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Are people with chronic diseases more vulnerable to coronavirus?

Amy Mackelden writer headshot By | April 14, 2020
Medically reviewed by Lindsey Hudson, APRN, NP-C

Approximately six in 10 U.S. adults have a chronic disease according to the Centers for Disease Control (CDC), many of whom are considered to be immunocompromised. While some patients take immunosuppressant medications, others may have conditions that put them at a greater risk of respiratory infections. The question on all of their minds: Are people with chronic diseases more vulnerable to COVID-19 during the current pandemic?

Are people with a chronic disease more at risk for coronavirus?

While there is limited information available, some clinicians believe that people with chronic illnesses could have a higher risk of contracting coronavirus.

According to Chirag Shah, MD, cofounder of telehealth platform Push Health, “While more research needs to be done, people with underlying chronic conditions are often in active inflammatory states, which may compromise the efficacy of their immune systems. Some conditions, like poorly controlled diabetes, likely have a more significant impact when compared to milder chronic conditions when it comes to infection susceptibility.” 

Soma Mandal, MD, a board-certified internist at Summit Medical Group in Berkeley Heights, New Jersey, agrees, “Older adults and people who have serious chronic medical conditions are at higher risk for contracting COVID-19,” on account of having weakened immune systems.

Meanwhile, Lili Barsky, MD, offers an alternate opinion, “There is minimal evidence that having a certain chronic illness puts one at increased risk of actually contracting the virus to begin with.” However, Barsky notes, “There are certain chronic illnesses whose care may render social distancing and other precautions more challenging, thus potentially putting these individuals at elevated risk of becoming infected.”

Chronic disease increases the chances of adverse outcomes in COVID-19 patients

While research is still ongoing, sources seem to agree that adverse outcomes are much more likely when a person already has an underlying condition. According to the World Health Organization (WHO), “older persons and persons with pre-existing medical conditions… appear to develop serious illness more often than others.” Dr. Shah agrees and says, “Chronic health issues can impair one’s ability to fight off an infection before it takes hold.” 

The CDC warns that older adults, and those living with serious underlying medical conditions have worse outcomes if they contract COVID-19. Those thought to be most at risk include people with asthma, lung disease, chronic heart conditions, diabetes, liver and kidney conditions, and anyone who is considered immunocompromised, including patients undergoing treatment for cancer, smokers, and those living with conditions such as HIV/AIDS. 

“A healthy and robust immune system is important for protecting the body against infections, and when a person’s immune system is compromised, an individual is more likely to contract a disease,” says Abe Malkin, MD, MBA, founder and medical director of Concierge MD LA. As such, if a person’s immune system is weakened on account of a chronic illness, or a course of medication they’re taking, it’s possible that they might be at a higher risk of contracting coronavirus.

The bottom line is we’re still learning about this virus. “The medical community doesn’t know why some people experience COVID-19 severely and others experience mild symptoms or are asymptomatic,” says Ramzi Yacoub, Pharm.D., the chief pharmacy officer of SingleCare. “There are many factors that can play a part in the severity of symptoms including chronic diseases, immunity status, and age. It’s typically the body’s inflammatory response to the virus that attaches to our lungs and secondary diseases like pneumonia that are causing the most severe cases.”

How to protect yourself from coronavirus if you have a chronic disease 

Some people with chronic illness are more likely to come into contact with the virus on a daily basis, especially if their condition requires ongoing hospital treatment or regular care. “It is more challenging to observe social distancing among those with chronic illness requiring the care of an outside caregiver,” Dr. Barsky notes. 

According to Dr. Mandal: “The best advice for older adults and people who have chronic health conditions would be to stay home if possible, practice social distancing, wash hands with soap and water, and clean and disinfect frequently touched surfaces. In addition, people must have their conditions under the best control possible, which means to take your prescribed medications daily, watch your diet carefully, manage and reduce stress as much as possible (as this can also affect your immune system), and exercise.”