New evidence shows that adults with chronic conditions have an outsized risk of severe COVID-19 outcomes, and New Orleans is a case in point. 

The city’s death rate is three times that of coronavirus hot spot New York City’s and four times that of Seattle’s, reports Reuters. And those high numbers are likely explained by the rates of diabetes, obesity, and hypertension among residents, say health officials. 

“We already had tremendous healthcare disparities before this pandemic – one can only imagine they are being amplified now,” former Louisiana health secretary Rebekah Gee told the news outlet.

The latest U.S. data support this claim. The Centers for Disease Control and Prevention on Tuesday released preliminary case report findings showing that people with underlying health conditions such as diabetes mellitus, chronic lung disease and cardiovascular disease face greater odds of severe COVID-19–associated outcomes than their healthier peers.

“Persons in the United States with underlying health conditions appear to be at higher risk for more severe COVID-19, consistent with findings from other countries,” the agency stated. 

Meanwhile, endocrinologists are cautioning that special care considerations may be necessary for individuals with endocrine disorders and type 2 diabetes in particular. 

Diabetes affects up to 34% of nursing home residents, and people who suffer from this and other endocrine disorders (such as adrenal gland dysfunction) can have a harder time fighting off an infection. Medication and fluid intake adjustments may be critical to some of these patients’ recovery from coronavirus, wrote Paul Stewart, M.D., editor in chief of the Journal of Clinical Endocrinology & Metabolism, in a new editorial

In Louisiana, 97% of those who have died from COVID-19 had a pre-existing condition. Diabetes was seen in 40% of the deaths, obesity in 25%, chronic kidney disease in 23% and cardiac problems in 21%, Reuters reported.