COVID-19: Who's at higher risk?
Underlying health conditions, such as heart or lung disease, can increase your risk of developing dangerous symptoms if you become infected with coronavirus disease 2019 (COVID-19).By Mayo Clinic Staff
Coronavirus disease 2019 (COVID-19) symptoms can vary widely. Some people have no symptoms at all, while others become so sick that they eventually need mechanical assistance to breathe.
The risk of developing dangerous symptoms of COVID-19 may be increased in people who are older and also in people of any age who have other serious health problems — such as heart or lung conditions, weakened immune systems, severe obesity, or diabetes. This is similar to what is seen with other respiratory illnesses, such as influenza.
People of any age, even children, can catch COVID-19. But it most commonly affects middle-aged and older adults. The risk of developing dangerous symptoms is higher in people age 65 and older. The highest rate of mortality from the disease is in people age 80 and older. Risks are even higher for older people when they have underlying health conditions.
Nursing home residents are at high risk because they often have multiple underlying health problems, combined with advanced age. And germs can spread very easily between people who live in close proximity to each other.
Lung problems, including asthma
COVID-19 targets the lungs, so you're more likely to develop severe symptoms if you have preexisting lung problems, such as:
- Moderate to severe asthma
- Chronic obstructive pulmonary disease (COPD)
- Lung cancer
- Cystic fibrosis
- Pulmonary fibrosis
While some medications for these conditions can weaken your immune system, it's important to stay on your maintenance medications to keep symptoms as controlled as possible. You may want to talk to your doctor about obtaining an emergency supply of prescription medications, such as asthma inhalers.
It may also help to avoid the things that make your asthma worse. These asthma triggers can vary from person to person. Examples include pollen, dust mites, tobacco smoke and cold air. Strong emotions and stress can trigger asthma attacks in some people. Others are bothered by strong odors, so make sure the disinfectant you're using isn't an asthma trigger for you.
In addition to being an asthma trigger, smoking or vaping can harm your lungs and inhibit your immune system, which increases the risk of serious complications with COVID-19.
Heart disease, diabetes and obesity
People with diabetes, high blood pressure or severe obesity are more likely to experience dangerous symptoms if infected with COVID-19. This may be of particular concern in the United States, which has seen increasing rates of obesity and diabetes over the years.
Obesity and diabetes both reduce the efficiency of a person's immune system. Diabetes increases the risk of infections in general. This risk can be reduced by keeping blood sugar levels controlled.
Because COVID-19 is so new, experts have been looking at information from older diseases caused by similar types of viruses, such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). SARS and MERS have both been linked to heart attacks and heart failure, so the same may be true of COVID-19.
Weakened immune system
A healthy immune system fights the germs that cause disease. But many conditions can weaken your immune system, including:
- Cancer treatments
- Bone marrow or organ transplants
- Prolonged use of prednisone or similar drugs
If you have a weakened immune system, you may need to take extra precautions to avoid the virus that causes COVID-19. Routine doctor appointments may be delayed or happen via phone or video conference. You may want to have your medications mailed to you, so you don't have to go to the pharmacy.
Protect yourself; prevent unnecessary risk
Although there is no vaccine available to prevent infection with the new coronavirus, you can take steps to reduce your risk of infection. The World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC) recommend following these precautions for avoiding COVID-19:
- Avoid large events and mass gatherings.
- Avoid close contact (within 6 feet, or about 2 meters) with anyone who is sick or has symptoms.
- Keep distance between yourself and others if COVID-19 is spreading in your community, especially if you have a higher risk of serious illness.
- Wash your hands often with soap and water for at least 20 seconds, or use an alcohol-based hand sanitizer that contains at least 60% alcohol.
- Cover your mouth and nose with your elbow or a tissue when you cough or sneeze. Throw away the used tissue.
- Avoid touching your eyes, nose and mouth.
- Avoid sharing dishes, glasses, bedding and other household items if you're sick.
- Clean and disinfect high-touch surfaces daily.
- Stay home from work, school and public areas if you're sick, unless you're going to get medical care. Avoid taking public transportation if you're sick.
In addition to these everyday precautions, if you are at higher risk of infection or of developing serious COVID-19 symptoms, you might also want to:
April 09, 2020
- Make sure you have a 30-day supply of your regular prescription and over-the-counter medications. Most people recover from COVID-19 at home.
- Check to see if your vaccinations are up to date, particularly for influenza and pneumonia. These vaccines won't prevent COVID-19, but becoming ill with influenza or pneumonia may worsen your outcome if you also catch COVID-19.
- Establish an alternate way of communicating with your doctor if you have to stay at home for a few weeks. Some doctors are doing appointments via phone or video conference.
- Arrange for delivery orders of restaurant meals, groceries or medications so you don't have to leave your home.
See more In-depth
- Coronavirus disease 2019 (COVID-19): People who are at higher risk. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-at-higher-risk.html. Accessed March 31, 2020.
- McIntosh K. Coronavirus disease 2019 (COVID-19). https://www.uptodate.com/contents/search. Accessed March 31, 2020.
- Lung Health & COVID-19. American Lung Association. https://www.lung.org/lung-health-diseases/lung-disease-lookup/covid-19/faq. Accessed April 3, 2020.
- What heart patients should know about coronavirus. American Heart Association. https://www.heart.org/en/news/2020/02/27/what-heart-patients-should-know-about-coronavirus. Accessed March 31, 2020.
- Muniyappa R, et al. COVID-19 pandemic, coronavirus, and diabetes mellitus. American Journal of Physiology, Endocrinology, Metabolism and Gastrointestinal Physiology. 2020; doi:10.1152/ajpendo.00124.2020.
- Gupta R, et al. Clinical considerations for patients with diabetes in times of COVID-19 epidemic. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2020; doi:10.1016/j.dsx.2020.03.002.
- Frydrych LM, et al. Obesity and type 2 diabetes mellitus drive immune dysfunction, infection development, and sepsis mortality. Journal of Leuckocyte Biology. 2018; doi:10.1002/jlb.5vmr0118-021rr.
- Coronavirus: What people with cancer should know. National Cancer Institute. https://www.cancer.gov/contact/emergency-preparedness/coronavirus. Accessed March 31, 2020.
- Q&A on coronaviruses (COVID-19). World Health Organization. https://www.who.int/news-room/q-a-detail/q-a-coronaviruses. Accessed April 3, 2020.