Who is at Increased Risk From Covid-19?

The information below is the most recent (Jan, 12, 2021) information available and will help you evaluate your potential risk of developing serious illness from contracting the coronavirus, SARS-CoV-2 and developing Covid-19. Not everyone who develops Covid-19 will experience the disease in the same way.

Some may experience diarrhea, high fevers and a “brain fog” whilst not developing respiratory symptoms, whilst others may develop severe respiratory distress or a combination of both. We still aren’t certain why some people react so severely to the virus whilst others do not even become ill. What we do know for sure is that certain sections of our population are at increased risk for developing serious Covid-19.

If you fall into one of these categories, then you need to take measures to ensure you protect yourself properly, take advantage of the vaccine as soon as it is made available to you and seek early treatment if you start experiencing any Covid-19 related symptoms. Most of the advice you see below is in accordance with the FDA’s guidelines on Covid-19.

At-Risk Groups for Covid-19

Increased Age

The risk for severe illness with COVID-19 increases with age, with older adults at the highest risk.

For example, people in their 50s are at higher risk for severe illness than people in their 40s. Similarly, people in their 60s or 70s are, in general, at higher risk for severe illness than people in their 50s. The greatest risk for severe illness from COVID-19 is among those aged 85 or older.

This table below will allow you to gauge how your associated risk of death from Covid-19 increases with age.

Age	Hospitalization	Death
18-29 years	Comparison Group	Comparison Group
30-39 years	2x higher	4x higher
40-49 years	3x higher	10x higher
50-64 years	4x higher	30x higher
65-74 years	5x higher	90x higher
75-84 years	8x higher	220x higher
85+ years	13x higher	630x higher

Medical Conditions

Adults of any age with the following conditions are at increased risk of severe illness from the virus that causes COVID-19:

• Cancer
• Chronic kidney disease
• COPD (chronic obstructive pulmonary disease)
• Down Syndrome
• Heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies
• Immunocompromised state (weakened immune system) from solid organ transplant
• Obesity (body mass index [BMI] of 30 kg/m² or higher but < 40 kg/m²)
• Severe Obesity (BMI ≥ 40 kg/m²)
• Pregnancy
• Sickle cell disease
• Smoking
• Type 2 diabetes mellitus

Based on what we know at this time, adults of any age with the following conditions might be at an increased risk for severe illness from the virus that causes COVID-19:

• Asthma (moderate-to-severe)
• Cerebrovascular disease (affects blood vessels and blood supply to the brain)
• Cystic fibrosis
• Hypertension or high blood pressure
• Immunocompromised state (weakened immune system) from blood or bone marrow transplant, immune deficiencies, HIV, use of corticosteroids, or use of other immune weakening medicines
• Neurologic conditions, such as dementia
• Liver disease
• Overweight (BMI > 25 kg/m², but < 30 kg/m²)
• Pulmonary fibrosis (having damaged or scarred lung tissues)
• Thalassemia (a type of blood disorder)
• Type 1 diabetes mellitus

Pregnancy and Covid-19

Based on what we know at this time, pregnant people are at an increased risk for severe illness from COVID-19 and death, compared to non-pregnant people. Additionally, pregnant people with COVID-19 might be at increased risk for other adverse outcomes, such as preterm birth (delivering the baby earlier than 37 weeks).

Racial and Ethnic Minority Groups

There is a raft of data and statistical evidence that shows some racial and ethnic minority groups are being disproportionately affected by COVID-19. Inequities in the social determinants of health, such as poverty and healthcare access, affecting these groups are interrelated and influence a wide range of health and quality-of-life outcomes and risks. The following factors contribute;

• Discrimination: Unfortunately, discrimination exists in systems meant to protect well-being or health. Examples of such systems include health care, housing, education, criminal justice, and finance. Discrimination, which includes racism, can lead to chronic and toxic stress and shapes social and economic factors that put some people from racial and ethnic minority groups at increased risk for COVID-19.

• Healthcare access and utilization: People from some racial and ethnic minority groups are more likely to be uninsured than non-Hispanic whites. Healthcare access can also be limited for these groups by many other factors, such as lack of transportation, child care, or ability to take time off of work; communication and language barriers; cultural differences between patients and providers; and historical and current discrimination in healthcare systems. Some people from racial and ethnic minority groups may hesitate to seek care because they distrust the government and healthcare systems responsible for inequities in treatment and historical events such as the Tuskegee Study of Untreated Syphilis in the African American Male and sterilization without people’s permission.
• Occupation: People from some racial and ethnic minority groups are disproportionately represented in essential work settings such as healthcare facilities, farms, factories, grocery stores, and public transportation. Some people who work in these settings have more chances to be exposed to the virus that causes COVID-19 due to several factors, such as close contact with the public or other workers, not being able to work from home, and not having paid sick days.
• Educational, income, and wealth gaps: Inequities in access to high-quality education for some racial and ethnic minority groups can lead to lower high school completion rates and barriers to college entrance. This may limit future job options and lead to lower-paying or less stable jobs. People with limited job options likely have less flexibility to leave jobs that may put them at a higher risk of exposure to the virus that causes COVID-19. People in these situations often cannot afford to miss work, even if they’re sick, because they do not have enough money saved up for essential items like food and other important living needs.
• Housing: Some people from racial and ethnic minority groups live in crowded conditions that make it more challenging to follow prevention strategies. In some cultures, it is common for family members of many generations to live in one household. In addition, growing and disproportionate unemployment rates for some racial and ethnic minority groups during the COVID-19 pandemic may lead to a greater risk of eviction and homelessness or sharing of housing.

A warning for our younger populations

The following facts have recently been highlighted by John Hopkins University and figures for children being admitted for Covid-19 are on the increase.

According to a recent article in JAMA, between March and July 2020, there were almost 12,000 excess deaths in people ages 25 to 44. (Excess deaths refers to the gap between actual deaths and the expected number of death based on historical norms.) Though not all of the excess deaths were due to COVID-19, many were.

It’s true that younger adults are less likely than older adults to die of COVID-19: Adults in the 25 to 44 age range account for less than 3% of COVID deaths, compared to 80% for people older than 65.

But younger people can get sick enough from the disease to require hospitalization or to die. And they may be among the long haulers — people who continue to experience fatigue, brain fog, shortness of breath, or other symptoms weeks and months after their illness.

And as is true in other age groups, COVID illness and death has a disproportionate impact on younger adults of color.

Because healthy younger adults are at lower risk than other populations, they are likely to be among the last to be vaccinated. That means it is even more important to continue wearing masks, maintaining physical distance, and avoid gathering in groups.