Health conditions that elevate the risk of severe COVID-19

In May 2023, the World Health Organization (WHO) released a statement downgrading COVID-19 from a pandemic to “an established and ongoing health issue which no longer constitutes a public health emergency of international concern.” In other words, by 2023 COVID-19 had become a part of everyday life for the foreseeable future, but it was also significantly less dangerous to the general public than it was when it first arrived.

The WHO’s decision to downgrade COVID-19 from a public health emergency was made in response to downward trends in COVID-19 deaths, hospitalizations, and intensive care unit (ICU) admissions for infections, as well as increasing public immunity. By the time the public health emergency ended, over 670 million doses of COVID-19 vaccines had been administered in the United States.

Severe COVID-19 infections remain a risk for many

Although COVID-19 is no longer a public health emergency, severe infections remain a significant risk to the health of many individuals. Being 65 years or older, being under 6 months of age, being immunocompromised, and over 20 different health conditions are associated with an elevated risk of severe COVID-19.

Conditions associated with elevated risk of severe COVID-19:

• Asthma
• Cancer
• Cardiovascular disease
• Dementia
• Diabetes type 1 and type 2
• Chronic lung disease
• Chronic kidney disease
• Cerebrovascular disease, including stroke
• Chronic liver disease
• Cystic fibrosis
• Depression
• Disability
• HIV infection
• Schizophrenia
• Substance use disorders
• Obesity
• Organ or stem cell transplant
• Pregnancy or recent pregnancy
• Primary immunodeficiencies
• Tuberculosis
• Smoking (current and former)
• Sickle cell disease

Roughly 3 out of 4 adults living in the United States have an existing health condition like those listed above or comparable to those listed above. The prevalence of chronic conditions increases with increasing age.

It’s important to recognize that this list does not cover every circumstance where a person is at elevated risk. Everyone’s health and medical history is unique. A healthcare provider will be your best source of information about your risk of severe COVID—as well as other types of respiratory infections, like the flu and RSV (respiratory syncytial virus). A great place to start is by talking to a primary care provider.

What can you do if you or a loved one is at elevated risk?

Again, your best source of information will be a healthcare provider. If you or a loved one is diagnosed with any of the conditions above, or another health condition that requires ongoing management, you should have regular appointments with a healthcare provider to discuss symptoms and treatment. These appointments are also a time to discuss health concerns like COVID-19.

Some questions you may want to cover:

• What is your risk of severe COVID based on overall health, existing conditions, and medical history?
• Are you up to date on COVID-19 vaccinations?
• What can you do to prevent becoming infected with COVID-19? For example, basic strategies like avoiding crowds, wearing a mask, and washing hands.
• What can you do if you are exposed to COVID-19?
• What can you do if you have a COVID-19 infection?

In addition to vaccines, treatment options for COVID-19 have also improved since the pandemic and continue to expand.

People who are moderately-to-severely immunocompromised may be eligible for pre-exposure prophylaxis (PrEP), which provides additional protection against contracting COVID-19.

There is also post-exposure prophylaxis (PEP) which can prevent an infection from developing after a high-risk exposure, as well as antiviral medications that can reduce the duration and severity of a COVID-19 infection.

Always discuss the potential for adverse effects and drug interactions before starting any medication. Your healthcare provider or pharmacist will be your best source of information.