“Why am I at a higher risk than you for this virus and what exactly does immunocompromised mean?”
Ok, NOW IT'S PERSONAL! My wife, Judge Rachel, is a Type 1 diabetic, a pretty well-controlled one, but one, nonetheless. As we sat glued to the TV watching newscasters talk about the global pandemic caused by SARS-CoV2 which causes the disease COVID-2019, she looks over at me and asks that question.
My answer to her sounded something like this: “Immunocompromised means that a person has a weakened immune system, that is, the system in your body that helps to fight off infections. The immune system of patients, like diabetics or someone with cancer, doesn’t fight off infections as well as someone who has a normal functioning immune system. This leaves them susceptible to all types of illness and disease.
“An immunocompromised state can be caused by a variety of reasons. Some people are born that way, some people are on medications which depress their immune systems, some have had their spleen (a white blood cell factory) removed, and some have chronic illnesses like diabetes, renal disease, lupus, sarcoidosis and other autoimmune disorders.”
I think that may have answered her question…even if it was a little TMI and probably more than she expected. As far as COVID-19 goes, preliminary data shows that people with diabetes do face an increased risk for serious complications caused by the virus. One bit of good news, however, is that preliminary data has not shown that diabetics contract the virus easier than people with a normal immune system.
When a diabetic is sick for any reason they face a greater risk of experiencing diabetic ketoacidosis (DKA), a condition that can makes it harder for them to control their fluid balance and their electrolytes.
When this happens, doctors have a much more difficult time treating sepsis, an overwhelming response of your body to an infection, and the shock associated with it. This can a significant increase in the morbidity and mortality of their illness and in this case, COVID-19. Because of their now severely immunocompromised state, other diseases, like bacterial infections can come along and attack the body as well.
What can we do?
During this pandemic, we must not only protect ourselves, but we MUST take all precautions to protect our loved ones whose immune system may not function as well as it should. If you have a diabetic family member in your household, you should treat them as if you are a significant risk. If no one in the house has any symptoms, washing hands, covering coughs and sneezes, staying home and disinfecting surfaces should be enough not to transmit the virus. If a person is sick, make sure to give them a mask or face covering and confine them to one room. Clean the sick room as needed so that you are not being exposed to the sick person unnecessarily.
Having someone I love with a compromised immune system sleeping in the bed next to me, I am more cognizant of the precautions that I should take in order to keep her well. Please remember, treat everything and everyone like they’re infected and avoid putting yourself and your family at risk. It’s just not worth it.
Dorsha James, MD, is a 15-year veteran emergency medicine physician in the Nashville, TN area. She now serves as the CEO and chief medical officer for her company myURGENCYMD. myURGENCYMD is a national telemedicine company that provides members with access to 24-hour, seven-day-a-week virtual consultations with a board-certified physician to discuss non-emergency conditions. She enjoys empowering patients by helping them understand how to properly utilize the many avenues for the treatment of medical conditions to obtain optimal health. To learn more about the company, visit www.myurgencymd.com
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