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FAQs on COVID-19 and chronic medical conditions

Serious complications from COVID-19 are most likely to develop in elderly people, as well as those who have weakened immune systems, or who are immunocompromised.

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This illustration was created at the Centers for Disease Control and Prevention (CDC)

Serious complications from COVID-19 are most likely to develop in elderly people, as well as those who have weakened immune systems, or who are immunocompromised, says infectious disease specialist Alan Taege, M.D. from Cleveland Clinic in the U.S.

When people are immunocompromised, their body has a reduced ability to fight off and recover from infections. This could be because they have a certain chronic condition that affects the immune system, or because of certain medications they are taking. For example, some cancer treatments and medications used for autoimmune conditions weaken a person’s immune response, as do medicines that people take after having an organ transplant.

Unfortunately, there is not yet a vaccine that can prevent COVID-19, so we cannot prevent the disease, but there are many things you can do to minimize your risk such as social distancing, frequent handwashing and routinely disinfect surfaces in your home, such as doorknobs, faucet handles and cell phones.

It is especially important for older adults and those with underlying medical conditions to avoid being exposed to the virus in the first place. It’s spread by droplets that come out the nose and mouth of someone who’s infected when they cough or sneeze, so you can get COVID-19 from being in close contact (within about 2 metres) with an infected person who has these symptoms. You might also be able to get it from touching a surface that’s been contaminated with infected droplets.

It is also important to maintain healthy habits, like eating well, getting enough sleep and managing your stress levels, in order to keep your immune system as strong as it can be.

Dr. Taege has answered some of the most common questions about protecting the most vulnerable populations:

Q: Who is most at-risk for getting severely sick from the coronavirus?

A: The coronavirus that causes COVID-19 is new, so we don’t yet understand exactly how it impacts specific groups of high-risk people. But those who are thought to be most susceptible to serious complications of COVID-19 include people who are older than 65, or are taking medications that suppress the immune system or suffer from conditions such as cancer, hypertension. lung disease, diabetes, heart disease or other conditions that compromise the immune system.

Q: Why are people over the age of 65 more at risk?

A: Our immune system naturally becomes weaker as we age, which makes it harder for our bodies to fight off infections.

Q: Should someone who is immunocompromised still go to medical appointments?

A: Call your healthcare provider and ask. Some appointments might be able to be rescheduled, or handled by phone, or if available, virtually through a telemedicine visit or by phone. Healthcare facilities are taking special precautions to protect the health and safety of patients during this time.

Q: Should someone on immunosuppressing medications stop taking them?

A: Do not stop taking your medications without talking to your healthcare provider first. Just as there is risk associated with having a compromised immune system, there is also risk associated with stopping medication suddenly and potentially having disease flares. If you have questions or concerns, or if you become sick, talk with your doctor.

Q: In addition to the advice on hygiene, social distancing and all of the other precautions given to the general public, what extra steps could a vulnerable person take to prepare for a COVID-19 outbreak in the community?

A: Consider the following:

Ask your healthcare provider if it’s possible to get an advance supply of your medications, in case there is an outbreak in your community and you need to stay home for more than a few weeks. You can also ask your healthcare provider or pharmacy if ordering medications online and having them shipped to your home is an option.

Have enough groceries and household supplies on-hand so that you could comfortably stay home for a few weeks if you had to. Many grocers offer online ordering and delivery, which could also help you avoid having to go out.

Talk to your doctor to make sure you are up to date on your recommended vaccinations, such as the pneumonia and flu shots, which can help prevent those serious illnesses. These will not protect you against COVID-19, but they will protect you from other infections that could require you to seek medical care.

Make a plan for who will take care of you if you do get sick.

If you have a chronic condition and live alone, ask family members, friends or neighbors to check on you regularly during an outbreak. Ask them to call or contact you through email or social media.

Q: How can someone help a loved one who is in the high-risk category?

A: You can start by checking in on your love one’s well-being frequently via phone, email or social media. You might also consider:

Offering to pick up groceries or prescriptions and drop them off at your loved one’s doorstep so they do not have to go out.

Learning what medications your loved one is taking, and helping them get extra medication and supplies, if possible.

If your loved one is in a hospital or long-term care facility, check ahead of time to see if they have restrictions on visitation. And never visit when you’re sick.

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The look and feel of your neighborhood may affect your sleep

Those living in neighborhoods rated as having a stronger sense of safety tended to sleep longer, and that this rating appeared to be shaped by the streetscape.

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Your neighborhood’s “streetscape”—the physical environment of your street—is something that you have probably never consciously thought about, despite seeing it every day. But what if the streetscape was affecting you on a subconscious level and disrupting your sleep? 

This intriguing question is posed by the findings of a study led by Professor Daisuke Matsushita of the Graduate School of Human Life and Ecology at Osaka Metropolitan University. The research team used AI to analyze more than 200,000 Google Street View images to identify visual neighborhood characteristics. They then linked these characteristics to the self-reported sleep of 1,089 working adults living on the lower floors of apartments in Tokyo, who were most likely to be affected by the streetscape.  

They found that those living in neighborhoods rated as having a stronger sense of safety tended to sleep longer, and that this rating appeared to be shaped by the streetscape. Generally, people slept longer in areas with lots of greenery, such as leafy trees, on the street. Similarly, high “enclosure”—meaning many tall vertical buildings and few wide-open spaces—was also associated with longer sleep and fewer insomnia symptoms. 

However, the study also made a surprising finding. The researchers found that highly walkable streetscapes, such as those with more sidewalks and traffic signs, were associated with a lowered sense of safety and shortened sleep duration.  

This suggests that walkability does not always represent a reassuring environment. Instead, a possible explanation is that streets with extensive pedestrian infrastructure are often busier, more crowded, and used by more strangers, which may be perceived as less safe or less relaxing than quieter residential streets.  

“This study demonstrates the potential for evaluating streetscape characteristics across large geographic areas in a cost-effective manner,” Dr. Matsushita said. “Based on the technique used in this study, cities could potentially measure perceived safety, beauty, liveliness, and enclosure as well as pollution and noise.”  

“We hope that opening up this new perspective creates further possibilities for designing healthier neighborhoods,” he concludes.  

The findings were published in Building and Environment.

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Workout or nap? Either can help your sleepless brain, study finds

People who either completed 20 minutes of moderate-to-vigorous exercise or took a 90-minute nap performed about 22 per cent better on memory tests after 30 hours without sleep than those who did neither.

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A short workout or a nap can help protect memory after a sleepless night, a McGill University-led study has found.

Researchers found people who either completed 20 minutes of moderate-to-vigorous exercise or took a 90-minute nap performed about 22 per cent better on memory tests after 30 hours without sleep than those who did neither. The findings, published in Proceedings of the National Academy of Sciences (PNAS), point to practical ways to counter the effects of sleep deprivation.

“Sleep loss affects nearly every aspect of how we think and function, but many people can’t simply stop what they’re doing and get more sleep,” said senior author Marc Roig, Professor in McGill’s School of Physical and Occupational Therapy. “Our findings show that even a brief bout of exercise may help preserve one of our most important cognitive abilities.”

The study involved 54 healthy young adults who stayed awake for 30 consecutive hours under lab supervision. Participants were then assigned to one of three groups: a 20-minute cycling session, a 90-minute nap or a control condition. Three days later, researchers tested their memory for images they had viewed immediately after the intervention. Those who exercised or napped remembered significantly more images than participants who did neither.

Same result, different pathways

While the memory benefits were nearly identical, brain recordings revealed that exercise and napping helped in different ways.

Napping appeared to help the brain recharge, making it easier to take in and remember new information. Exercise, by contrast, helped the brain use its remaining resources more efficiently, without making participants feel more tired.

The findings could eventually inform fatigue-management strategies in workplaces where sleep loss is common and mistakes can have serious consequences, such as health care, transportation and emergency response.

“A nap isn’t always possible in the middle of a shift,” said first author Madhura Lotlikar, a doctoral candidate in McGill’s Department of Neurology and Neurosurgery. “Exercise is accessible, inexpensive and easy to implement. That makes it a promising tool to help people stay cognitively sharp when sleep is limited.”

The researchers emphasize that exercise cannot replace sleep, but it may help people function better when getting enough rest isn’t possible.

About the study

Protecting episodic memory after sleep loss: Similar benefits of exercise and naps via distinct neural contributions” by Madhura Lotlikar and Marc Roig et al., was published in Proceedings of the National Academy of Sciences of the United States of America.

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Study links coffee consumption to metabolic health and sex hormones

Despite having a similar body mass index (BMI), individuals with higher coffee consumption had lower total and visceral fat and greater skeletal muscle mass than those who consumed less coffee.

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Coffee is one of the world’s most widely consumed beverages, and previous research has linked its consumption to a lower risk of conditions such as type 2 diabetes and cardiovascular disease. However, the biological mechanisms behind these benefits remain unclear. A new Finnish study links habitual coffee consumption to healthier body composition and metabolic markers, while revealing distinct associations with sex hormones in men and women.

The study, conducted at the University of Oulu, analysed data from 2,264 participants aged 46 in the Northern Finland Birth Cohort 1966. Researchers examined how habitual coffee consumption was associated with circulating metabolites, cardiometabolic risk markers and sex hormones.

Despite having a similar body mass index (BMI), individuals with higher coffee consumption had lower total and visceral fat and greater skeletal muscle mass than those who consumed less coffee.

In both men and women, higher coffee consumption was correlated with lower circulating levels of branched-chain amino acids, biomarkers that have previously been linked to insulin resistance and an increased risk of type 2 diabetes when chronically elevated.

The strongest sex-specific associations were observed in men. Higher coffee consumption was linked to a more favourable glucose–insulin profile, higher concentrations of total and bioavailable testosterone, and increased levels of sex hormone-binding globulin (SHBG). At the same time, free testosterone and the free androgen index were modestly lower. In women, hormonal associations were more limited and were primarily characterised by higher SHBG and lower measures of free androgens.

“Coffee is consumed by millions of people every day, yet we still know surprisingly little about how it relates to our metabolism and hormones. What stood out in our findings was a distinct hormonal signature that didn’t disappear even after we took into account BMI and lifestyle factors, with several of these associations differing between men and women,” says Luca Verroest, lead author of the study and Doctoral Researcher at the University of Oulu.

The results suggest that hormonal pathways may partly explain the relationship between coffee consumption and metabolic health. However, as this was an observational study, the findings demonstrate associations rather than cause-and-effect relationships.

The study is particularly relevant in Finland, one of the world’s highest coffee-consuming countries, where annual consumption averages around 11.8 kilograms per person.

The researchers say the findings provide a foundation for future studies aimed at determining whether coffee itself drives these biological changes and identifying the compounds responsible. These questions are currently being investigated in animal models, with the long-term goal of progressing to human intervention studies. Further research will be needed before the findings could inform dietary recommendations.

The study, Associations of habitual coffee intake with testosterone and cardiometabolic markers: the Northern Finland Birth Cohort 1966 study, has been published in the European Journal of Nutrition.

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