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Comorbidities the CDC classifies as risk factors for severe COVID-19*[1-3]

Comorbidities the CDC classifies as risk factors for severe COVID-19*[1-3]
Established, probable, and possible risk factors (comorbidities that have been associated with severe COVID-19 in at least 1 meta-analysis or systematic review, in observational studies, or in case series):
  • Age ≥65 years
  • Asthma
  • Cancer
  • Cerebrovascular disease
  • Children with certain underlying conditionsΔ
  • Chronic kidney disease
  • Chronic lung disease (interstitial lung disease, pulmonary embolism, pulmonary hypertension, bronchiectasis, COPD)
  • Chronic liver disease (cirrhosis, non-alcoholic fatty liver disease, alcoholic liver disease, autoimmune hepatitis)
  • Cystic fibrosis
  • Diabetes mellitus, type 1 and type 2
  • Disabilities (eg, ADHD, cerebral palsy, congenital malformations, limitations with self-care or activities of daily living, intellectual and developmental disabilities, learning disabilities, spinal cord injuries)
  • Heart conditions (such as heart failure, coronary artery disease, or cardiomyopathies)
  • HIV
  • Mental health disorders (mood disorders including depression, schizophrenia spectrum disorders)
  • Neurologic conditions (dementia)
  • Obesity (BMI ≥30 kg/m2) and overweight (BMI 25 to 29 kg/m2), or ≥95th percentile in children
  • Physical inactivity
  • Pregnancy or recent pregnancy
  • Primary immunodeficiencies
  • Smoking (current and former)
  • Sickle cell disease or thalassemia
  • Solid organ or blood stem cell transplantation
  • Substance use disorders
  • Tuberculosis
  • Use of corticosteroids or other immunosuppressive medications
Possible risk factors but evidence is mixed (comorbidities have been associated with severe COVID-19 in at least 1 meta-analysis or systematic review, but other studies had reached different conclusions):
  • Alpha 1 antitrypsin deficiency
  • Bronchopulmonary dysplasia
  • Hepatitis B
  • Hepatitis C
  • Hypertension

CDC: Centers for Disease Control and Prevention; COVID-19: coronavirus disease 2019; COPD: chronic obstructive pulmonary disease; ADHD: attention deficit hyperactivity disorder; HIV: human immunodeficiency virus; BMI: body mass index.

* Listed comorbidities are associated with severe COVID-19 in all adults independent of age. People of color are also at increased risk of severe disease and death, often at a younger age, due to systemic health and social inequities.

¶ Risk of severe disease also rises steadily with age, with more than 93% of deaths occurring among adults ≥50 years and 74% of deaths occurring in adults ≥65 years.

Δ Underlying medical conditions are also associated with severe illness in children, but evidence implicating specific conditions is limited. Children with the following conditions might be at increased risk for severe illness: medical complexity; genetic, neurologic, or metabolic conditions; congenital heart disease; obesity; diabetes; asthma or other chronic lung disease; sickle cell disease; immunosuppression.
References:
  1. Centers for Disease Control and Prevention. Underlying medical conditions associated with high risk for severe COVID-19: Information for healthcare providers. Available at: https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/underlyingconditions.html (Accessed on March 1, 2022).
  2. Centers for Disease Control and Prevention. Science brief: Evidence used to update the list of underlying medical conditions that increase a person's risk of severe illness from COVID-19. Available at: https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/underlying-evidence-table.html (Accessed on March 1, 2022).
  3. Centers for Disease Control and Prevention. Risk for COVID-19 infection, hospitalization, and death by age group. Available at: https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-age.html (Accessed on June 16, 2022).
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