What Are Health Factors That Impact Patient Response to Pathogens?
More Programs and Publications Featuring Dr. Rodney Rohde
In this program:
How is patient response to pathogens impacted by various health factors? Medical laboratory scientist Dr. Rodney Rohde discusses the impact of some comorbidities and health conditions on infectious diseases.
Transcript
Interviewer:
How do pre-existing comorbidities such as diabetes, respiratory conditions, cardiac conditions, impact the susceptibility, severity, and outcome for individuals infected with emerging pathogens?
Dr. Rodney Rohde:
Yeah, this is an unfortunate and true thing that we deal with, right? So again, during the COVID pandemic and even the, I'll bring in Alaskapox virus here, that we had the recent death in Alaska in the Fairbanks area, and it hasn't been a big problem. Alaskapox, we believe, is still rare. They've only seen it in seven human beings with one death, but that one death was likely attributed to comorbidities. The person had some really underlying problems. So whenever the human body has underlying comorbidities, it really impacts their ability to fight off disease. So diabetes, like you mentioned, respiratory conditions, COPD, cancer, you're recovering from cancer or you're dealing with cancer, or perhaps you've got individuals with lupus or other types of autoimmune diseases.
Really all of those and many more will impact the immune system all the way down to the ability, for example, if you have HIV, your T helper cell count may be so low that it really can't mount an immune response against another infection. So most people know this, but if you're suffering from HIV, for example, HIV attacks your T helper cells, which is kind of the keystone to your immune system. If you don't have good T helper cell counts, then it has a problem activating so many other components of your immune system. And so what happens when that occurs? The HIV indirectly is working to kill you because what happens is without those T helper cells, people start dying from weird fungal infections.
In fact, that's how we kind of correlated HIV early on in the '80s as people were dying from weird Kaposi sarcoma and pneumocystis pneumonia and other things. It just really wasn't a problem in a healthy human being. And so sometimes even the detection of new agents can come about from people who have comorbidities, because their bodies are allowing these kinds of bizarre infections to occur. So it's really about how it allows that human being to become more susceptible. And then, of course, they typically have more severe disease. Again, if you just look at the most recent issue with SARS-CoV-2 and COVID-19, even from the very beginning, we kind of understood that something's going on here. And if you look at some of the slides I have, looking at age, ethnicity, male versus female, a lot of those will show you the impacts of those types of demographics as well as some of the comorbidities.
So, for example, even looking at age, for example, really 65 and older, you could drop that to 50, but the big impact was 65 and 75 and older, just massive death, massive mortality in those populations. It's easy to forget this, but remember early on in that COVID-19 pandemic, we were really just doing everything we could. We were really wringing our hands when you think about long-term care in nursing homes. How do we deal with this? Because we had no vaccination yet. We had no good preventative measures or treatments. And then here's another really bad outcome that happened because of COVID.
There was so much respiratory infection. Remember, they were turning patients on their stomachs. They were ventilating them. They were doing almost anything they could to keep them alive. The other thing that was happening, unfortunately, during that time, because of that massive respiratory infection, there was a danger of bacterial pneumonia developing. And so many physicians had no other choice but to start prescribing empirical antibiotics, broad spectrum. And everyone knows that that's not the greatest way to start curbing antimicrobial resistance. So data is coming out right now. Some of these studies are being published almost monthly now of the impact of that. And so we kind of slid backwards on AMR, antimicrobial resistance, as well as some of the other issues around antifungal resistance. We're seeing kind of an explosion with Candida auris and even ringworm resistance, which is a fungus. So all of these things, unfortunately, at the time they were doing it, and it's kind of understandable, but there are impacts. And sometimes there's negative impacts. And so we've kind of...
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