#15,161
Although SARS-CoV-2 - the novel virus that causes COVID-19 - appears to infect indiscriminately -and bad outcomes are possible for individuals of any age - the elderly and those with high risk comorbidities are considered to be at greatest risk of severe illness and/or death.
Much of what we know about COVID-19's course of illness comes from China and Italy, but as the number of cases increase in the United States, enough data has been gathered to put together a preliminary estimate of which underlying health conditions have the greatest impact on COVID-19 infection and illness.The following MMWR Early release is based on a subset of 7,162 COVID-19 cases ( < 6% of the total) for whom most underlying health conditions and other risk factors were known. This is a preliminary study, and so there may be gaps in patient information, and not all patient outcomes were available at the time of publication.
I've reproduced the summary, and some excerpts from the full report. Follow the link to read it in its entirety.
Preliminary Estimates of the Prevalence of Selected Underlying Health Conditions Among Patients with Coronavirus Disease 2019 — United States, February 12–March 28, 2020
Early Release / March 31, 2020 / 69
CDC COVID-19 Response Team (View author affiliations)View suggested citation
Summary
What is already known about this topic?
Published reports from China and Italy suggest that risk factors for severe COVID-19 disease include underlying health conditions, but data describing underlying health conditions among U.S. COVID-19 patients have not yet been reported.
What is added by this report?
Based on preliminary U.S. data, persons with underlying health conditions such as diabetes mellitus, chronic lung disease, and cardiovascular disease, appear to be at higher risk for severe COVID-19–associated disease than persons without these conditions.
What are the implications for public health practice?
Strategies to protect all persons and especially those with underlying health conditions, including social distancing and handwashing, should be implemented by all communities and all persons to help slow the spread of COVID-19.
PDF [141K]
On March 11, 2020, the World Health Organization declared Coronavirus Disease 2019 (COVID-19) a pandemic (1). As of March 28, 2020, a total of 571,678 confirmed COVID-19 cases and 26,494 deaths have been reported worldwide (2). Reports from China and Italy suggest that risk factors for severe disease include older age and the presence of at least one of several underlying health conditions (3,4).
U.S. older adults, including those aged ≥65 years and particularly those aged ≥85 years, also appear to be at higher risk for severe COVID-19–associated outcomes; however, data describing underlying health conditions among U.S. COVID-19 patients have not yet been reported (5). As of March 28, 2020, U.S. states and territories have reported 122,653 U.S. COVID-19 cases to CDC, including 7,162 (5.8%) for whom data on underlying health conditions and other known risk factors for severe outcomes from respiratory infections were reported.
Among these 7,162 cases, 2,692 (37.6%) patients had one or more underlying health condition or risk factor, and 4,470 (62.4%) had none of these conditions reported. The percentage of COVID-19 patients with at least one underlying health condition or risk factor was higher among those requiring intensive care unit (ICU) admission (358 of 457, 78%) and those requiring hospitalization without ICU admission (732 of 1,037, 71%) than that among those who were not hospitalized (1,388 of 5,143, 27%).
The most commonly reported conditions were diabetes mellitus, chronic lung disease, and cardiovascular disease. These preliminary findings suggest that in the United States, persons with underlying health conditions or other recognized risk factors for severe outcomes from respiratory infections appear to be at a higher risk for severe disease from COVID-19 than are persons without these conditions.
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Discussion
Among 122,653 U.S. COVID-19 cases reported to CDC as of March 28, 2020, 7,162 (5.8%) patients had data available pertaining to underlying health conditions or potential risk factors; among these patients, higher percentages of patients with underlying conditions were admitted to the hospital and to an ICU than patients without reported underlying conditions.
These results are consistent with findings from China and Italy, which suggest that patients with underlying health conditions and risk factors, including, but not limited to, diabetes mellitus, hypertension, COPD, coronary artery disease, cerebrovascular disease, chronic renal disease, and smoking, might be at higher risk for severe disease or death from COVID-19 (3,4). This analysis was limited by small numbers and missing data because of the burden placed on reporting health departments with rapidly rising case counts, and these findings might change as additional data become available.
It is not yet known whether the severity or level of control of underlying health conditions affects the risk for severe disease associated with COVID-19. Many of these underlying health conditions are common in the United States: based on self-reported 2018 data, the prevalence of diagnosed diabetes among U.S. adults was 10.1% (7), and the U.S. age-adjusted prevalence of all types of heart disease (excluding hypertension without other heart disease) was 10.6% in 2017 (8). The age-adjusted prevalence of COPD among U.S. adults is 5.9% (9), and in 2018, the U.S. estimated prevalence of current asthma among persons of all ages was 7.9% (7).
CDC continues to develop and update resources for persons with underlying health conditions to reduce the risk of acquiring COVID-19 (10). The estimated higher prevalence of these conditions among those in this early group of U.S. COVID-19 patients and the potentially higher risk for more severe disease from COVID-19 associated with the presence of underlying conditions highlight the importance of COVID-19 prevention in persons with underlying conditions.
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Persons in the United States with underlying health conditions appear to be at higher risk for more severe COVID-19, consistent with findings from other countries. Persons with underlying health conditions who have symptoms of COVID-19, including fever, cough, or shortness of breath, should immediately contact their health care provider.
These persons should take steps to protect themselves from COVID-19, through washing their hands; cleaning and disinfecting high-touch surfaces; and social distancing, including staying at home, avoiding crowds, gatherings, and travel, and avoiding contact with persons who are ill. Maintaining at least a 30-day supply of medication, a 2-week supply of food and other necessities, and knowledge of COVID-19 symptoms are recommended for those with underlying health conditions (10).
All persons should take steps to protect themselves from COVID-19 and to protect others. All persons who are ill should stay home, except to get medical care; should not go to work; and should stay away from others. This is especially important for those who work with persons with underlying conditions or who otherwise are at high risk for severe outcomes from COVID-19.
Community mitigation strategies, which aim to slow the spread of COVID-19, are important to protect all persons from COVID-19, especially persons with underlying health conditions and other persons at risk for severe COVID-19–associated disease (https://www.cdc.gov/coronavirus/2019-ncov/downloads/community-mitigation-strategy.pdfpdf icon).
