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CDC List of High-Risk Conditions for Severe COVID-19 Illness

Since the earliest days of the COVID-19 pandemic, health experts have been struggling to make sense of the virus and figure out who is most likely to develop dangerous complications. From the beginning, it seemed clear that older adults and people with certain underlying health conditions were at greatest risk.

That hasn’t changed, but the U.S. Centers for Disease Control and Prevention (CDC) recently updated its information on high-risk groups to provide more specifics, based on the latest available information.

Age

While people of all ages have been hospitalized with COVID-19 or died from it, advancing age continues to be a major risk factor. According to the most recent info from the CDC, the risk of serious complications goes up the older you are. The agency reported that people 85 and up face the greatest risk; eight out of 10 who’ve died from the virus have been at least 65 years old.

However, the new list specifically states that “people of any age with certain underlying medical conditions are at increased risk for severe illness from COVID-19.”

In fact, the CDC’s info specifically mentions children with underlying health issues being at increased risk compared with healthy children: “Children who are medically complex, who have neurologic, genetic, metabolic conditions, or who have congenital heart disease are at higher risk for severe illness from COVID-19 than other children.”

Underlying Medical Conditions

A lot of attention is also being paid to underlying medical conditions. In this latest update, the CDC broke medical conditions into two categories: one that definitely puts people into the high-risk group and another that might raise the risk but is less definitive.

The confirmed highest-risk category includes people with:

  • Kidney disease
  • Chronic obstructive pulmonary disease (COPD)
  • Organ transplant recipients
  • Obesity
  • Serious heart conditions like heart failure and cardiomyopathy
  • Sickle cell disease
  • Type 2 diabetes

The secondary group of conditions that “might” increase your risk includes people with:

  • Moderate-to-severe asthma
  • Cerebrovascular disease
  • Cystic fibrosis
  • High blood pressure
  • Dementia and other neurological conditions
  • Liver disease
  • Pulmonary fibrosis
  • Thalassemia
  • Type 1 diabetes
  • Those who are pregnant
  • Smokers

It also includes people who are immunocompromised as a result of having a blood or bone marrow transplant, HIV, or use of immune-weakening medications including corticosteroids.

Aside from corticosteroids, the CDC did not specify which medications weaken the immune system sufficiently to pose a risk.

What Rheumatic Disease Patients Should Know

Rheumatologists say that corticosteroids such as prednisone are most problematic when taken at high doses for extended periods of time. That’s because these drugs broadly suppress inflammation. That can be helpful in the short-term, such as when you’re in the midst of a disease flare, but when steroids are used for long periods it can reduce your immune system’s ability to combat infections.

Many other medications that are commonly used to treat rheumatic diseases, including conventional disease-modifying antirheumatic drugs (DMARDs) and biologics, do have some immune-suppressing properties, but not to the same extent.

If you’re currently taking a steroid, the American College of Rheumatology advises considering lowering the dose or weaning off the drug provided you can do so safely while controlling your disease activity. (Check with your doctor, and never stop steroids cold turkey.)

If you’re taking almost any other rheumatic medications — including methotrexate, biologics, JAK inhibitors, etc. — you should continue with your usual treatment. If you actually contract COVID-19, your doctor may advise temporarily taking a break, but it’s not wise to stop these drugs unless you’re currently battling an infection.

You should also know that, in general and based on research available so far, people with rheumatic disease do not seem any more likely than others to require hospitalization for COVID-19.

Talk to your doctor if you have any questions about your risk factors or treatment regimen during the pandemic. Read more here about getting optimal rheumatology care during the coronavirus pandemic.

Advice for Staying Safe If You Have an Underlying Health Condition

The CDC also issued updated information about how people at increased risk of severe illness from COVID-19 can stay safe as states continue to reopen. “In general, the more people you interact with, the more closely you interact with them, and the longer that interaction, the higher your risk of getting and spreading COVID-19,” the CDC says, noting that the best way to protect yourself is to:

  • Limit your interactions with other people as much as possible.
  • Take precautions to prevent getting COVID-19 when you do interact with others.

The advice includes:

  • Consider your level of risk before deciding to go out and ensure you are taking steps to protect yourself.
  • Avoid activities where taking protective measures may be difficult, such as situations where social distancing can’t be maintained.
  • Protect yourself by practicing everyday preventive actions, such as wearing a face covering, staying at least six feet apart from others, and washing or sanitizing your hands frequently.
  • Always bring these items with you when you leave the house: a cloth face covering, tissues, and a hand sanitizer with at least 60 percent alcohol, if possible.
  • Visit with your friends and family outdoors, when possible.
  • If you must be indoors, make sure the room or space is well-ventilated (for example, open windows or doors) and large enough to allow for social distancing.
  • Avoid others who are not wearing cloth face coverings or ask others around you to wear cloth face coverings.
  • Avoid close contact with visitors — don’t shake hands, elbow bump, or hug.
  • Consider keeping a list of people you visited or who visited you and when the visit occurred. This will help with contract tracing if someone becomes sick.

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People Who Are at Increased Risk for Severe Illness. Coronavirus Disease 2019 (COVID-19). U.S. Centers for Disease Control and Prevention. Updated June 25, 2020. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html.