Most people have heard the familiar warning by now: People with certain health conditions are at a higher risk of serious illness if they contract COVID-19.
While older adults are also at a high risk for serious illness, people of any age with certain health conditions may be especially vulnerable, health experts say.
The Centers for Disease Control and Prevention keeps an evolving list of nearly two dozen health conditions ranked by the strength of scientific evidence available to support that they put a person at risk of serious illness if they get COVID-19. Here’s what you need to know.
Conditions with the strongest evidence
Eleven health conditions are listed under the CDC’s strongest and most consistent evidence category, meaning consistent evidence from multiple small studies, or an association from one large study, supports the conclusion that they put people at a high risk.
Cancer: Cancer itself, as well as cancer treatments, affect the body’s immune response. Some types of cancer affect the immune system blood cells, and treatments like chemotherapy, radiation therapy or immunotherapy can cause short-term damage to the immune system, according to the American Cancer Society.
People with cancer may also be poorly nourished due to the type of cancer they have or their cancer treatments, which can also weaken the body’s immune response.
In Dallas County, 7% of hospitalized patients through Nov. 20 have had cancer, according to data collected by the county.
Chronic kidney disease: Health experts say people with chronic kidney disease are at a higher risk because dialysis treatments can weaken the immune system, making it harder for a person to fight infection.
People with kidney disease may also have other health conditions, like hypertension and diabetes, which further increases risks. There are reports of patients having severe kidney damage after recovering from COVID-19 even though they did not have kidney disease or damage prior to getting the virus.
About 10% of all hospitalized patients in Dallas County through Nov. 20 have had kidney disease.
COPD and smokers: People with chronic obstructive pulmonary disease (COPD), a condition that affects the lungs and makes it hard to breathe, or people who smoke, are also at an increased risk because their lungs are already weakened. COVID-19 targets the lungs, and serious cases can lead to pneumonia or acute respiratory distress syndrome.
About 10% of all patients hospitalized in Dallas County through Nov. 20 had lung disease, including COPD.
Heart conditions: The CDC lists heart failure, coronary artery disease and cardiomyopathies as some of the heart conditions that increase risk of serious COVID-19 illness.
If someone gets COVID-19 and their lungs become damaged, an inflammatory response is triggered, which puts stress on the heart. A person’s blood pressure may drop, and the heart may have to work harder to get oxygen to the rest of the body, health experts say. There is also increasing evidence that COVID-19 patients may experience heart damage after recovering from the virus, putting people with existing heart conditions at greater risk.
About 13% of people hospitalized with the virus in Dallas County through Nov. 20 have had a heart condition.
Obesity: The CDC says a person who is obese is someone who has a body mass index of 30 kg/m2 or more, while someone who is severely obese has a body mass index of 40 kg/m2 or more.
UTSW researchers and other health experts say people with obesity may be at higher risk because obesity is associated with other health conditions that increase COVID-19 risk, including hypertension, diabetes, inflammation, a weakened immune system and an increased likelihood of blood clotting. Additionally, having more weight on the chest can push on a person’s lungs, making it harder to breathe.
In Dallas County, 17% of patients hospitalized with the virus through Nov. 20 were obese. The county does not distinguish between obesity and severe obesity in its reports.
Pregnancy: The CDC added pregnancy to this category in early November, citing studies that indicate pregnant women with COVID-19 are more likely to be admitted to intensive care units and require oxygen or ventilation than women who are not pregnant.
Health experts say pregnancy is known to put a woman at risk if she contracts a respiratory illness. As a fetus grows, more pressure is put on the woman’s lungs, which makes breathing difficult. The heart may also have to work harder to provide both the woman and the fetus with oxygen. And a woman’s immune system, which is adjusted to care for both herself and the fetus, may create complications if it over-responds to a COVID-19 infection.
Sickle cell disease: Sickle cell disease is a genetic condition that affects the red blood cells. While normal red blood cells are round and can move easily through the body, red blood cells in someone with sickle cell disease are C-shaped and die early, causing a shortage of red blood cells.
Symptoms of the disease range from mild to severe, and can include an increased likelihood of blood clotting, oxygen deprivation, pain and inflammation. Health experts say that because COVID-19 affects the lungs, the production of sickle-shaped cells may increase, leading to lower oxygen levels in the body and more inflammation.
Sickle cell disease mainly affects people whose ancestors came from places including sub-Saharan Africa, Spanish-speaking regions in the Western Hemisphere, Saudi Arabia, India and certain Mediterranean countries, according to the CDC.
The disease occurs in 1 out of every 365 African-American births and in 1 out of every 16,300 Hispanic-American births, according to the CDC. Health experts say that Black and Hispanic people are already disproportionally affected by COVID-19.
Solid organ transplantation: Health experts say that people who have received an organ transplant are at a higher risk of COVID-19 complications because of the medications they take after the transplant. Many organ recipients are on immunosuppressant medications, which weaken their immune system to ensure that their body does not reject the new organ.
Type 2 diabetes: Health experts say that many people with diabetes have chronic inflammation, which can lead to a more severe inflammatory response if they get the virus. Health experts have said it’s often the body’s response to a COVID-19 infection that causes serious complications, and not the virus itself. People with diabetes may also have a weakened immune system, making it harder to fight the infection.
In Dallas County, 31% of all patients hospitalized through Nov. 20 had diabetes. The county does not distinguish between type 1 and 2 in its reports.
Conditions with mixed or limited evidence
The CDC lists four conditions as having mixed evidence for increasing the risk of COVID-19 complications, meaning multiple studies reached different conclusions about the risk of the condition.
Conditions with mixed evidence include asthma, cerebrovascular disease, or a group of conditions that affect blood vessels and blood supply to the brain, hypertension, or high blood pressure, and people who use corticosteroids or other immunosuppressive medications.
Eleven more conditions are listed under the limited evidence category, meaning consistent evidence from a small number of studies shows that these conditions increase the risk of serious COVID-19 cases.
Conditions with limited evidence include HIV, immune deficiencies, inherited metabolic disorders, liver disease, neurologic conditions like dementia, chronic lung diseases not listed in the previous two categories, type 1 diabetes, and thalassemia, a blood disorder that affects the production of hemoglobin.
The CDC says limited evidence also shows that children, people who have received bone marrow transplants and people who are overweight (defined as having body mass index between 25 kg/m2 and 30 kg/m2), may also be at increased risk.
How to protect yourself
The CDC says people with conditions in any of these categories should strictly follow public health guidelines that are recommended for the entire population, like social distancing, wearing a face mask in public, frequent hand washing and limiting contact with frequently touched surfaces or shared items as much as possible.
People with high-risk conditions should also continue taking their medications as instructed, and should not change their treatment plan without consulting with their doctor. Those with high-risk conditions should not avoid or delay going to the doctor if they need care, the CDC says.
If you have a high-risk condition, the CDC said it’s particularly important to get a flu and pneumonia vaccine this year. The CDC also recommends keeping a 30-day supply of medication on hand to limit trips to the pharmacy.
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