7 Groups of People Who Are at Higher Risk for COVID-19 and Don’t Know It
Understanding your odds of acquiring coronavirus can help you decide on prevention measures
The details surrounding the new coronavirus, which causes the respiratory illness COVID-19, are emerging daily, and sometimes even hourly. But there’s one piece of solid information that’s emerged: It’s not an equal opportunity disease.
Everyone is considered susceptible to coronavirus, but certain groups are much more vulnerable to COVID-19, says Manish Trivedi, M.D., director of the division of infectious diseases at AtlantiCare, a health system in New Jersey.
“For people in these higher-risk groups, it’s important to develop a plan now, in case they or their community is impacted by the spread of COVID-19,” Dr. Trivedi says.
Who’s in these groups? Here’s a look at factors that could be in play for you. Plus, the best ways to protect yourself.
Risk #1: You’re in Your 50s
You’ve likely heard that older adults are stricken particularly hard by COVID-19. To date, the majority of deaths related to the disease have occurred in those over age 60.
But people who are in their 50s should also be extra vigilant at this time, says Aimee Ferraro, Ph.D., a faculty member for Walden University’s Master of Public Health program, and a researcher on infectious and vector-borne diseases.
That’s because your immune system—which is tasked with keeping your body healthy by going toe-to-toe with bacteria, viruses, and other invaders—isn’t as robust as it was before you started sprouting gray hairs and wrinkles.
Both the severity of the disease and the death rate associated with it appear to increase dramatically with age, says Ferraro. For example, the death rate in 40-somethings is 0.4 percent, but it climbs to 1.3 percent for those in their 50s, 3.6 percent for 60-somethings, 8 percent for people in their 70s, and 15 percent for those over age 80.
That pattern is similar to that of other infectious diseases like measles, SARS, and MERS, she says.
“We don’t fully understand why this occurs,” says Ferraro. The leading hypothesis is that older adults tend to have two strikes against them: weaker immune systems and a higher likelihood of a chronic health condition.
Risk #2: You Have Heart Disease
Having heart disease doesn’t mean you’re more likely to contract coronavirus, according to the American Heart Association (AHA). But you are more likely to have complications if you do develop COVID-19, explains Dr. Trivedi.
Those with underlying heart troubles often have immune systems that operate at less than full capacity, he says. So any virus is prone to latching on and causing complications.
“Coronavirus can lead to a buildup of fluid in the lungs, and that puts greater strain on the heart,” he says.
Looking at early reports out of China, the first country to grapple with the coronavirus, 40 percent of hospitalized COVID-19 patients had cardiovascular disease.
Even if your only heart-disease factor is that you’ve been diagnosed with hypertension (aka high blood pressure), the American College of Cardiology and the AHA recommend taking sensible everyday precautions (see “How to Protect Yourself” below). Also, make sure you’re up to date on your pneumococcal vaccine.
Risk #3: You Have Diabetes
People with diabetes are in a similar situation to those with heart disease, says Dr. Trivedi. High blood sugar levels can weaken your immune system. That makes it harder to treat viral infections.
Also, diabetes-related health problems, such as reduced blood flow to hands and feet, can put you at greater risk of infection—and can lead to worse outcomes if you come down with COVID-19, according to the American Diabetes Association (ADA).
While there’s lots to be learned about COVID-19, right now it doesn’t appear that the disease poses a difference in risk between people with type 1 diabetes and type 2 diabetes.
Some things you can do to stay safe and healthy, according to the ADA:
- Refamiliarize yourself with your sick plan
- Get extra refills of your prescription medications
- Have plenty of glucagon and ketone strips, in case of lows and highs
- Replenish your stock of simple carbs (like Jell-O, regular soda, and hard candies) to help keep your blood sugar up if you do become sick
Risk #4: You Have Lung Disease
Because COVID-19 is a respiratory virus, it can have a greater impact on people with existing lung diseases, such as chronic obstructive pulmonary disease (COPD) or asthma.
“These people already have impaired breathing, so getting coronavirus would make that worse,” says Dr. Trivedi.
Also, this is another case of lowered immune function, which, according to research, is unfortunately very common in people with COPD and other respiratory illnesses. This can make you more likely to get COVID-19.
Risk #5: Your Immune System Is Compromised
In addition to the conditions that are listed above, there are many others that involve a compromised immune system, including:
- Multiple sclerosis
- Genetic syndromes
- Kidney disease
- Crohn’s disease
In some cases, both the condition and the treatment may suppress immune function. For example, chemotherapy and radiation temporarily lower immune function so that those cancer treatments can work. But that could leave patients more susceptible to COVID-19 and other viruses.
"Any bad infection can be life-threatening to someone who is immune-compromised,” says Ferraro. “That might make them less easily able to fight off severe infection.”
Risk #6: You’re Pregnant
Good news: There is no evidence yet that pregnant women are more susceptible to coronavirus infection or mortality compared to the general population, says Ferraro.
That said, pregnancy does alter a woman’s immune system (that’s why your OB-GYN wants you to get the flu shot and eat more fruits and vegetables before your due date). So if you do develop COVID-19, you will land a spot on this list of those who may be at higher risk for complications from the new illness.
“Fever in the first trimester can increase risk for birth defects, so any pregnant woman with symptoms of coronavirus should seek medical attention right away,” she says.
Health experts are learning more and more about COVID-19 on the spot. The Centers for Disease Control and Prevention (CDC) reports that they don’t yet know if COVID-19 causes pregnancy complications or affects the health of the baby after birth.
Right now, experts don’t believe COVID-19 transfers from mother to child, or through breast milk. Learn more about the CDC’s current breastfeeding guidelines for moms with COVID-19 here.
Risk #7: Your BMI Is Over 40
When researchers in the United Kingdom began looking into the underlying risk factors of their first COVID-19 patients who were hospitalized, they discovered that 64 percent were overweight, with a Body Mass Index (BMI) of 25 to 40. Another seven percent had a BMI over 40. (BMI is one screening tool that doctors use to help them determine if a person’s weight falls within a healthy range. The number is takes into account your weight in relation to your height.)
Those are early findings, and more research is needed. But current guidelines from the CDC state that "people of any age with severe obesity” (defined as having a BMI over 40) might be at higher risk for severe illness from COVID-19.
Carrying excess pounds has been shown to impact a person’s immune system. It increases inflammation, which in turn forces the body’s immune system to work harder to fight off infections. Extra weight also puts extra pressure on the lungs.
How to Protect Yourself
If you’re in a higher-risk group, take extra precautions to safeguard your health.
- Avoid large crowds and non-essential travel
- Practice social distancing (even among friends). That means keeping people six feet away
- Whenever you’re in public, you should be appropriately masked, which means layering a disposable surgical mask underneath a snug-fitting cloth mask or placing a mask fitter over your cloth mask to ensure a tight fit, according to the CDC’s latest guidance
- Have a two-week supply of prescribed medications for chronic conditions
- Consider signing up for mail-order refills in the event that you can’t leave home
- Have over-the-counter cold and flu medications on hand
- Stock up on food supplies, water, and other essential household items, including soap and tissues
And it’s always a good idea to practice good self-care: Wash your hands often with soap and water, get plenty of rest and exercise, and enjoy a variety of healthy foods.
If you do spike a fever or notice a cough or other signs of a respiratory illness, Dr. Trivedi stresses that it’s important to call your doctor or an urgent care center first. Don’t just show up unannounced or head to the ER.
That way, he says, you can be directed to the right location based on your symptoms. In some cases, you may be advised to stay at home. This also helps to prevent you from catching and spreading illnesses. Of course, if you are having a life-threatening emergency like extreme shortness of breath, call 911.
The information in this story is accurate as of press time and posting. To limit the spread of the coronavirus, it’s important to continue practicing social distancing (keeping at least 6 feet away from people outside your household) and washing your hands frequently. You should also be appropriately masked any time you’ll be in public. According to the CDC’s latest guidance means layering a disposable surgical mask underneath a snug-fitting cloth mask or placing a mask fitter over your cloth mask to ensure a tight fit. Because the situation surrounding COVID-19 continues to evolve, we encourage readers to follow the news and recommendations for their own communities by using the resources from the CDC, WHO, and their local public health department.