6 groups of people who are at higher risk for COVID-19

Scientists continue to learn more about COVID-19 every day. But one thing has become clear: It’s not an equal opportunity disease.

Everyone is considered susceptible to the new coronavirus, but certain groups are much more vulnerable, says Manish Trivedi, MD. He’s the director of infectious diseases at AtlantiCare, a health system in New Jersey.

Here’s a look at who’s in these groups and the best ways to protect yourself.

Risk No. 1: You’re 50 or older.

You’ve likely heard that older adults are hit particularly hard by COVID-19. Most deaths related to the disease have occurred in those over age 60.

But people who are in their 50s should also be extra vigilant, says Aimee Ferraro, PhD. She’s a faculty member for Walden University’s Master of Public Health program and a researcher on infectious and vector-borne diseases.

That’s because your immune system — which keeps your body healthy by fighting germs — isn’t as robust.

The severity of COVID-19 appears to increase dramatically with age, says Ferraro. The Centers for Disease Control and Prevention (CDC) compared the hospitalization rates for adults with those of children ages 5 to 17. Here’s what it found:

• People in their 40s are 15 times more likely to be hospitalized with COVID-19.
• People 50 to 64 are 25 times more likely to end up in the hospital.
• People 65 to 74 are 35 times more likely to be hospitalized.

That pattern is similar to other diseases such as measles, SARS, and MERS, Ferraro says. “We don’t fully understand why this occurs,” she says. The leading theory is that older adults tend to have weaker immune systems and a higher likelihood of a chronic health condition.

Risk No. 2: You have heart disease.

Having heart disease doesn’t mean you’re more likely to contract the coronavirus, according to the American Heart Association (AHA). But you are more likely to have complications if you do develop COVID-19, explains Dr. Trivedi.

Those with heart trouble often have impaired immune systems, he says. So any virus is more prone to causing complications. Plus: “The coronavirus can lead to a buildup of fluid in the lungs. That puts greater strain on the heart,” he says.

What’s especially concerning is that having heart disease can significantly increase your risk of dying from COVID-19. A study presented at the 2020 American Heart Association Scientific Sessions meeting reviewed the medical records of nearly 20,000 people hospitalized with COVID-19 in the U.S. Researchers found that underlying heart problems increased the risk of dying by 25.5% to 38.4%.

Even if your only heart-related risk factor is high blood pressure, the American College of Cardiology and the AHA still recommend taking everyday precautions. (See “How to Protect Yourself,” below.)

Risk No. 3: You have diabetes.

High blood sugar levels can weaken your immune system, says Dr. Trivedi. That makes it harder to treat viral infections.

Also, diabetes-related health problems, such as reduced blood flow to hands and feet, can raise your risk of infection. Plus, it can lead to worse outcomes if you come down with COVID-19, according to the American Diabetes Association (ADA).

Thus far, it doesn’t appear that COVID-19 poses a difference in risk between people with type 1 diabetes and type 2 diabetes. Some things you can do to stay healthy, according to the ADA:

• Get extra refills of your prescription medications to limit trips out of the house.
• Have plenty of glucagon and ketone strips, in case of lows and highs.
• Replenish your stock of simple carbs to help keep your blood sugar up if you do become sick.

Risk No. 4: You have lung disease.

Because COVID-19 is a respiratory virus, it can have a greater impact on people with existing lung diseases, such as chronic obstructive pulmonary disease (COPD). “These people already have impaired breathing, so getting coronavirus would make that worse,” says Dr. Trivedi.

People with COPD and other breathing problems also tend to have lowered immune function. That can make you more likely to get COVID-19. That’s why the CDC recommends people with COPD do the following to prevent getting COVID-19:

• Continue taking all your medications, including those that contain steroids.
• Make sure you have at least a 30-day supply of your medicines.
• Try to avoid triggers that make your breathing worse.
• Stay up to date on your pneumococcal vaccine.

Risk No. 5: Your immune system is compromised.

In addition to the conditions listed above, there are many others that involve a compromised immune system, including:

• HIV,
• Lupus,
• Multiple sclerosis,
• Genetic disorders,
• Kidney disease,
• Crohn’s disease, and
• Cancer.

In some cases, both the condition and the treatment may suppress immune function. For example, chemotherapy and radiation temporarily lower immune function so that those cancer treatments can work. But that could leave patients more susceptible to COVID-19 and other viruses.

"Any bad infection can be life-threatening to someone who is immune-compromised,” says Ferraro.

Risk No. 6: You have obesity.

Obesity is now a known risk factor for more serious illness from COVID-19. In fact, nearly one-third of all COVID-19 hospitalizations were attributed to obesity, according to the CDC. The risk was high among people under 65 as well.

Carrying extra pounds increases inflammation. That in turn forces the body’s immune system to work harder to fight off infections. Extra weight also puts extra pressure on the lungs.

How to protect yourself

The best way to protect yourself is to get your COVID-19 vaccine. As of April 15, 2021, everyone in California age 16 and older is eligible to get the shot. Schedule yours now at My Turn.

In the meantime, continue to:

• Avoid large crowds and nonessential travel.
• Keep social distancing and wearing your mask in public.
• Practice good self-care: Wash your hands often with soap and water. Get plenty of rest and exercise. And enjoy a variety of healthy foods.

If you do spike a fever or notice signs of a respiratory illness, call your doctor or an urgent care center. Don’t just show up unannounced or head to the ER. That way, Dr. Trivedi says, you can be directed to the right location based on your symptoms. In some cases, you may be advised to stay home.

This also helps to prevent you from catching and spreading illnesses. Of course, if you are having a life-threatening emergency like extreme shortness of breath, call 911.

The information in this story is accurate as of press time and posting. Getting vaccinated is one of the best ways to limit the spread of the coronavirus. It’s also important to continue practicing social distancing (keeping at least 6 feet away from people outside your household) and washing your hands frequently. You should also be appropriately masked any time you’ll be in public. According to the CDC’s latest guidance, this means layering a disposable mask underneath a snug-fitting cloth mask or placing a mask fitter over your cloth mask to ensure a tight fit. Because the situation surrounding COVID-19 continues to evolve, we encourage readers to follow the news and recommendations for their own communities by using the resources from the CDC, WHO, their local public health department, and our COVID member site.