CDC expands list of people at high risk of severe illness from COVID-19

Coronavirus cases continue to rise in Florida

The Centers for Disease Control and Prevention on Thursday expanded its list of risk factors that make people more likely to develop severe illness or die from COVID-19. The update comes as the number of confirmed coronavirus infections rises to record levels in the United States, driven by alarming spikes in Florida, Texas and other states across the South and West.

The agency also said that pregnant women might be at higher risk, though more research is needed on that and a number of other underlying health conditions that may affect risk.

The chance of severe illness from COVID-19 increases with age, with older adults at highest risk, but the CDC noted that the risk doesn't begin suddenly at age 65. Instead, "people in their 50s are at higher risk for severe illness than people in their 40s. Similarly, people in their 60s or 70s are, in general, at higher risk for severe illness than people in their 50s. The greatest risk for severe illness from COVID-19 is among those aged 85 or older."

The CDC says studies have shown that these conditions increase a person's risk of severe COVID-19 illness, regardless of their age:

  • Chronic kidney disease
  • COPD (chronic obstructive pulmonary disease)
  • Obesity (BMI of 30 or higher)
  • Immunocompromised state (weakened immune system) from solid organ transplant
  • Serious heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies
  • Sickle cell disease
  • Type 2 diabetes

An estimated 60% of U.S. adults have at least one chronic medical condition, according to the CDC, meaning the agency's expanded list of risk factors drastically increases the number of people classified as high risk. 

Obesity alone affects about 40% of American adults, and is one of the most common underlying conditions that increases one's risk for severe illnesses. The agency warns: "The more underlying medical conditions people have, the higher their risk."

"As more information becomes available, it is clear that a substantial number of Americans are at increased risk of severe illness — highlighting the importance of continuing to follow preventive measures," reads the CDC's statement.

On Friday, the number of confirmed new coronavirus cases per day in the U.S. hit an all-time high of 40,000 — eclipsing the mark set during one of the deadliest stretches in late April. While the increase is believed to reflect, in part, greatly expanded testing, experts say there is ample evidence the virus is mounting a deadly comeback, with rising numbers of hospitalizations and deaths in numerous states.

In the face of climbing case counts, Texas and Florida have paused or rolled back some of their broad reopening measures.

"Every activity that involves contact with others has some degree of risk right now," warns the CDC. "Knowing if you are at increased risk for severe illness and understanding the risks associated with different activities of daily living can help you make informed decisions about which activities to resume and what level of risk you will accept. This information is especially critical as communities begin to reopen."

In addition to the high-risk categories listed above, CDC also lists these conditions as potentially increasing a person's risk of severe COVID-19:

  • Asthma (moderate-to-severe)
  • Cerebrovascular disease (affects blood vessels and blood supply to the brain)
  • Cystic fibrosis
  • Hypertension or high blood pressure
  • Immunocompromised state (weakened immune system) from blood or bone marrow transplant, immune deficiencies, HIV, use of corticosteroids, or use of other immune weakening medicines
  • Neurologic conditions, such as dementia
  • Liver disease
  • Pregnancy
  • Pulmonary fibrosis (having damaged or scarred lung tissues)
  • Smoking
  • Thalassemia (a type of blood disorder)
  • Type 1 diabetes

A report published Friday by the CDC concluded that "pregnant women were significantly more likely to be hospitalized, admitted to the intensive care unit, and receive mechanical ventilation than nonpregnant women." The agency, however, did not find that pregnant women have a greater risk of death from COVID-19. 

The CDC found that black and Hispanic pregnant women "appeared to be disproportionately affected" by COVID-19 infection during pregnancy. That would be in line with higher overall maternal mortality rates for black women, as well as the disproportionate toll the coronavirus pandemic has taken on blackHispanic and Native American communities.

"Understanding who is most at risk for severe illness helps people make the best decisions for themselves, their families, and their communities," CDC Director Dr. Robert Redfield said in a press release. "While we are all at risk for COVID-19, we need to be aware of who is susceptible to severe complications so that we take appropriate measures to protect their health and well-being."

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