Groups at Higher Risk for Severe Illness

COVID-19 is a new disease and there is limited information regarding risk factors for severe illness. Based on currently available information and clinical expertise, older adults and people of any age who have serious underlying medical conditions might be at higher risk for severe illness from COVID-19.

We are learning more about COVID-19 every day; CDC will update the advice below as new information becomes available.

Reduce your risk of getting sick with COVID-19

  • Continue your medications and do not change your treatment plan without talking to your doctor.
  • Have at least a 2-week supply of prescription and non-prescription medications. Talk to your healthcare provider, insurer, and pharmacist about getting an extra supply (i.e., more than two weeks) of prescription medications, if possible, to reduce trips to the pharmacy.
  • Talk to your healthcare provider about whether your vaccinations are up-to-date. People older than 65 years, and those with many underlying conditions, such as those who are immunocompromised or with significant liver disease, are recommended to receive vaccinations against influenza and pneumococcal disease.
  • Do not delay getting emergency care for your underlying condition because of COVID-19. Emergency departments have contingency infection prevention plans to protect you from getting COVID-19 if you need care for your underlying condition.
  • Call your healthcare provider if you have any concerns about your underlying medical conditions or if you get sick and think that you may have COVID-19. If you need emergency help, call 911.

Learn what else you can do as someone who may be at higher risk for severe illness, including staying home and away from other people as much as possible.

Actions you can take based on your conditions and other risk factors

Asthma (moderate-to-severe)

Moderate-to-severe asthma may put people at higher risk for severe illness from COVID-19.

Actions to take

  • Follow your Asthma Action Plan.
  • Keep your asthma under control.
  • Continue your current medications, including any inhalers with steroids in them (“steroids” is another word for corticosteroids).
  • Know how to use your inhaler.
  • Avoid your asthma triggers.
  • If possible, have another member of your household who doesn’t have asthma clean and disinfect your house for you. When they use cleaning and disinfecting products, have them:
    • Make sure that people with asthma are not in the room.
    • Minimize use of disinfectants that can cause an asthma attack.
    • Open windows or doors and use a fan that blows air outdoors.
    • Always follow the instructions on the product label.
    • Spray or pour spray products onto a cleaning cloth or paper towel instead of spraying the product directly onto the cleaning surface (if the product label allows).

Why you might be at higher risk

COVID-19 can affect your respiratory tract (nose, throat, lungs), cause an asthma attack, and possibly lead to pneumonia and serious illness.

Chronic kidney disease being treated with dialysis

Chronic kidney disease being treated with dialysis may increase a person’s risk for severe illness from COVID-19.

Actions to take

Why you might be at higher risk

Dialysis patients are more prone to infection and severe illness because of weakened immune systems; treatments and procedures to manage kidney failure; and coexisting conditions such as diabetes.

Chronic lung disease

Chronic lung diseases, such as chronic obstructive pulmonary disease (COPD) (including emphysema and chronic bronchitis), idiopathic pulmonary fibrosis and cystic fibrosis, may put people at higher risk for severe illness from COVID-19.

Actions to take

  • Keep taking your current medications, including those with steroids in them (“steroids” is another word for corticosteroids).
  • Avoid triggers that make your symptoms worse.

Why you might be at higher risk

Based on data from other viral respiratory infections, COVID-19 might cause flare-ups of chronic lung diseases leading to severe illness.

Diabetes

Diabetes, including type 1, type 2, or gestational, may put people at higher risk of severe illness from COVID-19.

Actions to take

  • Continue taking your diabetes pills and insulin as usual.
  • Test your blood sugar every four hours and keep track of the results.
  • Make sure that you have at least a two-week supply of your diabetes pills and insulin.
  • Follow the sick day guidelines for people with diabetes.

Why you might be at higher risk

People with diabetes whose blood sugar levels are often higher than their target are more likely to have diabetes-related health problems. Those health problems can make it harder to overcome COVID-19.

Hemoglobin Disorders

Hemoglobin disorders such as sickle cell disease (SCD) and thalassemia may put people at higher risk for severe illness from COVID-19.

Actions to take

Why you might be at higher risk

Living with a hemoglobin disorder can lead to serious multi-organ complications, and underlying medical conditions (such as heart disease, liver disease, diabetes, iron overload, kidney disease, viral infections, or weakened immune system) may increase the risk of severe illness from COVID-19.

Immunocompromised

Many conditions and treatments can cause a person to have a weakened immune system (immunocompromised), including cancer treatment, bone marrow or organ transplantation, immune deficiencies, HIV with a low CD4 cell count or not on HIV treatment, and prolonged use of corticosteroids and other immune weakening medications. People who are Immunocompromised

Actions to take

  • If you are immunocompromised, continue any recommended medications or treatments and follow the advice of your healthcare provider.
  • Call your healthcare provider if you have concerns about your condition or feel sick.

Why you might be at higher risk

People with a weakened immune system have reduced ability to fight infectious diseases, including viruses like COVID-19. Knowledge is limited about the virus that causes COVID-19, but based on similar viruses, there is concern that immunocompromised patients may remain infectious for longer than other COVID-19 patients.

Liver disease

Chronic liver disease,  including cirrhosis, may increase risk for serious illness from COVID-19.

Actions to take

  • Take your medications exactly as prescribed.

Why you might be at higher risk

Severe illness caused by COVID-19 and the medications used to treat some severe consequences of COVID-19 can cause strain on the liver, particularly for those with underlying liver problems. People living with serious liver disease can have a weakened immune system, leaving the body less able to fight COVID-19.

People aged 65 years and older

Older adults, 65 years and older, are at higher risk for severe illness and death from COVID-19.

Actions to take

  • Take your medications for any underlying health conditions exactly as prescribed.
  • Follow the advice of your healthcare provider.
  • Develop a care plan that summarizes your health conditions and current treatments.
  • Prepare yourself to stay home for long periods using this checklist.

Why you might be at higher risk

Although COVID-19 can affect any group, the older you are, the higher your risk of serious disease. Eight out of 10 deaths reported in the U.S. have been in adults 65 years or older; risk of death is highest among those 85 years or older. The immune systems of older adults weaken with age, making it harder to fight off infections. Also, older adults commonly have chronic diseases that can increase the risk of severe illness from COVID-19.

People who live in a nursing home or long-term care facility

Many cases of COVID-19 in the U.S. have occurred among older adults living in nursing homes or long-term care facilities

Actions to take

  • Carefully follow your facility’s instructions for infection prevention.
  • Notify staff right away if you feel sick.
  • Ask your caretakers about the actions that are being taken at your nursing home or long-term care facility to protect you and your loved ones, including if and how they are limiting visitors.

Why you might be at higher risk

The communal nature of nursing homes and long-term care facilities, and the population served (generally older adults often with underlying medical conditions), put those living in nursing homes at higher risk of infection and severe illness from COVID-19.

Serious heart conditions

Serious heart conditions, including heart failure, coronary artery disease, congenital heart disease, cardiomyopathies, and pulmonary hypertension, may put people at higher risk for severe illness from COVID-19.

Actions to take

  • Take your medication exactly as prescribed. Continue angiotensin converting enzyme inhibitors (ACE-I) or angiotensin-II receptor blockers (ARB) as prescribed by your healthcare provider for indications such as heart failure or high blood pressure. This is recommended by current clinical guidelines.
  • Make sure that you have at least a two-week supply of your heart disease medications (such as those to treat high cholesterol and high blood pressure).
  • People with hypertension should continue to manage and control their blood pressure and take their medication as directed.

Why you might be at higher risk

COVID-19, like other viral illnesses such as the flu, can damage the respiratory system and make it harder for your heart to work. For people with heart failure and other serious heart conditions this can lead to a worsening of COVID-19 symptoms.

Severe obesity

Severe obesity, defined as a body mass index (BMI) of 40 or above, puts people at higher risk for complications from COVID-19.

 Actions to take

  • Take your medications for any underlying health conditions exactly as prescribed.

Why you might be at higher risk

Severe obesity increases the risk of a serious breathing problem called acute respiratory distress syndrome (ARDS), which is a major complication of COVID-19 and can cause difficulties with a doctor’s ability to provide respiratory support for seriously ill patients. People living with severe obesity can have multiple serious chronic diseases and underlying health conditions that can increase the risk of severe illness from COVID-19.