Here’s Why Certain People Face More Serious COVID-19 Illness Than Others
Cases of the novel coronavirus continue to climb in the United States, and multiple deaths have been reported.
While anyone can contract COVID-19, certain groups seem to be more vulnerable to severe illness and complications.
An infectious disease doctor explains why some groups are considered high-risk, and steps you can take to protect yourself and loved ones.
Cases of the novel coronavirus continue to climb in the United States, with multiple reported deaths, according to the Centers for Disease Control and Prevention (CDC). While anyone can contract COVID-19 and experts are “seeing all age groups impacted,” some people seem to be more affected by the illness than others, explains infectious disease expert Amesh A. Adalja, M.D., senior scholar at the Johns Hopkins Center for Health Security.
COVID-19 can cause a spectrum of symptoms, ranging from mild, common cold-like cases, to severe cases that lead to life-threatening complications like pneumonia. There isn’t a magical cut-off age for who will and won’t experience serious effects from the disease, Dr. Adalja says, but some groups do face a higher risk of complications. Here’s what you need to know.
Who is most at risk for novel coronavirus complications?
Most of what is known about the risk factors for COVID-19 is based on what’s been reported out of China, where the novel coronavirus outbreak originated and an overwhelming majority of cases and deaths have occurred. Here are two groups that seem to be especially vulnerable:
Older adults
The majority of deaths from coronavirus have been in the elderly, Dr. Adalja says. “Above age 50 is when you start to see more severe complications,” he explains, adding that older patients have a harder time recovering, similar to to the flu. (Common flu complications in high-risk groups include bronchitis and pneumonia, which have also been reported in patients with COVID-19.)
For example, the first novel coronavirus-related death in Placer County, Calif. was confirmed in “an elderly adult with underlying health conditions,” local health officials reported in early March. The patient “was likely exposed during international travel from Feb. 11 to 21 on a Princess cruise ship.” During the initial outbreak of coronavirus-related deaths in Washington state, a majority of patients were residents of a nursing facility and over the age of 70.
People with underlying health conditions
People with underlying health conditions are at a higher-than-normal risk of developing severe forms of COVID-19, Dr. Adalja says. When your body is already dealing with a separate health condition, it has less energy to put toward fighting an acute infection, he explains. The CDC says these conditions include:
Blood disorders, such as sickle cell disease or taking blood thinners
Chronic kidney disease, as defined by your doctor
Chronic liver disease, as defined by your doctor
Compromised immune system, including undergoing cancer treatment such as chemotherapy or radiation, having received an organ or bone marrow transplant, or taking high doses of corticosteroids or other immunosuppressant medications, and HIV or AIDS
Current or recent pregnancy in the last two weeks
Endocrine disorders, such as diabetes
Metabolic disorders
Heart disease
Lung disease, including asthma
Neurological and neurologic and neurodevelopment conditions
How are younger adults dealing with COVID-19?
People in their 20s, 30s, and 40s seem to have a lower risk of novel coronavirus complications, Dr. Adalja says. “It’s very unlikely for young people to have severe cases,” but that doesn’t mean it can’t happen, Dr. Adalja says, especially if you have direct or frequent contact with the disease or an underlying condition. (Li Wenliang, the 34-year-old Chinese doctor who was one of the original whistleblowers on coronavirus died of the virus in early February.)
What about the COVID-19 risk in children?
Unlike other respiratory viruses like the flu, COVID-19 has not been severely impacting children in the United States, Dr. Adalja says. “It’s not that it’s impossible,” he explains, “but we haven’t seen it yet.”
Limited reports out of China “suggest that children with confirmed COVID-19 have generally presented with mild symptoms,” the CDC states, “and though severe complications have been reported, they appear to be uncommon.” While there is currently no direct evidence that kids are more susceptible, they should still be taught basic hygiene practices to avoid infection.
How can you protect yourself or loved ones who are considered high-risk?
The CDC says coronaviruses most commonly spread from an infected person to others via respiratory droplets that travel through the air by coughing or sneezing or by touching a surface contaminated with the virus and then touching your mouth, nose, or eyes.
So it’s important to follow certain precautions, whether you’re considered high-risk or not, Dr. Adalja says. Per the CDC, those include:
Avoid touching your eyes, mouth, or nose.
Avoid close contact with anyone who appears to be sick.
Wash your hands well and frequently with soap and water for at least 20 seconds.
Use alcohol-based hand sanitizer when soap and water isn’t readily available.
Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
Clean and disinfect frequently touched objects and surfaces.
Talk to your doctor if you develop symptoms within 14 days of returning from a country with a COVID-19 outbreak.
Stay home if you develop cold or flu-like symptoms.
Avoid nonessential travel to areas with active COVID-19 outbreaks.
Visit the website for your local health department to make sure you are getting accurate updates.
If you’re in a high-risk group and you’re especially worried about the virus, it’s not a bad idea to steer clear of large public gatherings—especially if there are known COVID-19 cases in your area—as well as public transit, if possible, Dr. Adalja says.
As a whole, it’s important to remember that most cases of COVID-19 are not severe. “The vast majority of people are going to have a mild illness and many are not going to require hospitalization,” Dr. Adalja says.
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