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COVID-19: Why Do Some Survive and Others Don’t?

Medically reviewed by Ika Villanueva Caperonce, MD · Infectious Disease · Makati Medical Center

Written by Lorraine Bunag, R.N. · Updated Jul 13, 2021

COVID-19: Why Do Some Survive and Others Don’t?

In the early days of the COVID-19 pandemic, experts were quick to inform the public that the coronavirus affects people differently. That’s why some patients only develop mild symptoms, while others will turn out to need mechanical ventilators. This begs the question: why do some survive COVID-19 while others don’t?

The Initial Premise

At the start of the pandemic, Filipinos thought that age was the factor that determined if someone would survive COVID-19. After all, that was consistent with what was happening – older people suffered more severe symptoms. And those who were younger either develop mild, cold-like symptoms or moderate symptoms that only required a short hospital stay.

Eventually, news started spreading that fairly young and healthy people were experiencing critical symptoms, while some older people in their 70s and above survived the coronavirus disease.

It turned out that most of these “young and healthy” people had underlying conditions. Still, the question as to why do some survive COVID-19 remains.

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The Role of Pre-existing Conditions in the Severity of COVID-19

There are now many studies on the impact that a patient’s pre-existing conditions have on the severity of COVID-19 symptoms. The Centers for Disease Control (CDC) states that regardless of age, people with certain pre-existing medical conditions have a heightened risk for severe illness from the novel coronavirus. Some of the underlying medical conditions mentioned are the following:

Type 2 Diabetes

Seeing that Type 2 diabetes is a common condition among Filipinos, we put this one at the top of the list.

One review analyzed 13 relevant studies and found out that diabetic patients were almost 3.7 times more likely to develop a critical case of COVID-19 than people who didn’t have pre-existing conditions. These included diabetes, hypertension, and other respiratory illnesses. Additionally, there are also more incidences of COVID-related deaths among diabetic patients.


Does weight play a role in surviving COVID-19?

In one study, researchers analyzed COVID-positive patients from New York below the age of 60. They found out that obese patients are twice as likely to be hospitalized than patients who have a normal BMI. Additionally, the results showed that obese patients are 1.8 times more likely to receive critical care.

Note: People who have large builds are not automatically obese. Medically speaking, being obese means having a Body Mass Index (BMI) of 30 or more.

Heart Conditions

According to the CDC, people with serious heart conditions like coronary artery disease, heart failure, and cardiomyopathy have an increased risk of suffering from severe COVID-19 infections. However, doctors are still encouraging people with healthy hearts to be careful. This is because the virus may “attack” a supposedly healthy heart and cause deadly complications.

For instance, the first COVID-19-related death in the US affected a 57-year old woman, who, by all means, had a healthy heart of normal size and weight. Reports even stated that she worked out regularly to maintain her health. Apparently, the virus attacked her heart’s muscles, causing the organ to burst.

Other Conditions that Increase Risk of Severe COVID-19 Infection

The following conditions also raise the risk of severe COVID-19 complications:

  • Sickle cell disease
  • COPD or Chronic obstructive pulmonary disease
  • Weakened immunity in relation to organ transplant
  • Chronic kidney disease
  • Cancer

Other Factors that May Affect Survival from COVID-19

Why do some survive COVID-19 even if they have underlying health conditions? It may be due to one of these less established risk factors:

  • Smoking. Smoking can lead to a number of diseases, so it’s not surprising that it’s also related to COVID-19. For one, smokers tend to be more prone to respiratory infections because of weakened immunity. Additionally, there was this study involving at least 1,000 patients in China. Results showed that 12.3% of smoker-participants either got confined to intensive care, used a ventilator, or died due to complications.
  • Blood Type. As surprising as it may be, blood type might affect a person’s susceptibility to the virus. Several studies suggest that people in the A-group (A+, A-, AB+, and AB-) are more at risk of contracting COVID-19 than those with O-type blood. However, the researchers arrived at these findings by simply comparing the participants’ blood types.

More research is needed to confirm how smoking and blood type affect a patient’s chances of surviving the disease.

why do some survive covid-19

Access to Good Health Care is Crucial

Why do some survive COVID-19 despite their aggravating circumstances? In many instances, these patients had better access to health care.

For mild symptoms, home confinement may be enough. However, for a patient with more severe symptoms, in-hospital management, supportive medications, and oxygen supplementation are vital.

Key Takeaways

So, why do some survive COVID-19 while others die or suffer permanent damage? It is a combination of good health care and the body’s response to the virus.

Though we’re learning more about the disease each day, we still have to wait for more definitive answers. We need more studies to prove how some factors affect the gravity of the illness. After all, the pandemic is still relatively new, despite the damage and deaths it has caused across the globe.

Learn more about COVID-19 here.


Hello Health Group does not provide medical advice, diagnosis or treatment.

Medically reviewed by

Ika Villanueva Caperonce, MD

Infectious Disease · Makati Medical Center

Written by Lorraine Bunag, R.N. · Updated Jul 13, 2021

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