All the conditions we know increase your risk of dying from COVID-19

The president’s age and weight put him at high risk, but that doesn’t guarantee he’ll have severe symptoms.
Blood pressure taken at the doctor's office.
A number of factors may make a COVID-19 infection especially risky. Pixabay

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Early Friday morning, news broke that President Donald Trump and First Lady Melania Trump received tests that confirmed active cases of COVID-19. And while most of us know what the symptoms may look like, both in the short and long term, understanding what factors raise your risk of a deadly case of the disease can be a little more confusing. Here’s a summary of what we know so far:

Definitely more at risk

Older age

COVID-19 patients have 90-times higher risk of hospitalization if they are between the ages of 65-74 as compared to 18-29 year olds. Around eight out of every ten COVID-19 deaths have been in the 65 and up age sector, according to the CDC. At 74 years old, President Trump is considered high risk.

Cancer

According to the CDC, currently having cancer of any kind puts you at risk of a severe case of COVID-19. Whether or not risks are higher for people with a history of cancer is still up in the air. In two Lancet studies, somewhere between 13 and 28 percent of COVID-19 patients who had cancer died. In the US, COVID-19 has a mortality rate under three percent as of October 2. Older patients and men were more at risk, but cancer treatments like chemotherapy didn’t appear to have an effect on mortality in either study.

Chronic kidney disease

Chronic kidney disease is when your kidneys, which normally filter wastes, toxins, and excess fluid out of your blood, can no longer get the job done. Excess fluid and waste in the bloodstream put a patient at risk of heart disease and stroke, according to the CDC. In the worst-case scenarios, a patient will need dialysis or a kidney transplant. The most at-risk kidney disease patients for COVID-19 are those who are immunosuppressed due to a transplant, or who do in-center hemodialysis treatments multiple times a week.

COPD (chronic obstructive pulmonary disease)

Having COPD, including emphysema and chronic bronchitis, puts you at a higher risk of developing a severe case of COVID-19. In one analysis of 1,590 Chinese ICU patients, 62.5 percent of severe cases had a history of COPD and 25 percent of those who died were COPD patients. In non-severe cases, COPD patients made up 15 percent, and of surviving patients, they made up only three percent. The main issue here is the toll that COVID-19 can take on the lungs, which are already under stress in COPD patients.

Immunocompromised state (weakened immune system) from solid organ transplant

When you undergo a solid organ transplant, you have to take drugs to weaken your immune system—otherwise your body will attack the unfamiliar tissue. While you certainly should not delay life-saving care, this kind of procedure puts you at a high risk of developing a severe case of COVID-19 if you do catch the virus. Some treatments may also be riskier for these patients. According to a new study from the University of Michigan, treatment of COVID-19 with hydroxychloroquine was associated with a ten-fold higher risk of death among organ-transplant patients compared to those who did not use it.

Obesity (body mass index of 30 or higher)

Having a BMI of 30 or higher puts a patient at a higher risk of a severe case of COVID-19. Studies have shown that more than 75 percent of hospitalized COVID-19 patients were overweight or obese, and that compared to peers with a “healthy” BMI, they had a higher chance of ICU visits or death. Around 40 percent of American adults are obese, including the president, based on the height and weight recorded in his April physical.

Serious heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies

Patients with heart failure and other serious heart diseases are at risk of struggling with a complicated or severe case of COVID-19. Respiratory complications from the disease can force the heart to work harder. The virus can also attack the heart directly, which puts these patients at higher risk of complications, according to Scripps Hospital.

Sickle cell disease

Sickle cell disease puts you at a higher risk of a serious case of COVID-19. One study found that 69 percent of people with sickle cell disease who were infected with COVID-19 were hospitalized, 11 percent were admitted to the intensive care unit, and 7 percent died, all of which are higher than the general population’s rate. Between January and May 2020, US rates are 14 percent for hospitalization, two percent for ICU, and five percent for death.

Type 2 diabetes mellitus

Patients with type two diabetes are at a higher risk of experiencing a dangerous case of COVID-19. Poor glucose control, the hallmark of diabetes, can lead to all sorts of issues with the kidney, heart, liver, and nervous system. In one study, patients with type two diabetes and COVID-19 infections suffered a death rate of 260 per 100,000, which is double the fatality rate of those with type one diabetes and nearly 10 times higher than that of patients without diabetes.

Might be more at risk

Asthma (moderate-to-severe)

As of right now, doctors aren’t entirely sure how moderate-to-severe asthma affects your risk of serious COVID-19 symptoms. Some studies have shown little difference in hospitalization rates, whereas others have hinted that non-allergic asthma may put you at a higher risk of a rough case of COVID-19 than allergic asthma.

Cerebrovascular disease (affects blood vessels and blood supply to the brain)

Cerebrovascular disease may add to COVID-19 risk factors, but research is still needed. What is known, however, is that COVID-19 infections have led to some complications and risks for stroke.

Cystic fibrosis

Cystic fibrosis may lead to a higher risk of a severe case of COVID-19, but the jury is still out. One report even shows that CF patients are less likely to catch the disease at all, since these patients are likely to already practice social distancing due to their high risk of catching dangerous lung infections.

Hypertension or high blood pressure

High blood pressure, especially if not managed with medication and a careful lifestyle, can put a person at a higher risk of severe COVID-19. One study has found that hypertension patients have twice as much risk of death from COVID-19 as those without the disease, and those who are not currently taking medication for hypertension put themselves at even greater risk.

Immunocompromised state (weakened immune system) from blood or bone marrow transplant, immune deficiencies, HIV, use of corticosteroids, or use of other immune weakening medicines

Patients undergoing bone marrow transplants or struggling with HIV are also at risk of COVID-19 simply because as a result of being immunocompromised. If your immune system is weakened for any reason, take extra care to avoid contracting the virus. However, research still needs to be done to see how much risk these diseases add to the chance of contracting a serious case of COVID-19.

Neurologic conditions, such as dementia

Dementia likely does not add to the risk of COVID-19 in and of itself, according to the Alzheimer’s Association. However, forgetting to wash your hands, wear a mask, and keep your distance from other people puts you at risk, which may pose a problem for people with serious cognitive decline.

Liver disease

Scarring of the liver, also known as cirrhosis, may lead to an increased risk of a serious case of COVID-19. COVID-19 has been shown to impact the liver, which one study shows increases mortality in patients who are already struggling with cirrhosis. Additionally, mortality was significantly higher in cirrhosis patients with COVID-19 than those hospitalized for bacterial infections.

Pregnancy

Pregnant COVID-19 patients may be at a higher risk of severe infection, as well as pregnancy complications like preterm birth. Additionally, pregnant women are more likely to fall at the dramatic ends of the spectrum, either showing very little or no symptoms or falling seriously ill. On rare occasions, the virus has been found to pass from parent to newborn child.

Pulmonary fibrosis (having damaged or scarred lung tissues)

Pulmonary fibrosis may put a person at higher risk for a bad case of COVID-19. However, research shows that pulmonary fibrosis may alsi be showing up as an after-effect of COVID-19 infections in surviving patients.

Smoking

Being a regular smoker can lead to all sorts of cardiovascular diseases that can put you at high risk for detrimental COVID-19 infections. Smoking has been found to be associated with worse cases of COVID-19, but more research must be done to directly link the two.

Thalassemia (a type of blood disorder)

Thalassemia and other hemoglobin disorders may put a patient at risk of a worse COVID-19 outcome, however, research has shown that most patients who caught the virus ended up with mild or moderate cases thus far.

Type 1 diabetes mellitus

Similarly to type two diabetes, type one also may put a patient at a higher risk of a severe case of COVID-19. However, the Lancet study in the UK shows that patients with type one were at less risk than those with type two, and more research is needed.