Risk Groups: Who Is Most At Risk From Covid-19?

Risk Groups: Old People, Men, Smokers And People With Chronic Diseases

The new lung disease COVID-19 is mild for most people, and the SARS-CoV-2 infection sometimes even goes unnoticed. However, very severe courses with a fatal outcome are also possible. It is not currently possible to say exactly who is most likely to be affected by these severe courses in individual cases. However, some risk groups can be clearly identified.

High-risk group of people with chronic diseases

The risk of a complicated course of COVID-19 is particularly high in people with chronic diseases. In the case of lung diseases such as asthma or COPD, the explanation for this is obvious: In people with diseases of the respiratory tract, healthy lung function is already impaired and the lungs are therefore particularly vulnerable.

The high-risk groups also include people with diseases that at first glance have little to do with the lungs or breathing. These are mainly people with heart failure, high blood pressure, diabetes, cancer, liver disease, or chronic kidney disease.

Why do the chronically ill belong to the high-risk group?

The chronically ill belong to the high-risk groups primarily because they are usually already burdened by the underlying disease. In the event of an infection with SARS-CoV-2 or a COVID-19 illness, the physical resources are not fully available to them as with a healthy person. In addition, some common chronic diseases indirectly affect healthy lung function. Heart failure, for example, increases the risk of pulmonary hypertension. Atherosclerosis promotes circulatory disorders, which in turn can put a strain on the cardiovascular system.

According to the Robert Koch Institute, according to the current state of research, young people with chronic diseases also belong to the high-risk group of people with an increased risk of severe disease progression.

Risk Increases With Combinations Of Risk Factors

A particularly susceptible high-risk group is made up of people who have a combination of risk factors. According to the RKI, this applies, for example, to older people with an underlying disease compared to one of the risk factors (age or underlying disease). Old and young people with several underlying diseases are particularly hard hit.

Risk From Covid-19

High-risk group of people with sick or suppressed immune systems

People whose immune systems are not functioning or not functioning adequately are particularly at risk from COVID-19. This does not mean people with general immune deficiencies, but people with serious diseases of the immune system such as HIV, primary immunodeficiencies, or secondary immunodeficiencies.

Primary and secondary immunodeficiencies

Primary immunodeficiencies are congenital disorders of the immune system. Medicine now knows more than 300 different clinical pictures, many of which are among the rare diseases.

  • Secondary immunodeficiencies are permanent disorders of the immune system that are only acquired in the course of life. Common causes of such immune deficiencies are, for example, cancer, side effects of drugs, or metabolic disorders such as diabetes.

High-Risk Group Of People Taking Immunosuppressive Drugs

Another high-risk group is people in whom the immune system is suppressed or weakened by drugs. So-called immunosuppressants such as glucocorticoids (in colloquial language cortisone) are used, among other things, after transplants or for autoimmune diseases. Chronic asthma, inflammatory bowel disease, or rheumatic diseases are other areas of application for drugs that suppress the immune system.

The Risk Increases For Everyone Aged 50 And Over And For Smokers

SARS-CoV-2 does not only infect high-risk groups. According to the Robert Koch Institute, the risk of a severe course of COVID-19 increases from the age of 50 and increases steadily thereafter. This is mainly due to the fact that the immune system becomes weaker over the years and is less able to fight pathogens such as viruses. There is also the possibility that the disease is recognized late in people with a weakened immune system. Why is that?

Fever is the classic symptom of infection. However, fever is not caused by pathogens such as SARS-CoV-2 but is a result of the reaction of the immune system. If the immune system is weak, a fever may be low or it may not occur. This increases the likelihood that infections such as COVID-19 will be discovered late and may have advanced.

Male mortality is nearly twice that of women

According to the RKI, the risk of infection with SARS-CoV-2 is about the same for women and men at 49 to 51 percent at the current state of knowledge (beginning of April). On the other hand, mortality seems to be significantly higher in men than in women. Of the 732 deaths with corona infection (as of April 1), 65 percent were men. An evaluation of the COVID-19 cases in China had previously also come to the conclusion that the mortality rate for men is almost twice as high as that for women.

The reasons for the higher mortality are not yet known. The virologist Alexander Kekulé names the overall poorer health of older men (compared to women of the same age) as a possible cause.

Even Young And Healthy People Shouldn’t Think They Are Safe

So far, it is not known how the individual risk of COVID-19 disease can be reliably assessed. After numbers at the beginning of the pandemic had suggested that young and healthy adults might have a rather small risk of severe disease, the number of those affected is now increasing in this group as well. According to the US Centers for Disease Control (CDC) as of mid-March, a fifth of COVID-19 patients admitted to the hospital were between 20 and 44 years old. According to the study, almost half required intensive care treatment. Young, healthy people must therefore under no circumstances feel safe.