CDC links illnesses with Covid symptom severity

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Summary of Recent Changes

Revisions were made on December 23, 2020 to reflect recent data supporting increased risk of severe illness among persons with Down syndrome from the virus that causes COVID-19. Revisions also include addition of sickle cell disease and chronic kidney disease to the conditions that might increase the risk of severe illness among children.

We are learning more about COVID-19 every day. The below list of underlying medical conditions is not exhaustive and only includes conditions with sufficient evidence to draw conclusions; it is a living document that may be updated at any time, subject to potentially rapid change as the science evolves. This list is meant to inform clinicians to help them provide the best care possible for patients, and to inform individuals about their level of risk so they can make individual decisions about illness prevention. Notably, the list may not include every condition that might increase one’s risk for developing severe illness from COVID-19, such as those for which evidence may be limited (e.g., rare conditions). Individuals with any underlying medical condition (including those conditions that are NOT on the current list) should consult with their healthcare providers about personal risk factors and circumstances to determine whether extra precautions are warranted.

Adults of any age with certain underlying medical conditions are at increased risk for severe illness from the virus that causes COVID-19. Severe illness from COVID-19 is defined as hospitalization, admission to the ICU, intubation or mechanical ventilation, or death.

Adults of any age with the following conditions are at increased risk of severe illness from the virus that causes COVID-19:

COVID-19 is a new disease. Currently there are limited data and information about the impact of many underlying medical conditions on the risk for severe illness from COVID-19. Based on what we know at this time, adults of any age with the following conditions might be at an increased risk for severe illness from the virus that causes COVID-19:

Want to see the evidence behind these lists?

While children have been less affected by COVID-19 compared to adults, children can be infected with the virus that causes COVID-19 and some children develop severe illness. Children with underlying medical conditions are at increased risk for severe illness compared to children without underlying medical conditions. Current evidence on which underlying medical conditions in children are associated with increased risk is limited. Children with the following conditions might be at increased risk for severe illness: obesity, medical complexity, severe genetic disorders, severe neurologic disorders, inherited metabolic disorders, sickle cell disease, congenital (since birth) heart disease, diabetes, chronic kidney disease, asthma and other chronic lung disease, and immunosuppression due to malignancy or immune-weakening medications.

We do not yet know who is at increased risk for developing the rare but serious complication associated with COVID-19 in children called Multisystem Inflammatory Syndrome in Children (MIS-C), nor do we know what causes MIS-C. Learn about MIS-C.

Reduce your risk of getting COVID-19

It is especially important for people at increased risk of severe illness from COVID-19, and those who live with them, to protect themselves from getting COVID-19.

The best way to protect yourself and to help reduce the spread of the virus that causes COVID-19 is to:

If you start feeling sick and think you may have COVID-19, get in touch with your healthcare provider within 24 hours.  If you don’t have a healthcare provider, contact your nearest community health centerexternal icon or health department.

What to consider before being around other people

There is no way to ensure you have zero risk of infection, so it is important to understand the risks and know how to be as safe as possible if or when you do resume some activities, run errands, or attend events and gatherings.

People at increased risk of severe illness from COVID-19, and those who live with them, should consider their level of risk before deciding to go out and ensure they are taking steps to protect themselves. Consider avoiding activities where taking protective measures may be difficult, such as activities where social distancing can’t be maintained. Everyone should take steps to prevent getting and spreading COVID-19 to protect themselves, their communities, and people who are at increased risk of severe illness.

In general, the more people you interact with, the more closely you interact with them, and the longer that interaction, the higher your risk of getting and spreading COVID-19.

  • If you decide to engage in public activities, continue to protect yourself by practicing everyday preventive actions.
  • Keep these items on hand and use them when venturing out: a mask, tissues, and a hand sanitizer with at least 60% alcohol, if possible.
  • If possible, avoid others who are not wearing masks or ask others around you to wear masks.

Are you considering in-person visits with family and friends? Here are some things to consider to help make personal and social activities as safe as possible:

When to delay or cancel a visit

In general, the more people you interact with, the more closely you interact with them, and the longer that interaction, the higher the risk of COVID-19 spread. So, think about:

  • How many people will you interact with?
  • Can you keep at least 6 feet of space between you and others?
  • Will you be outdoors or indoors?
  • What’s the length of time that you will be interacting with people?

Encourage social distancing

  • Limit the number of people you interact with and ensure you keep safe distances (at least 6 feet) between you when possible and if not in the same household.
  • Visit with your friends and family outdoors, when possible. If this is not feasible, make sure the room or space is well-ventilated (for example, open windows or doors) and large enough to accommodate social distancing.
  • Arrange tables and chairs to allow for social distancing. People from the same household can be in groups together and don’t need to be 6 feet apart from each other.
  • Consider activities where social distancing can be maintained, like sidewalk chalk art or yard games.
  • Try to avoid close contact with your visitors. For example, don’t shake hands, elbow bump, or hug. Instead wave and verbally greet them.
  • If possible, avoid others who are not wearing masks or ask others around you to wear masks.
  • Consider keeping a list of people you visited or who visited you and when the visit occurred. This will help with contact tracing if someone becomes sick.
  • Limit the time you have close contact with visitors to less than 15-20 minutes as much as possible.

Wear masks

Masks prevent people from getting and spreading the virus, especially those who may not know they have it.

  • Masks should be worn over the nose and mouth. Masks are especially important to help protect each other when it is difficult to stay at least 6 feet apart from others or when people are indoors.
  • Masks prevent people from getting and spreading the virus.
  • CDC recognizes that wearing masks may not be possible in every situation or for some people such as children. Some older adults with cognitive, sensory, or behavioral issues might find wearing a mask difficult. Adaptations and alternatives should be considered whenever possible to increase the feasibility of wearing a mask or to reduce the risk of spreading COVID-19 if it is not possible to wear one. These adults need to take extra precautions when interacting with others. Additionally, some people may rely on reading lips or facial expressions during social interactions. This can be difficult when others are wearing masks that cover large portions of their face.
  • Who should NOT use masks: Children under age 2 or anyone who has trouble breathing, is unconscious, or is incapacitated or otherwise unable to remove the mask without assistance.

Wash hands often

  • Everyone should wash their hands with soap and water for at least 20 seconds at the beginning and end of the visit and whenever you think your hands may have become contaminated.
  • If soap and water are not readily available, such as with outdoor visits or activities, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry.
  • Remind guests to wash or sanitize their hands before serving or eating food.
  • Use single-use hand towels or paper towels for drying hands so visitors do not share towels. Have a no-touch trash can available for guests to use.

Limit contact with commonly touched surfaces or shared items

  • Encourage your visitors to bring their own food and drinks.
  • Clean and disinfect commonly touched surfaces and any shared items between use.
  • If you choose to use any shared items that are reusable (e.g., seating covers, tablecloths, linen napkins), wash, clean, and sanitize them after the event.

If you are thinking about participating in an event or gathering:

If you are at increased risk for severe illness, consider avoiding high-risk gatherings. Here are things to consider for personal and social activities.

Stay healthy during the COVID-19 pandemic

Staying healthy during the pandemic is important. Talk to your healthcare provider about whether your vaccinations and other preventive services are up to date to help prevent you from becoming ill with other diseases.

  • It is particularly important for those at increased risk of severe illness, including older adults, to receive recommended vaccinations against influenza and pneumococcal disease.
  • Talk with your healthcare provider about maintaining preventive services like cancer screenings during the pandemic.
  • Remember the importance of staying physically active and practicing healthy habits to cope with stress.
  • Ask your healthcare provider about telemedicine or remote healthcare visits, and know when to go to the emergency department.
  • If you have a medical emergency, do not delay seeking emergency care.

 If you have an underlying medical condition, you should continue to follow your treatment plan:

  • Continue your medicines and do not change your treatment plan without talking to your healthcare provider.
  • Have at least a 30-day supply of prescription and non-prescription medicines. Talk to a healthcare provider, insurer, and pharmacist about getting an extra supply (i.e., more than 30 days) of prescription medicines, if possible, to reduce your trips to the pharmacy.
  • Do not delay getting emergency care for your underlying medical condition because of COVID-19. Emergency departments have contingency infection prevention plans to protect you from getting COVID-19 if you need care.
  • Call your healthcare provider if you have any concerns about your underlying medical conditions or if you get sick and think that you may have COVID-19. If you need emergency help, call 911 right away.
  • If you don’t have a healthcare provider, contact your nearest community health centerexternal icon or health department.

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