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CDC Expands List of Underlying Conditions for Severe COVID-19

Agency also removes 65-plus age threshold for risk of serious illness

 A Centers for Disease Control and Prevention (CDC) mobile web screen on the topic of the Coronavirus Disease 2019 is  displayed over an illustrated map of the United States that tracks the virus

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En español | The Centers for Disease Control and Prevention (CDC) has once again updated information on who is most at risk for severe illness from a coronavirus infection by more clearly defining the level of evidence associated with each condition that could lead to a severe case of COVID-19.

Older adults and people with underlying health conditions remain the primary high-risk populations. However, in an update on June 25, the CDC removed its specific age threshold (65 and older) for risk, and now cautions that “among adults, risk increases steadily as you age, and it's not just those over the age of 65 who are at increased risk for severe illness.”


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"To put it another way: There's not an exact cutoff of age at which people should or should not be concerned,” Jay C. Butler, CDC deputy director of infectious diseases and COVID-19 response incident manager, said in a media briefing on the June 25 update.

Part of the reason risk increases with age is because people are more likely to have more health issues later in life, Butler explained. And underlying health conditions are a huge driver of complications that arise from COVID-19.


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Chronic kidney disease, cancer, chronic obstructive pulmonary disease (COPD), obesity (BMI of 30 or higher), type 2 diabetes, sickle cell disease, solid organ transplantation and serious heart conditions, such as heart failure, coronary artery disease or cardiomyopathies, have been shown with the most evidence to increase a person's risk of severe illness from a coronavirus infection, according to the CDC's latest update.

Asthma, high blood pressure, pregnancy, cerebrovascular disease, smoking, and use of corticosteroids or other immunosuppressive medications have been shown with “mixed evidence” to increase a person’s risk for severe illness from COVID-19. There is limited evidence that bone marrow transplantation, HIV, immune deficiencies, inherited metabolic disorders, liver disease, neurologic conditions, other chronic lung diseases, pediatrics, thalassemia and type 1 diabetes contribute to severe coronavirus complications.

The CDC notes that this list of underlying conditions is “a living document” that will be updated “as the science evolves.” 

"[A]s your numbers of underlying medical conditions increase, your risk of severe illness from COVID also increases."

-CDC Director Robert Redfield

CDC Director Robert Redfield on June 25 emphasized “that as your numbers of underlying medical conditions increase, your risk of severe illness from COVID also increases.” An estimated 60 percent of American adults have at least one chronic medical condition, the CDC notes; about 40 percent have two or more.

The CDC's June 25 risk update came a day after the U.S. reported more than 38,000 new cases of COVID-19; six states set record highs, including California, Florida and Texas, according to the COVID Tracking Project. In late July, the country passed 4.5 million confirmed cases of COVID-19.

Knowing if you are at increased risk for severe illness can help people make more informed decisions about “which activities to resume and what level of risk you will accept,” especially as more communities begin to loosen restrictions, the CDC says.

"While we are all at risk for COVID-19, we need to be aware of who is susceptible to severe complications so that we take appropriate measures to protect their health and well-being,” Redfield added.

COVID-19 and Underlying Medical Conditions

There is strong evidence that the following conditions increase risk for severe illness from COVID-19: 

  • Serious heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies
  • Cancer
  • Chronic kidney disease 
  • COPD (chronic obstructive pulmonary disease)
  • Obesity (BMI of 30 or greater) 
  • Sickle cell disease
  • Solid organ transplantation 
  • Type 2 diabetes

There is mixed evidence that the following conditions increase risk for severe illness from COVID-19:

  • Asthma (moderate to severe)
  • Cerebrovascular disease
  • Hypertension
  • Pregnancy
  • Smoking
  • Use of corticosteroids or other immunosuppressive medications

There is limited evidence that the following conditions contribute to increased risk for severe illness from a coronavirus infection: 

  • Bone marrow transplantation
  • HIV
  • Immune deficiencies
  • Inherited metabolic disorders
  • Liver disease
  • Neurologic conditions 
  • Other chronic lung diseases
  • Pediatrics 
  • Thalassemia
  • Type 1 diabetes

Source: CDC

This article, originally published on June 25, 2020 was updated with new information on July 31, 2020.

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