~
samatman
Yes, but at the risk of repeating myself, if this crossed a certain murky
threshold, we would have more than reports and support fora, we would have
preprints and preliminary numbers.

From my own small sample of people I personally know, I can tell you about
twenty reports of complete recovery, and one long hauler.

Is that typical? We agree that it will be years before we know with any
certainty. I'm pointing out the dog that isn't barking.

Also worth pointing out: a family friend in her 80s never recovered from a
bout of pneumonia, suffering a reduced quality of life until her death about a
year later. Severe illnesses do this sometimes, that's known. Is Covid more
likely to? Not known.

~~~
toss1
I understand. Have you been actively searching for preprints of long-term
conditions (I haven't, only noticing what I come across in definitely non-
exhaustive just-trying-to-keep-up-with-it-all reading)? If so, do you have any
good recommendations for where to look?

------
gregwebs
This article only briefly mentions that co-morbidities (obesity,
hypertenstion, etc) are important but doesn't use them for data analysis.

So I don't think anyone can determine their risk from this article. It is much
higher or lower depending on whether or not you have co-morbidities.

------
mensetmanusman
It will be interesting to see how the long-term illness of Covid-19 compares
to the long-term illness of obesity.

~~~
burtonator
Obesity is worse.

~~~
vkou
I don't catch obesity by hanging around obese people, though.

~~~
121789
Actually, hanging around obese people does increase your likelihood of being
obese

[https://news.harvard.edu/gazette/story/2007/07/obesity-is-
co...](https://news.harvard.edu/gazette/story/2007/07/obesity-is-contagious/)

~~~
vkou
There are so many correlation-and-causation problems with that study that it's
very difficult to take it seriously. And from common knowledge about the
world, if this effect does exist, it's not a very large one for indirect
relations. [1] COVID, on the other hand, is contagious as all hell.

The other thing about COVID, though, is that I don't even need to know the
person who I can catch it from.

[1] If your obese parents raised you, it's quite likely you'll be obese. If
you and your extended family fell into poverty, and your cousins became obese,
it's quite likely you will become obese, too. But subtract direct role models,
direct sources of your habits, changes to your economic status, and the fact
that as time goes on, you get older (And older people tend to be more obese),
geographic effects (The rust belt started becoming depressed and poor over the
years, which lead to obesity)... And what sort of effect is left?

------
denebola
The previous century was very hard on ,mostly(??), mens respiratory systems.
Asbestos, silica etc. were inhaled by many. I don't find it surprising that
60+ men are more susceptible.

------
mellosouls
Both of these categories have been known since early on. There have been
plenty of stories and initiatives focused on age (and BAME and comorbidities
like obesity).

"Male" not so much.

~~~
samatman
Maleness as a risk factor was being reported in Chinese statistics before
Covid was prevalent in the rest of the world.

As was the weird underrepresentation of smokers among the infected. Which
persisted through at least New York, there were several papers about it, but I
haven't seen anything on the subject since.

------
nradov
This recent pre-print meta analysis has more complete data on age and sex
risks.

Age-specific mortality and immunity patterns of SARS-CoV-2 infection in 45
countries

[https://doi.org/10.1101/2020.08.24.20180851](https://doi.org/10.1101/2020.08.24.20180851)

Infection fatality rate is <0.1% below age 50 and then trends up rapidly from
from there.

------
jfoster
The article proves itself a little bit pointless by closing with this without
any elaboration:

> Although fatality estimates are important for understanding the risk of
> viral spread to people in different age groups, they don’t tell the full
> story of the toll COVID-19 takes, says Kilpatrick. “There is a fascination
> with death, but COVID-19 appears to cause a substantial amount of long-term
> illness,” he adds.

I've been very surprised by how little attention the media gives to the damage
that covid does to people, but here's a few articles:

[https://www.theguardian.com/science/2020/jul/13/heart-
scans-...](https://www.theguardian.com/science/2020/jul/13/heart-scans-of-
covid-19-patients-show-range-of-abnormalities)

[https://www.smh.com.au/national/seizures-and-battered-
heart-...](https://www.smh.com.au/national/seizures-and-battered-heart-how-
covid-19-scarred-a-healthy-sydney-doctor-20200802-p55hqj.html)

[https://www.forbes.com/sites/robertglatter/2020/08/17/covid-...](https://www.forbes.com/sites/robertglatter/2020/08/17/covid-19-can-
cause-heart-damageeven-if-you-are-asymptomatic/)

It makes me wonder what's going to happen in a few years from now in the
countries that haven't controlled covid well. Will there be a huge demand for
new types of medical treatments to help covid survivors?

~~~
tyfon
I had something with symptoms similar to corona in March but there was not
enough tests to get me prioritised (40 year old healthy male, 22.5 BMI).

It wasn't too bad but it lasted three weeks and I still have periodic
shortness of breath and fatigue and my doctor has no clue what to do. I hope
it's not permanent.

Death is definitely not the only bad outcome.

~~~
ahelwer
If you're in the USA, Red Cross is giving free coronavirus antibody tests when
you go donate blood so they can get more convalescent plasma donors. I was
very mildly ill a couple weeks back (wasn't worth getting tested at the time
with 6-10 days turnaround) so I've scheduled my appointment to donate blood
this Tuesday. Supposedly blood antibody levels drop to undetectable levels a
couple of months after infection though (note: we still have T cells for long
term immunity) so this might not be useful for you.

~~~
Pfhreak
This is the most grim thing I've read in a while. Get your free test, the
price is only a pound of blood and an hour of your time.

In Seattle, at least, you can just go get a free test in a drive thru with
almost 0 hassle and no cost. This is the way it should be -- as accessible as
possible and free. Otherwise you'll have infected folks skipping testing.

~~~
jccooper
That's a PCR test, for active infection. That's not the same thing as the
parent comment is talking about.

Antibody is a blood test for (potentially) detecting past infection. Its
public health benefits are lower and is usually not offered in a drive-through
format. But it is available free with prescription, besides being included in
blood donations.

------
cainxinth
> The risk of dying from COVID-19 increases significantly with age.

Not exactly shocking news. The risk of dying from most diseases increases
significantly with age.

~~~
iguy
This was news in Feb or so, because not every disease has this profile. The
1919 flu, for instance, was much more deadly in the young (whose stronger
immune systems could over-react more dramatically).

~~~
occamrazor
Even the normal flus are somewhat dangerous for infants and young children,
while COVID-19 is not.

------
iamgopal
One of my friend's father with blood pressure and diabetes survive the
covid-19.

~~~
SketchySeaBeast
Thankfully, "more likely" does not mean "guaranteed". In the article if you're
male and over 80 you still only had a 12% shot of passing due to it. Which
means you actually probably won't die of it, but I wouldn't play a game with
those odds, not to mention all the secondary effects - at least Russian
Roulette has a fairly binary outcome.

