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Who is at Highest Risk for Getting SARS-CoV-2 and COVID-19 Illness?

Updated September 22, 2023


Persons considered most at risk for severe illness include those with cardiovascular disease, hypertension, cerebrovascular disorders, cystic fibrosis, pulmonary fibrosis, liver disease, Downs Syndrome, dementia and neurological disorders, chronic obstructive pulmonary disease (COPD), type 1 and type 2 diabetes mellitus, chronic kidney disease, cancer, sickle cell disease, thalassemia, and those who are immunocompromised due to solid organ transplant, HIV, immune deficiencies, blood or bone marrow transplant, or those taking medications that suppress the immune system. Persons who are obese (body mass index of 30 or higher), pregnant, smokers, including current and former smokers, and persons with substance use disorders are also considered to be at a higher risk of developing severe illness. 

Also at risk for developing COVID-19 are front-line health care workers treating SARS-CoV-2 infected patients. Individuals who work outside the home and in positions that require contact with the public are also at an increased risk of infection. Additionally, persons who require personal care from others such as those who are aged or disabled are also at an increased risk. 

Minorities are considered to be at an increased risk of COVID-19, including severe illness. However, no biological mechanism has been identified and health official report that a lack of health insurance and limited access to health care are likely responsible for this increased susceptibility. Moreover, a higher percentage of minorities may work in public settings which also places them at a higher risk of illness.  Many rely on public transportation and live in crowded apartments, which increases their risk of exposure. 

According to the National Academies of Sciences, Engineering, and Medicine: 

“People of color — specifically Black, Hispanic or Latinx, and American Indian and Alaska Native — have been disproportionately impacted by COVID-19 with higher rates of transmission, morbidity, and mortality. Currently there is little evidence that this is biologically mediated, but rather reflects the impact of systemic racism leading to higher rates of co-morbidities that increase the severity of COVID-19 infection and the socioeconomic factors that increase likelihood of acquiring the infection, such as having front line jobs, crowded living conditions, lack of access to personal protective equipment, and inability to work from home.”

Persons experiencing homelessness are also thought to be at a greater risk due to frequent close contact with others in shelters and on the streets. 

IMPORTANT NOTE: NVIC encourages you to become fully informed about covid-19 and the covid-19 vaccine by reading all sections in the Table of Contents, which contain many links and resources such as the manufacturer product information inserts, and to speak with one or more trusted health care professionals before making a vaccination decision for yourself or your child. This information is for educational purposes only and is not intended as medical advice.

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