Know Your Risk

It is important to know that a severe infection with COVID-19 can occur at any age, yet older adults and those with certain medical conditions are especially prone to severe infection. Severe disease can be defined as an infection with the COVID-19 virus that requires a hospital stay or admission to intensive care. Those with severe COVID-19 may also require a breathing tube, or intubation. Severe COVID-19 infection can also lead to death.

Age is an important risk factor as older adults are more likely to have severe COVID-19. There are many studies that show different “cut offs” for age. Some of these studies were performed in China and others in the United States. Nonetheless, in general anyone over the age of 65 years is considered to be at the high risk of severe infection with the COVID-19 virus. (1,2)

There are also several pre-existing medical conditions that makes one more likely to have a severe COVID-19 infection. These conditions include: heart disease, diabetes, high blood pressure, and kidney disease. Also being overweight and a smoker increases the risk of severe COVID-19 infection. Since COVID-19 causes a viral pneumonia, having lung disease, such as asthma or emphysema, can further increase the risk of severe infection. Finally, cancer is a significant risk as well. Particularly, blood and lung cancers, including cancer that have spread thought the body, have the highest risk. (3)

There are also certain gender and ethnic groups that appear to be more at risk. Specially men tend to have a higher rate of death when compared to women. Also, African Americans, Latinos and South Asians have higher rates of infections and death. (4) The differences across ethnic groups highlight socioeconomic disparities in access to healthcare and an inability for essential frontline workers to shelter in place without experiencing financial turmoil.

In all, not only can anyone in any age group be infected with the COVID-19 virus, there are certain population that are at risk for severe infection and death. Care must be taken to protect the venerable members of our society. Furthermore, we should appreciate the differences in healthcare outcomes that remind us that we still have work to do in leveling the playing field for everyone to have equal access to healthcare and economic opportunities.

REFERENCES

1. CDC COVID-19 Response Team. Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) – United States, February 12-March 16, 2020. MMWR Morb Mortal Wkly Rep. 2020 Mar 27;69(12):343-346. doi: 10.15585/mmwr.mm6912e2. PMID: 32214079.
2. Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020 Apr 7;323(13):1239-1242. doi: 10.1001/jama.2020.2648. PMID: 32091533.
3. Dai M, Liu D, Liu M, Zhou F, Li G, Chen Z, Zhang Z, You H, Wu M, Zheng Q, Xiong Y, Xiong H, Wang C, Chen C, Xiong F, Zhang Y, Peng Y, Ge S, Zhen B, Yu T, Wang L, Wang H, Liu Y, Chen Y, Mei J, Gao X, Li Z, Gan L, He C, Li Z, Shi Y, Qi Y, Yang J, Tenen DG, Chai L, Mucci LA, Santillana M, Cai H. Patients with Cancer Appear More Vulnerable to SARS-CoV-2: A Multicenter Study during the COVID-19 Outbreak. Cancer Discov. 2020 Jun;10(6):783-791. doi: 10.1158/2159-8290.CD-20-0422. Epub 2020 Apr 28. PMID: 32345594; PMCID: PMC7309152.
4. Moore JT, Ricaldi JN, Rose CE, Fuld J, Parise M, Kang GJ, Driscoll AK, Norris T, Wilson N, Rainisch G, Valverde E, Beresovsky V, Agnew Brune C, Oussayef NL, Rose DA, Adams LE, Awel S, Villanueva J, Meaney-Delman D, Honein MA; COVID-19 State, Tribal, Local, and Territorial Response Team. Disparities in Incidence of COVID-19 Among Underrepresented Racial/Ethnic Groups in Counties Identified as Hotspots During June 5-18, 2020 – 22 States, February-June 2020. MMWR Morb Mortal Wkly Rep. 2020 Aug 21;69(33):1122-1126. doi: 10.15585/mmwr.mm6933e1. PMID: 32817602; PMCID: PMC7439982.