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COVID-19: Who’s at higher risk of serious symptoms?

Many people with COVID-19, also called coronavirus disease 2019, recover at home. But for some, COVID-19 can be a serious illness. Some people may need care in the hospital, treatment in the intensive care unit and the need for breathing help. In some people, severe COVID-19 illness can lead to death.

Not every risk factor for serious COVID-19 illness is known. But some risks stand out thanks to research gathered since the start of the pandemic.

The risk for serious COVID-19 illness depends on your health status, age and activities. Your risk also depends on other factors. This includes where you live, work or learn, how easy it is for you to get medical care, and your economic stability.

If you have more than one risk factor, your risk goes up with each one.

People age 65 and older and babies younger than 6 months have a higher than average risk of serious COVID-19 illness. Those age groups have the highest risk of needing hospital care for COVID-19.

Babies younger than 6 months aren’t eligible for the COVID-19 vaccine, which adds to their risk. For older people, the challenge is that the immune system is less able to clear out germs as people age. Also, as people age, medical conditions that raise the risk of severe COVID-19 are more likely. In the U.S. as of March 2024, about 76% of all deaths from COVID-19 have been among people age 65 and older.

Severe COVID-19 disease is more likely for people who have other health issues.

Some common diseases linked to aging are:

These diseases become more common as people age. But they can affect people of any age. The risk of serious COVID-19 illness is linked to having one or more underlying medical condition.

Your risk of having more severe COVID-19 illness is higher if you have lung disease. Having moderate to severe asthma raises some risks of serious COVID-19 illness. It raises the risk of needing care in the hospital, including intensive care, and needing mechanical help breathing.

The risk of serious COVID-19 illness also is higher for people who have conditions that damage lung tissue over time. Examples are tuberculosis, cystic fibrosis, interstitial lung disease, bronchiectasis or COPD, which stands for chronic obstructive pulmonary disease. These diseases raise the risk of needing care in the hospital for COVID-19. Depending on the condition, the risk of needing intensive care and the risk of death from COVID-19 also may go up.

Other lung conditions, such as a history of pulmonary hypertension or pulmonary embolism affect a person’s risk of serious illness after COVID-19. The risk of death may be higher after these conditions.

In general, people with cancer have a greater risk of getting serious COVID-19. People who have or had blood cancer may have a higher risk of being sick for longer, or getting sicker, with COVID-19 than people with solid tumors.

Having cancer raises the risk of needing care in the hospital, intensive care and the use of breathing support. Having blood cancer and getting COVID-19 raises the risk of death from the illness.

Treatment for blood cancer may raise the risk of severe COVID-19 but the research is still unclear. Cancer treatment may also affect your COVID-19 vaccine. Talk to your healthcare professional about additional shots and getting vaccinated after treatments that affect some immune cells.

If an organ or body system is already weakened by disease, infection with the COVID-19 virus can cause further damage. In other cases, medicine for the original condition can lower the immune system’s response to the virus that causes COVID-19.

Many different diseases can raise the risk of severe COVID-19 illness.

Other risk factors for severe COVID-19 are:

Also, as a general group, disability is linked to an increased risk of severe COVID-19. The risks are different depending on the disability.

These are not the only conditions that increase the risk of severe COVID-19. Talk to your healthcare professional if you have questions about your health and risk for getting a serious COVID-19 illness.

The COVID-19 vaccine can lower the risk of death or serious illness caused by COVID-19. Your healthcare team may suggest added doses of COVID-19 vaccine if you have a moderately or seriously weakened immune system.

Everyone can lower the risk of serious COVID-19 illness by working to prevent infection with the virus that causes COVID-19.

These basic actions are even more important for people who have weakened immune systems, and their caregivers.

The FDA also has authorized the monoclonal antibody pemivibart (Pemgarda) to prevent COVID-19 in some people with weakened immune systems.

People can take other actions based on their risk factors.

You may consider making a care plan. In the care plan, write your medical conditions, the medicine you take, and any special food or diet needs you have. The care plan also includes who you see for care and your emergency contacts.

© 1998-2024 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved.

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