Which precautions should high-risk persons take to prevent coronavirus disease 2019 (COVID-19)?

Updated: Jun 25, 2021
  • Author: David J Cennimo, MD, FAAP, FACP, FIDSA, AAHIVS; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

The CDC has published a summary of evidence of comorbidities that are supported by meta-analysis/systematic review that have a significant association with risk of severe COVID-19 illness. These include the following conditions [12]

  • Cancer 
  • Cerebrovascular disease
  • Chronic kidney disease 
  • COPD (chronic obstructive pulmonary disease) 
  • Diabetes mellitus, type 1 and type 2 
  • Heart conditions (eg, heart failure, coronary artery disease, cardiomyopathies)  
  • Immunocompromised state from solid organ transplant 
  • Obesity (BMI 30 kg/m 2 or greater) 
  • Pregnancy 
  • Smoking, current or former 

 Comorbidities that are supported by mostly observational (eg, cohort, case-control, or cross-sectional) studies include [12]

  • Children with certain underlying conditions 
  • Down syndrome 
  • HIV (human immunodeficiency virus) 
  • Neurologic conditions, including dementia 
  • Overweight (BMI 25 to less than 30 kg/m 2
  • Other lung disease (including interstitial lung disease, pulmonary fibrosis, pulmonary hypertension) 
  • Sickle cell disease 
  • Solid organ or blood stem cell transplantation 
  • Substance use disorders 
  • Use of corticosteroids or other immunosuppressive medications  

Comorbidities that are supported by mostly case series, case reports, or, if other study design, the sample size is small include [12]

  • Cystic fibrosis 
  • Thalassemia  

Comorbidities supported by mixed evidence include [12]

  • Asthma 
  • Hypertension 
  • Immune deficiencies 
  • Liver disease 

Such individuals should consider the following precautions [12] :

  • Stock up on supplies.
  • Avoid close contact with sick people.
  • Wash hands often.
  • Stay home as much as possible in locations where COVID-19 is spreading.
  • Develop a plan in case of illness.

Healthcare personnel are also referred to Medscape’s Novel Coronavirus (COVID-19) Resource Center for the latest news, perspective, and resources.


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