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Last updated April 1, 2020. 2 minute read

Who is most at risk of acquiring COVID-19?

Dr Tzvi Doron Do Written by Dr. Tzvi Doron, DO
Reviewed by Dr. Rachel Kwon, MD

Coronaviruses are a family of viruses that can infect animals and humans, although not all coronaviruses can infect both. Some coronaviruses that infect humans cause respiratory disease, which can be mild (e.g. cough, sore throat) or severe (e.g. high fever, difficulty breathing), and sometimes be serious enough to require hospitalization and even breathing assistance from a ventilator. In some cases, usually in people who have underlying medical conditions or problems with their immune system, the illness caused by these viruses can cause death, but most coronaviruses cause mild symptoms of a common cold. 

A novel coronavirus, called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first discovered at the end of 2019 in Wuhan City in the Hubei province of China. This virus causes a respiratory illness in humans called coronavirus disease 2019 (COVID-19). COVID-19 seems to spread easily from person to person. In most people (~80%) with symptoms who are found to have the infection, the symptoms are mild, but it can cause severe respiratory illness in others—usually, those who are older or have underlying medical conditions at baseline.

Who is most at risk for contracting coronavirus?

According to the Centers for Disease Control and Prevention (CDC), the people at highest risk for contracting coronavirus disease 2019 (COVID-19) are people who have traveled to Hubei, China in the previous 14 days or had close contact (defined as living with, being an intimate partner of, or providing care outside of a healthcare setting) with someone with a lab-confirmed case of COVID-19 in the previous 14 days. Other groups at increased risk include people who have traveled in the previous 14 days to other countries experiencing active outbreaks (see the CDC’s list of countries here). Those who have had more casual contact with lab-confirmed cases are considered to be at medium risk. Note that the 14 day period is the CDC’s best guess as to the incubation time of novel coronavirus, based on what is known about other similar coronaviruses, and that this information is evolving rapidly and may change.

Who is at greater risk for severe illness with COVID-19?

A paper published by JAMA on February 24, 2020, summarizing over 72,000 COVID-19 cases in China found that: 

  • 81% of cases were considered mild
  • 14% of cases were considered severe
  • 5% of cases were considered critical
  • 2.3% of cases resulted in death

It also found that certain groups are at increased risks of dying from COVID-19, including:

  • People aged 70–79 (8% died)
  • People over age 80 (14.8% died)
  • People with cardiovascular disease (10.5% died)
  • People with diabetes (7.3% died)
  • People with chronic respiratory disease, like asthma and COPD (6.3% died)
  • People with hypertension, or high blood pressure (6% died)
  • People with cancer (5.6% died)

It also appears that younger people have a lower risk of catching the virus and developing severe illness from it. As of February 11, 2020, only 2% of total cases were under age 20 (Wu, 2020). However, the risk for young people is not zero—as the disease has spread, it has affected some children. An infant under the age of one year old died of the disease in March 2020.

It is likely that people who smoke and people with weakened immune systems (due to illnesses like HIV or certain medications) are also at increased risk of severe illness, but the article did not address these groups. Finally, healthcare workers are more likely to be exposed to the virus and are at higher risk of infection when exposed.