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Mayo Clinic Health Library

COVID-19: Who's at higher risk?

Updated: 05-29-2020

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.

Older age

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.

Take all your medications as prescribed. Consider developing a care plan that includes information about your medical conditions, medications, doctors' names and emergency contacts.

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. If you live in a nursing home, follow the guidelines to prevent infection. Ask about protection measures for residents and visitor restrictions. Let staff know if you feel ill.

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, heart disease, 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 and continuing your diabetes medications and insulin.

Your risk of serious illness may also be higher if you have heart diseases such as cardiomyopathy, pulmonary hypertension, congenital heart disease, heart failure or coronary artery disease. Continue to take your medications exactly as prescribed. If you have high blood pressure, keep it controlled and take your medications as directed.

Weakened immune system

A healthy immune system fights the germs that cause disease. But many conditions can weaken your immune system, including:

  • Cancer treatments
  • Smoking
  • Bone marrow or organ transplants
  • HIV/AIDS
  • 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.

Chronic kidney or liver disease

If you have chronic liver disease or chronic kidney disease, you may be at higher risk of becoming seriously ill with COVID-19.

If you're on dialysis for chronic kidney disease, go to every dialysis appointment. Let your doctor know if you feel ill. You may have a weakened immune system if you have chronic kidney disease and are having dialysis.

If you have chronic liver disease, your risk of being seriously ill with COVID-19 may be higher because you may have a weakened immune system. Also, having serious COVID-19 symptoms and taking medications to treat the disease may have negative effects on the liver.

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 others. Avoid anyone who is sick.
  • Stay home when possible and 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 face with a cloth face mask in public spaces, such as the grocery store, where it's difficult to avoid close contact with others, especially if you're in an area with ongoing community spread.
  • Cover your mouth and nose with your elbow or a tissue when you cough or sneeze. Throw away the used tissue. Wash your hands right away.
  • Avoid touching your eyes, nose and mouth.
  • Avoid sharing dishes, glasses, towels, bedding and other household items if you're sick.
  • Clean and disinfect high-touch surfaces, such as doorknobs, light switches, electronics and counters, 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, taxis and ride-sharing 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:

  • Make sure you have at least a 14-day supply of your regular prescription and over-the-counter medications.
  • 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.
  • Call your doctor if you have questions about your medical conditions and COVID-19 or if you're ill. If you need emergency care, call your local emergency number or go to your local emergency department.
  • Call your doctor if you have questions about non-critical medical appointments. He or she will advise you whether a virtual visit, in-person visit, delaying the appointment or other options are appropriate.