You’ve probably heard that older adults are at increased risk of severe illness if they contract the novel coronavirus (COVID-19). But adults of any age who have chronic conditions like heart disease, diabetes and lung disease are also at increased risk, as are people who are undergoing cancer treatment or who have weakened immune systems.
“If they acquire the infection, because of their underlying illness, they’re more likely to have an illness that’s at the severe end of the spectrum,” says Dr. William Schaffner, medical director of the National Foundation for Infectious Diseases and professor of preventive medicine and infectious diseases at Vanderbilt University’s School of Medicine in Nashville.
Research shows that among 710 COVID-19 patients in China who were hospitalized with pneumonia as a complication of the illness, 40% had chronic health conditions.
Other research from China found that among 191 patients who were hospitalized due to COVID-19, 48% had chronic health conditions, with high blood pressure, diabetes and coronary heart disease the most common conditions. The research also suggests that COVID-19 mortality rates are higher among people with chronic illness; in the second study, 54 out of 191 patients died.
Take Extra Precautions if You Have a Chronic Condition
For this reason, the Centers for Disease Control and Prevention (CDC) recommends that people with chronic health conditions take extra steps to reduce the risk of COVID-19.
These steps are in addition to recommendations for all people, including washing hands often, staying at least six feet away from others, avoiding crowds and not touching your face.
The agency also suggests that people with chronic conditions ask their doctors for extra medication (in case they’re unable to go out) and staying home if COVID-19 is spreading in their communities.
The Centers for Disease Control and Prevention recommends that people with chronic health conditions take extra steps to reduce the risk of COVID-19.
Links to Chronic Disease-Specific Recommendations
These are links to COVID-19-dedicated pages:
Asthma and Allergy Foundation of America
American Psychiatric Association
American Psychological Association
Even If You Feel Healthy
Some people with diabetes, high blood pressure and other chronic health conditions may feel they have their conditions under control and, therefore, shouldn’t be lumped in with the higher-risk group. But experts disagree.
“What we’ll have is a lot of persons who have the characteristics of otherwise being pretty healthy,” Schaffner says. “‘Yes, I have diabetes, but I lift weights and I go jogging every day.’ Sorry, you have diabetes — we’re going to put you in the category of likely to have a more severe illness if you get coronavirus infection,” he says.
Don’t Assume the Worst
If you have a chronic illness and you do become ill with the coronavirus, you shouldn’t assume the worst.
“Even if you have COPD (chronic obstructive pulmonary disease) and even if you get an episode which is bad enough to end up in the hospital and bad enough, even, to end up in the ICU (intensive care unit), it doesn’t mean that you’re not going to get better,” says Dr. Byron Thomashow, chief medical officer of the COPD Foundation and professor of medicine at the Columbia University Medical Center in New York City. “I don’t want people who think that … they’re going to die. … Many of them will get better,” he says.
That said, if you have a chronic health condition, the following recommendations may reduce your risk of COVID-19.
For People With Diabetes
If you have diabetes, do your best to maintain tight blood-sugar control.
“There’s a suggestion, not only with this infection, but with many different infections — urinary infections, skin infections, post-operative wound infections — that blood-sugar control makes a difference in terms of improving outcome,” says Dr. Zachary Bloomgarden, editor of the Journal of Diabetes and clinical professor of medicine, endocrinology, diabetes and bone disease at Mount Sinai Hospital in New York City. “We could then conclude that taking proper care of diabetes is an appropriate way of preparing oneself, and protecting oneself, if the infection occurs.”
If you notice any symptoms, check in with your doctor, whether or not the symptoms are related to COVID-19. Some doctors may treat you remotely if you don’t want to visit the office.
“I can do a lot with telemedicine, and I’m moving more and more in that direction,” Bloomgarden says. “My patients test their blood sugars at home. Some of them do continuous glucose monitoring, where I can access these huge amounts of data… The physical examination is not really as important as the talking part of the examination.”
For People With COPD and Other Lung Diseases
Although people with COPD or other lung diseases may be unsure if new symptoms mean they’re having a flare-up or they have COVID-19, their doctors will offer guidance.
“It can be difficult to know for sure, but there are some clues that people can look at, particularly the presence of fever,” Thomashow says. “Fever is not a typical finding in somebody with a COPD flare, [but] it is very common, well over 90% … of people with COVID-19. [And] the cough tends to be different. The cough with most COPD exacerbations tends to be more productive, but a cough with COVID-19 is dry.”
For People Undergoing Cancer Treatments
Some people may be concerned about visiting a hospital or treatment center with a compromised immune system, but continuing cancer treatments outweighs the risk of being out in public, Schaffner says.
“Don’t disrupt the cancer chemotherapy. The folks in the hospital have always used appropriate infection-control precautions, and they will continue to do so,” he says.
For All People With Chronic Illnesses
If you have a chronic illness, your doctor has probably told you that staying active is an important aspect of your care. Now isn’t the time to stop.
“It’s critically important that these people exercise,” Thomashow says. “They will not be able to go to rehab centers [or] their gyms anymore, [so] they should set up an exercise program at home. If they have exercise equipment, that’s fine. If not, they need to walk. … This problem is not going to go away in a week or two, and therefore, they should set up a plan that works long-term.”