Who's Most At Risk For Coronavirus Complications? Experts Explain
By now I'm sure you've heard that elderly people and those who are immunocompromised are the most vulnerable to getting a more severe case of COVID-19. Because the word “immunocompromised” is so broad, however, it’s really hard to know exactly who's at risk for coronavirus complications. Simply put, a person who is immunocompromised has an immune system that isn't working optimally, and while these people are no more at risk for contracting coronavirus than anyone else, if they do fall ill, it's more likely that they'll experience complications.
“Without an intact immune system, the virus can replicate and overwhelm the body's defenses,” Dr. Bruce Moskowitz, an oculoplastic surgeon, tells Romper. A healthy immune system is especially important in fighting an illness like coronavirus, which has no vaccine and no known cure. “The only defenses are avoidance of infection and one's own immune system. It’s also the immune system which promotes healing after the infection is eliminated,” Moskowitz adds.
Avoidance of the infection is exactly why social distancing is important for all people. High-risk individuals have taken to Twitter (using the hashtag #HighRiskCovid19) to ask that all people, regardless of age or health, take social distancing seriously (as Forbes reported) and it's powerful to read through the tweets and get a sense of just how many people are immunocompromised.
It’s important that you keep your immune system in good condition, even if you’re not considered immunocompromised (and this requires more than chugging Emergen-Cs). “All patients should try to optimize their general health to ensure proper immune function,” Moskowitz says. “Good nutrition, adequate sleep, exercise, avoidance of alcohol, smoking, vaping and drugs are all very important.”
Pregnancy also lowers the immune system to a certain degree, "to accommodate for the foreign genetic material in the uterus (so the woman's immune system doesn't attack the father's genes in the baby)" Dr. Niket Sonpal, a New York-based internist and gastroenterologist, tells Romper. The goods news is that "data for COVID-19 does not follow this. According to WHO there is no evidence that pregnant women present with different signs or symptoms or are at higher risk of severe illness," Sonpal adds.
Read on for six factors that may make you more susceptible to coronavirus complications (and note that this is not an exhaustive list).
1. People Who Have Diabetes
The CDC notes diabetes as one of the chronic illnesses that puts people at a higher risk of developing severe cases of coronavirus.
"Diabetes is always a complicated factor because it takes the body longer to heal," Sheryl Buchholtz Rosenfield, RNBC in geriatrics, tells Romper. If you or a loved one is diabetic, the CDC recommends contacting your health care provider to ask about the possibility of getting extra medication.
2. People Who Smoke Or Have Respiratory Illness
Coronavirus is tough on the lungs, so it makes sense that the virus may be especially tough on smokers on those with reduced lung capacity.
"In China, the incidence of smoking amongst men is approximately 50% while for women it was 2%," Dr. Michael G. Schmidt, professor of microbiology and immunology at Medical School of South Carolina, tells Romper. "Men were more seriously affected [than women]. It's uncertain how smoking makes you more vulnerable —research needs to be done — it’s just what the data are saying. My suspicion is that any process (smoking, vaping, asthma, chronic lung diseases) that compromises lung function makes you more vulnerable."
Smoking is a risk because, among other things, it can cause, "poor clearance of pulmonary secretions," Moskowitz tells Romper, which can make it difficult to clear mucus from the body.
People with asthma or COPD may be at higher risk because "damaged airways make it more likely for the virus to enter [the body]," Sonpal tells Romper.
3. People With Heart Disease Or High Blood Pressure
People with heart disease, including "folks with stents, circulatory disorders, blood disorders, high blood pressure, [or] chronic inflammatory conditions all seem to [be] at a greater risk for a more severe form of what is normally a condition like a seasonal cold," Schmidt tells Romper. This also includes anyone who has recently had a stroke.
4. People On Certain Medications
Sometimes immunosuppressant drugs are used to treat autoimmune disorders. "With an autoimmune disease, the immune system attacks the body's own tissue. Because immunosuppressant drugs weaken the immune system, they suppress this reaction," per Healthline. People who are taking these medications are more vulnerable to illness, however.
"Those who are on immunosuppressive agents like steroids, chemotherapy and the new class of biologic agents (monoclonal antibodies) such as Humira, Rituxan, Cosentyx, etc., are at risk for serious medical complications from any infection," Moskowitz tells Romper.
5. People With Chronic Inflammatory Conditions
Inflammatory conditions include rheumatoid arthritis, lupus, multiple sclerosis, asthma, and even certain allergies.
For everyone, but especially those who are elderly or immunocompromised, it's important to frequently wash hands, avoid high-touch surfaces. "[Try] to de-stress by turning off your electronics, staying positive, and keeping human connection through phone and video calls are very important. Social distance doesn't mean social isolation. Remember to check in on those who may not have as many people looking after them as you do," Rosenfield says. If someone in your life is immunocompromised, it's a good idea to call them regularly as they are likely to be staying at home at all times and may be feeling isolated or lonely.
6. People Living With Cancer
Patients with underlying immunologic diseases such as lymphoma or leukemia are more at risk for developing complications if they were to get COVID-19, according to Moskowitz.
"Some types of chemotherapy damage the immune system, leaving people vulnerable to infections. A particularly stark example of this is ... with blood cancers, where complete destruction of certain types of immune cells is often required in order to get rid of the cancerous cells. But people with several other types of cancer can also be left with compromised immune systems, depending on what type of treatments they are receiving," per Forbes.
It's important that everyone, even those who have strong immune systems and feel healthy, practice social distancing. In addition to reducing your own risk of getting sick, you greatly reduce the risk that you infect someone who is elderly or immunocompromised.
If you think you’re showing symptoms of coronavirus, which include fever, shortness of breath, and cough, call your doctor before going to get tested. If you’re anxious about the virus’s spread in your community, visit the CDC for up-to-date information and resources, or seek out mental health support. You can find all our Romper’s parents + coronavirus coverage here on this page, and Bustle’s constantly updated, general “what to know about coronavirus” here.
Dr. Bruce Moskowitz, Oculoplastic Surgeon at Specialty Aesthetic Surgery
Dr. Michael G. Schmidt, Professor of Microbiology and Immunology at Medical School of South Carolina
Dr. Niket Sonpal, New York-based internist and gastroenterologist