NEW DELHI: People under 45 form a significantly higher proportion of COVID-19 fatalities in India compared to the US and China.
14 percent of the total number of deaths in India are those below 45 while the figure is 4.5 per cent in the US, as per an observational study of a large cohort in hospitals across New York. The US has registered the highest deaths--over 60,000 so far--due to the outbreak globally.
In China, where the pandemic originated, 6.3 per cent of deaths are people under 49 years, according to the Chinese Centre for Disease Control and Prevention’s report on epidemiological characteristics of the COVID-19 outbreak.
The Indian government in information made public on Thursday said 14 per cent of the COVID-19 fatalities were below 45 years, 34.8 per cent between 45-60 years and over 51 per cent above 60 years.
The overall mortality rate due to the infection in India -- with 1,152 deaths -- now stands at 3.3 per cent. In India, those who have died include some infants and kids too -- a group of population considered largely protected from the worst form of COVID-19 worldwide.
According to the Ministry of Health and Family Welfare Ministry’s estimate till Thursday, while 78 per cent of those who succumbed to the infection also had other pre-existing diseases, a whopping 22 per cent had none.
It has been estimated that co-morbidities like hypertension, diabetes, other cardiovascular diseases, chronic obstructive pulmonary disease, kidney failure and cancer significantly increases the risk of fatality in COVID-19 patients and those above 60 are particularly vulnerable.
But little has been understood about what kills otherwise healthy people who sometimes deteriorate very fast and even collapse suddenly.
“COVID-19 in a serious form causes cytokine storm, hypoxia, acute inflammatory response or clotting of blood that hampers crucial organs and a certain category of people are more susceptible,” said Dr Oommen John, public health expert who specializes in internal medicine.
“But nobody can predict the clinical outcome of the disease in anyone -- including young, healthy people who are at considerably lower risk.”
Cytokines are chemical signaling molecules that guide a healthy immune response but in a cytokine storm, levels of certain cytokines soar far beyond what’s needed and immune cells start to attack healthy tissues. It leads to blood vessel leaks, blood pressure drops, formation of blood clots and catastrophic organ failure killing some. The risk is higher with those with already compromised immunity but immune system of even those considered "healthy" can sometimes respond unexpectedly.
Dr Yatin Mehta, head of critical care medicine at Medanta hospital in Gurugram, said the fact that the burden of non-communicable diseases is higher in India could be a reason why people under 45 are a higher proportion of the dead.
“Also maybe some people are reporting late or are quickly deteriorating due to the delay in accessing appropriate medical care,” he said.