Underlying Conditions of Concern with COVID-19

What underlying conditions should I be worried about with COVID-19?

Anika H. Ahmed, MD

Being a physician dealing with infectious communicable diseases throughout my career, I find it particularly challenging to establish the main risk factors involved in causing an infection. Like other infectious communicable diseases, COVID-19 also poses this challenge. COVID-19 is a novel illness caused by a new strain of Coronavirus and is still being studied closely by medical experts. The main risk factors so far seen in most of the severely affected COVID-19 positive patients are age, underlying chronic medical conditions, and immunocompromised status.

Age has been one of the deciding risk factors in COVID-19 infections. Deaths and hospitalization records in reference to COVID-19 have so far shown in China, Italy, and the United States that the most severely affected COVID-19 patients are mostly over the age of 65. This is why the COVID-19 outbreak was first seen in nursing homes and long-term care facilities. The younger the person is, the milder the symptoms are and the older the person is, a general pattern of more severe symptoms are seen. However, if a young person has an underlying chronic medical condition, then he/she could be susceptible to more serious symptoms of COVID-19 leading to hospitalization and intensive care. There have been some reports very recently about young persons developing blood clots and suffering strokes as a result of COVID-19 that are being examined further.

Underlying chronic medical conditions, particularly if not well controlled, have been a major risk factor in COVID-19 infections. All chronic medical conditions do weaken the immune system by just making it easier for Coronavirus to multiply in the tissues and cause inflammation. The most frequent chronic medical conditions making one an easy target of Coronavirus are diabetes, chronic lung diseases, and cardiovascular diseases. In addition to these three, the other underlying chronic medical conditions making one more susceptible to severe COVID-19 symptoms are chronic liver diseases, chronic kidney diseases with ongoing dialysis, pregnancy, current and former smoking lifestyle, neurodevelopmental diseases, and disabilities. Due to the increased risk of Coronavirus for those with underlying medical conditions, it is suggested that these individuals remain cautious while also observing recommended measures such as social distancing and increased hand washing. Moreover, after social distancing initiatives are relaxed, those with underlying health conditions may still need to be cautious and careful when leaving the safe environment of their home while being out in public, especially in bigger gatherings or groups. Extra and extended precautions for at-risk groups may be necessary until a vaccine is available.

All immunocompromised individuals are also at a high risk of COVID-19 sickness. A person can be immunocompromised due to a variety of reasons, including cancer treatment in the form of radiotherapy or chemotherapy, bone marrow or organ transplantation, immune system deficiencies, uncontrolled or poorly controlled HIV or AIDS, smoking, and long term use of corticosteroids and other immune system weakening medicines.

Copyright Anika H. Ahmed, MD, The Stanwork Group

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