Common conditions that can contribute to COVID-19 deaths

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September 24, 2020
FRANCK FIFE/AFP via Getty Images

Common conditions contributing to COVID-19 deaths

The coronavirus death toll in the United States surpassed 200,000 on Sept. 22, which the Associated Press equated to a "9/11 attack every day for 67 days."

Many of these deaths have involved COVID-19 and at least one other condition, which is called a comorbidity. In some cases, coronavirus directly causes comorbid conditions like pneumonia or sepsis. Other comorbid conditions such as diabetes and hypertension are preexisting, but may complicate a patient’s reaction to COVID-19 and cause them to suffer a more serious outcome. The Centers for Disease Control has found that in as many as 94% of COVID-19-caused deaths, individuals also had a contributing comorbidity.

Stacker analyzed a National Center for Health Statistics dataset on conditions contributing to deaths involving coronavirus disease to examine common conditions that may contribute to COVID-19 deaths. The deaths tabulated in this dataset include Americans who had confirmed cases of COVID-19 and one or more other diseases or health conditions at the time of death. This story includes the deaths associated with COVID-19 and 21 common conditions from Feb. 1 to Aug. 15, 2020.

Keep reading to find out which common conditions can most contribute to COVID-19 fatalities.

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Sam Wordley // Shutterstock

#21. Respiratory arrest: Overall

- Deaths where deceased had COVID-19 and this condition: 12,115

Respiratory arrest is any event where a person either can’t breathe or can’t breathe effectively. Acute respiratory distress syndrome (ARDS) is a common result of COVID-19 infection, according to the U.S. National Library of Medicine (NLM) National Institutes of Health (NIH). When ARDS is present alongside COVID-19, patients are much more likely to require mechanical ventilation, which increases the likelihood of lung damage.

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#21. Respiratory arrest: Demographics

States with the most deaths where deceased had COVID-19 and this condition:
- #1. New Jersey (912 deaths)
- #2. New York (708 deaths)
- #3. California (660 deaths)
- #4. Massachusetts (496 deaths)
- #5. Alabama (272 deaths)

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#20. Intentional and unintentional injury: Overall

- Deaths where deceased had COVID-19 and this condition: 18,563

By mid-August, the CDC was reporting that at least 3% of COVID deaths were from “adverse events” like injuries and poisonings. The bulk of these cases involve patients becoming infected with COVID-19 after entering a hospital with a non-life-threatening injury.

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#20. Intentional and unintentional injury: Demographics

States with the most deaths where deceased had COVID-19 and this condition:
- #1. Florida (817 deaths)
- #2. New Jersey (772 deaths)
- #3. Texas (671 deaths)
- #4. Pennsylvania (614 deaths)
- #5. California (576 deaths)

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SUPERMAO // Shutterstock

#19. Obesity: Overall

- Deaths where deceased had COVID-19 and this condition: 19,903

Obesity, which the CDC defines as a body mass index (BMI) of 30 or above, complicates and/or aggravates COVID-19 patients in several ways, according to the Obesity Society. People with obesity are more likely to have compromised immune systems or preexisting cardiac or respiratory disease, which are the underlying conditions most likely to make COVID infection more severe. Also, people with obesity can be more challenging to diagnose early and accurately.

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#19. Obesity: Demographics

States with the most deaths where deceased had COVID-19 and this condition:
- #1. Florida (1,386 deaths)
- #2. Texas (1,118 deaths)
- #3. Illinois (877 deaths)
- #4. California (787 deaths)
- #5. New Jersey (520 deaths)

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#18. Other respiratory system diseases: Overall

- Deaths where deceased had COVID-19 and this condition: 20,631

The most common respiratory diseases are asthma, Chronic Obstructive Pulmonary Disease (COPD), chronic bronchitis, emphysema, lung cancer, cystic fibrosis/bronchiectasis, pneumonia, and pleural effusion. When combined with COVID-19—also an acute respiratory illness—the risk of severe complications rises dramatically, according to the CDC.

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#18. Other respiratory system diseases: Demographics

States with the most deaths where deceased had COVID-19 and this condition:
- #1. New Jersey (884 deaths)
- #2. Connecticut (848 deaths)
- #3. Texas (744 deaths)
- #4. Massachusetts (668 deaths)
- #5. California (646 deaths)

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#17. Alzheimer’s: Overall

- Deaths where deceased had COVID-19 and this condition: 20,828

Alzheimer’s disease is the most common cause of progressive dementia, and the degenerative disease presents difficult challenges when those who suffer from it contract the coronavirus. Alzheimer’s disease does not increase the likelihood of COVID-19 transmission in and of itself, according to the Northwest Indiana Times, but sufferers with failing memories are likely to neglect preventative tasks like hand-washing. Also, isolation is detrimental to dementia patients, whether they’re quarantined to prevent infection or to prevent the spread after becoming infected.

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#17. Alzheimer’s: Demographics

States with the most deaths where deceased had COVID-19 and this condition:
- #1. California (1,143 deaths)
- #2. New Jersey (699 deaths)
- #3. Pennsylvania (616 deaths)
- #4. Texas (579 deaths)
- #5. Massachusetts (570 deaths)

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#16. Malignant neoplasms: Overall

- Deaths where deceased had COVID-19 and this condition: 27,472

Malignant neoplasms are cancerous tumors that can spread to other parts of the body and invade and destroy healthy tissue. Cancer sufferers and those undergoing cancer treatment can be more susceptible to infection from viruses like COVID-19—but this comorbidity is a double-edged sword. Not only is transmission more likely, but cancer patients tend to suffer far more serious complications from the coronavirus once they are infected, according to the American Cancer Society.

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#16. Malignant neoplasms: Demographics

States with the most deaths where deceased had COVID-19 and this condition:
- #1. New Jersey (1,222 deaths)
- #2. Florida (1,080 deaths)
- #3. New York (1,007 deaths)
- #4. California (895 deaths)
- #5. Texas (721 deaths)

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#15. Cerebrovascular diseases: Overall

- Deaths where deceased had COVID-19 and this condition: 28,450

Cerebrovascular diseases include stroke, aneurysms, vascular malformations, vertebral stenosis, intracranial stenosis, carotid stenosis, and other conditions where blood flow is restricted or cut off from portions of the brain. According to NLM/NIH research, COVID-19 infections can cause a stroke even in low-risk groups like patients under 50 who don’t have cardiovascular risk factors. For older patients who do exhibit risk factors, cerebrovascular events are both more likely to occur and more severe when they do.

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#15. Cerebrovascular diseases: Demographics

States with the most deaths where deceased had COVID-19 and this condition:
- #1. New Jersey (1,302 deaths)
- #2. California (1,078 deaths)
- #3. Pennsylvania (1,064 deaths)
- #4. Florida (850 deaths)
- #5. New York (771 deaths)

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#14. Other circulatory system diseases: Overall

- Deaths where deceased had COVID-19 and this condition: 32,320

There are many circulatory system diseases, including heart attack, atherosclerosis, mitral valve prolapse, high cholesterol, hypertension, angina pectoris, and many more, all of which disrupt the circulation of blood through the body and to and from the heart. COVID-19 can cause serious cardiac and vascular complications in its victims, particularly those with comorbidity, “but patients with preexisting cardiovascular diseases suffer the highest mortality rate of all COVID patients,” according to Diagnostic and Interventional Cardiology.

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#14. Other circulatory system diseases: Demographics

States with the most deaths where deceased had COVID-19 and this condition:
- #1. New Jersey (1,486 deaths)
- #2. California (1,121 deaths)
- #3. New York (1,107 deaths)
- #4. Pennsylvania (1,044 deaths)
- #5. Texas (1,013 deaths)

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#13. Cardiac arrhythmia: Overall

- Deaths where deceased had COVID-19 and this condition: 36,504

Cardiac arrhythmia—which includes slow heartbeat, fast heartbeat, irregular heartbeat (or fibrillation), and early or premature heartbeat—is not usually severe and doesn’t always cause symptoms, but any variation of arrhythmia can lead to cardiac arrest or stroke. The presence of COVID, however, can aggravate both severe cases of arrhythmia and cases that would otherwise be relatively benign, according to Medical News Today.

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#13. Cardiac arrhythmia: Demographics

States with the most deaths where deceased had COVID-19 and this condition:
- #1. New Jersey (1,753 deaths)
- #2. California (1,308 deaths)
- #3. Texas (1,271 deaths)
- #4. Pennsylvania (1,252 deaths)
- #5. Florida (1,206 deaths)

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#12. Heart failure: Overall

- Deaths where deceased had COVID-19 and this condition: 39,730

Over time, conditions like hypertension and coronary artery disease leave the heart too stiff or too weak to effectively pump blood, which leads to heart failure. The Mayo Clinic cited two recent studies that “suggest that in many patients, COVID-19 could presage heart failure, a chronic, progressive condition in which the heart’s ability to pump blood throughout the body declines.”

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#12. Heart failure: Demographics

States with the most deaths where deceased had COVID-19 and this condition:
- #1. New Jersey (1,524 deaths)
- #2. Illinois (1,358 deaths)
- #3. California (1,290 deaths)
- #4. Pennsylvania (1,281 deaths)
- #5. Massachusetts (1,248 deaths)

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#11. Renal failure: Overall

- Deaths where deceased had COVID-19 and this condition: 50,984

Renal failure is kidney failure, which occurs when the kidneys stop functioning correctly. According to the National Kidney Foundation, “COVID-19 patients are becoming kidney patients” at disturbingly high rates. Although coronavirus is widely associated with damage to the respiratory system, even those closely tracking news about the illness tend to be unaware that the virus commonly attacks the kidneys, as well.

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#11. Renal failure: Demographics

States with the most deaths where deceased had COVID-19 and this condition:
- #1. New Jersey (2,632 deaths)
- #2. Texas (2,575 deaths)
- #3. California (2,505 deaths)
- #4. New York (1,662 deaths)
- #5. Massachusetts (1,451 deaths)

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#10. Chronic lower respiratory diseases: Overall

- Deaths where deceased had COVID-19 and this condition: 51,280

Shortness of breath caused by an obstructed airway is the hallmark of all three chronic lower respiratory diseases (CLRD): asthma, emphysema, and chronic bronchitis. COVID-19 attacks, among other critical systems, the respiratory system, and the presence of coronavirus and an existing CLRD at the same time can aggravate the severity of both, according to the Journal of Thoracic Disease.

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#10. Chronic lower respiratory diseases: Demographics

States with the most deaths where deceased had COVID-19 and this condition:
- #1. Florida (2,991 deaths)
- #2. Illinois (2,099 deaths)
- #3. New Jersey (1,565 deaths)
- #4. New York (1,513 deaths)
- #5. California (1,410 deaths)

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#9. Sepsis: Overall

- Deaths where deceased had COVID-19 and this condition: 52,348

Sepsis, which can lead to septic shock and eventually death, occurs when the body’s response to an infection creates toxicity in the blood that can damage multiple organs and systems. According to the Global Sepsis Alliance, there’s a direct cause-and-effect relationship between this condition and coronavirus—it can now be definitively stated that COVID-19 can cause sepsis.

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#9. Sepsis: Demographics

States with the most deaths where deceased had COVID-19 and this condition:
- #1. California (3,252 deaths)
- #2. New Jersey (2,735 deaths)
- #3. Texas (2,446 deaths)
- #4. New York (1,502 deaths)
- #5. Michigan (1,473 deaths)

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#8. Ischemic heart disease: Overall

- Deaths where deceased had COVID-19 and this condition: 67,392

Ischemic heart disease is characterized by narrow arteries that restrict the flow of blood and oxygen to the heart. ACE inhibitors and ARBs—commonly prescribed to treat conditions like ischemic heart disease—can cause an increase in an enzyme called ACE2, according to the American Heart Association. The coronavirus uses ACE2s to attach itself to a wide range of cells throughout the body.

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#8. Ischemic heart disease: Demographics

States with the most deaths where deceased had COVID-19 and this condition:
- #1. Florida (4,714 deaths)
- #2. New Jersey (2,811 deaths)
- #3. New York (2,319 deaths)
- #4. California (2,260 deaths)
- #5. Illinois (2,008 deaths)

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#7. Dementia: Overall

- Deaths where deceased had COVID-19 and this condition: 70,115

Dementia is a collection of symptoms that can be caused by several diseases, most notably Alzheimer’s, that degrade memory, cognition, and the ability to perform basic tasks. Coronavirus cannot cause dementia, and dementia does not increase the risk of COVID-19 transmission, but just as with Alzheimer’s disease, it can make sufferers less likely to succeed with precautionary measures like distancing and handwashing, and it can make the stress of isolation more pronounced.

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#7. Dementia: Demographics

States with the most deaths where deceased had COVID-19 and this condition:
- #1. Massachusetts (3,261 deaths)
- #2. Florida (3,098 deaths)
- #3. New Jersey (2,735 deaths)
- #4. Pennsylvania (2,634 deaths)
- #5. New York (2,329 deaths)

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#6. Cardiac arrest: Overall

- Deaths where deceased had COVID-19 and this condition: 77,144

Often called a heart attack, cardiac arrest occurs when the heart malfunctions (often suddenly) and stops beating. According to Future Medicine, acute pneumonia eventually kills a higher percentage of COVID-19 patients than any other comorbidity, but cardiac arrest is not far behind—many coronavirus sufferers die from heart attacks.

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#6. Cardiac arrest: Demographics

States with the most deaths where deceased had COVID-19 and this condition:
- #1. California (6,124 deaths)
- #2. New York (6,049 deaths)
- #3. New Jersey (5,271 deaths)
- #4. Massachusetts (1,742 deaths)
- #5. Texas (1,110 deaths)

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#5. Adult respiratory distress syndrome: Overall

- Deaths where deceased had COVID-19 and this condition: 83,667

Adult respiratory distress syndrome (ARDS) is a complication that NLM/NIH says can be caused by “such diverse conditions as burns, amniotic fluid embolism, acute pancreatitis, trauma, sepsis, and damage as a result of elective surgery in general.” Several of those causes, like sepsis, are directly related to COVID-19, and just like the most severe coronavirus patients, ARDS sufferers often require extended time on ventilators.

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#5. Adult respiratory distress syndrome: Demographics

States with the most deaths where deceased had COVID-19 and this condition:
- #1. New Jersey (4,888 deaths)
- #2. New York (4,696 deaths)
- #3. California (2,313 deaths)
- #4. Louisiana (1,956 deaths)
- #5. Florida (1,677 deaths)

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FRANCK FIFE/AFP via Getty Images

#4. Diabetes: Overall

- Deaths where deceased had COVID-19 and this condition: 96,402

Diabetes is a condition characterized by blood sugar (glucose) levels that are too high either because the body does not make insulin (Type 1) or does not use insulin well (Type 2). According to the American Diabetes Association, it is not yet conclusively known whether people with diabetes are more likely than the larger population to contract coronavirus. What is known: “People with diabetes have much higher rates of serious complications and death than people without diabetes.”

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#4. Diabetes: Demographics

States with the most deaths where deceased had COVID-19 and this condition:
- #1. Florida (5,366 deaths)
- #2. Illinois (4,245 deaths)
- #3. California (4,123 deaths)
- #4. Texas (3,743 deaths)
- #5. New Jersey (3,071 deaths)

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#3. Hypertensive diseases: Overall

- Deaths where deceased had COVID-19 and this condition: 132,173

Heart conditions caused by high blood pressure are known collectively as hypertensive diseases. The direct connection between hypertensive diseases and coronavirus is not fully understood, but the American College of Cardiology cited research from cases in New York City, Lombardy, Italy, and Wuhan, China, that “identified higher rates of hypertension among severely ill, hospitalized COVID-19 patients.”

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#3. Hypertensive diseases: Demographics

States with the most deaths where deceased had COVID-19 and this condition:
- #1. Florida (9,360 deaths)
- #2. Illinois (6,987 deaths)
- #3. New Jersey (4,362 deaths)
- #4. California (4,027 deaths)
- #5. Texas (3,820 deaths)

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#2. Respiratory failure: Overall

- Deaths where deceased had COVID-19 and this condition: 207,780

Respiratory failure occurs when the blood contains too little oxygen, too much carbon dioxide, or both. According to Johns Hopkins Medicine, COVID-19 can cause devastating damage to the lungs and fill the organ’s air sacs with fluid. Once compromised, the lungs can’t oxygenate the blood correctly, and the sufferer experiences shortness of breath and, eventually, respiratory failure.

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#2. Respiratory failure: Demographics

States with the most deaths where deceased had COVID-19 and this condition:
- #1. New Jersey (11,345 deaths)
- #2. California (9,431 deaths)
- #3. New York (7,601 deaths)
- #4. Pennsylvania (5,978 deaths)
- #5. Texas (5,818 deaths)

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#1. Influenza and pneumonia: Overall

- Deaths where deceased had COVID-19 and this condition: 257,407

Although they’re caused by different viruses, influenza and COVID-19 are very similar in how they’re transmitted and how they affect the patient. Pneumonia, on the other hand, is an infection that can be caused by viruses, fungi, bacteria, or other organisms. According to Johns Hopkins Medicine, the pneumonia associated with COVID-19 is especially dangerous because it usually occurs in both lungs instead of just one, and also because it’s often more severe than standard pneumonia, more likely to be fatal, and more likely to leave lasting damage in the lungs of those who survive.

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#1. Influenza and pneumonia: Demographics

States with the most deaths where deceased had COVID-19 and this condition:
- #1. New Jersey (13,086 deaths)
- #2. California (10,695 deaths)
- #3. New York (10,608 deaths)
- #4. Texas (8,246 deaths)
- #5. Florida (6,229 deaths)

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