Coronavirus: who is particularly at risk?
Updated onChristiane Fux studied journalism and psychology in Hamburg. The experienced medical editor has been writing magazine articles, news and factual texts on all conceivable health topics since 2001. In addition to her work for, Christiane Fux is also active in prose. Her first crime novel was published in 2012, and she also writes, designs and publishes her own crime plays.
More posts by Christiane Fux All content is checked by medical journalists.Infections with the Sars-CoV-2 coronavirus are mild or even symptom-free in over 80 percent of cases. Sometimes people get seriously ill or even die from Covid-19. Especially people from certain risk groups are at risk. Read here who is part of it and what these patients should be aware of.
Age as a risk factor
The greatest risk group for severe courses are the elderly. From the age of 40 onwards, the risk initially increases very slowly and then increases faster and faster - from 0.2 percent for those under 40 to up to 14.5 percent for those over 80.
The explanation: In old age the immune system is no longer as powerful as it was in younger years - and it becomes weaker and weaker (immune senescence). Since there are still no specific drugs against the virus, your own defenses have to deal with it. Many older people also lack the strength reserves to counteract the stress of a difficult course.
How do I behave? Older people should particularly protect themselves from infection - even if they still feel fit. The best protection is a vaccination against Sars-CoV-2. It becomes particularly critical when a previous illness is added to old age - and that is the case with most senior citizens.
People with previous illnesses
What one observes with other infectious diseases also applies to Covid-19: Anyone who is weakened anyway, cannot easily cope with an infection with the new type of coronavirus. Therefore, previous illnesses - for example heart disease, chronic respiratory diseases and metabolic disorders such as diabetes - can have a significant impact on the course of the disease.
In such cases, the infection can be difficult for young people.Previously ill people should take their risk of infection very seriously and protect themselves as much as possible - no matter how old they are.
It is also important that other people who live in a household with high-risk patients behave particularly carefully so that they do not bring in Sars-CoV-2. The most important protective measures include:
- Vaccination against Sars-CoV-2
- As little social contact as possible with people outside of your household
- Strict observance of distance rules (at least 1.5, better 2 meters)
You can read more about the protective measures in the article "Covid-19: How can I protect myself?".
Cardiovascular diseases
Coronavirus infections are more severe in people with cardiovascular diseases such as heart failure or coronary heart disease (CHD). According to Chinese data, more than one in ten people who also suffer from heart disease die from Covid-19. The German Heart Foundation advises: "Be more careful, yes, but please do not be too afraid."
The explanation: Every infection means an additional burden on the heart. In severe cases, patients develop pneumonia with difficulty breathing. As a result, the blood is no longer enriched with oxygen as much as usual. The heart tries to compensate for this and pumps harder than usual. Affected hearts are overwhelmed faster than healthy ones.
In addition, an infection with the novel coronavirus can also directly affect the heart.
How do I behave? The German Heart Foundation advises heart patients to be prudent. Adhering to protective measures is particularly important for them, but panic can worsen their existing heart disease.
high blood pressure
Even people who only suffer from pure high blood pressure are among the risk patients of a Sars-CoV-2 infection.
The explanation: It is not yet known for sure why increased blood pressure values could adversely affect the course of Covid-19. As a rule, the blood vessels in high blood pressure patients are damaged and can only adapt poorly to a circulation that has been changed by the infection. In addition, hypertension is one of the most common causes of heart failure. And that in turn favors severe courses of Covid-19.
How do I behave? In times of Corona, high blood pressure patients should make sure that their blood pressure is well controlled. For this, it is important to take the medication for high blood pressure reliably.
diabetes
According to the German Diabetes Society (DDG), according to current estimates, well-adjusted diabetics do not have a higher risk of severe courses of a Sars-CoV-2 infection.
However, during the larger outbreak in China, the death rate among diabetes patients was higher than among other infected people.
The explanation: Diabetics in particular who suffer from concomitant and secondary diseases of diabetes are more likely to be at risk. They mainly occur when the blood sugar has been poorly controlled for a long time. The DDG therefore advises patients with diabetic organ damage to the heart, kidneys or liver to pay particular attention and to heed the protective measures.
How do I behave? Less well-adjusted diabetes patients should try to optimize their blood sugar control in consultation with their doctor. You benefit from this not only in the current infection situation, but also later.
Chronic respiratory diseases (asthma, COPD)
People with chronic respiratory diseases are also at a higher risk of severe disease. These include, for example, patients with COPD, asthma, pulmonary fibrosis or sarcoid.
Explanation: In the case of chronic lung diseases, the barrier function of the airways is weakened. Pathogens such as the coronavirus can therefore penetrate more easily and cause severe pneumonia. In fact, the risk of acute lung failure is also higher in people with damaged lungs.
How do I behave? Lung patients, like all other risk groups, should follow the protective measures particularly strictly and get vaccinated.
Some people with lung disease are also unsettled because they fear that their cortisone-containing drugs could further weaken the immune system of the lungs. Well-adjusted patients should not change or even stop their drug therapy even in times of Corona, writes the German Respiratory League.
It is questionable that the drugs promote infection with the coronavirus (SARS-CoV-2). In fact, inhaled cortisone preparations could even help prevent severe disease in the meantime.
The danger that asthma, for example, worsens in a threatening way by reducing or omitting medication is also specific.
Smoker
Smoking damages the airways and lungs in both the short and long term. In fact, smokers are more at risk of developing severe pneumonia as a result of Covid-19 infection. How high the risk is mainly depends on how much the person smokes and how long they have been a smoker.
Experts therefore advise you to give up cigarettes and the like right now. Even if someone has smoked for a long time, an immediate cessation of smoking can still have a positive effect on the course of an infection with Sars-CoV-2.
You can find out more about this in our article "Coronavirus: Smokers get more sick"
Cancers
According to the Robert Koch Institute, cancer patients also have a higher risk of severe COVID-19 disease. However, a higher risk of death does not apply to all cancer patients, especially not to those whose illness was a long time ago.
According to the German Cancer Information Service, there is currently little information about how cancer patients react to the coronavirus. In fact, however, their immune system can be weakened by various factors and thus favor the penetration and spread of the viruses.
- For example, cancers such as leukemia or lymphoma can directly weaken the immune system.
- A severely weakened immune system can also be the result of cancer therapies (e.g. chemotherapy, radiation therapy, targeted therapy, antibody therapy, blood stem cell transplantation or CAR-T cell therapy). The decisive factor is how much the immune system was actually stressed.
Nevertheless, the German Society for Hematology and Medical Oncology (DGHO) recommends not postponing or suspending planned cancer therapy. Prompt treatment of the cancer is usually decisive for the patient's chances of survival. Only after careful medical consideration can it currently make sense to postpone therapy in individual cases of easily controllable cancer.
Cancer patients are also given priority vaccination. However, cancer therapy can weaken the build-up of immune protection. An interval of three, better six months after the last treatment is optimal.
immunodeficiency
A weakened immune system always represents an increased risk of infections and subsequent serious illnesses - this is also the case with Covid-19. A distinction is made between the following patient groups:
- People with a congenital immune deficiency
- People with an acquired immune deficiency, e.g. HIV-infected people who are not receiving any therapy
They have low defenses. Few or even missing immune cells cannot kill the pathogens properly, so that they have easy play in the body. Vaccination is therefore particularly important for them.
Taking immunosuppressive drugs
As a result, patients who have to take drugs that suppress the immune system (immunosuppressants such as cortisone) are also at greater risk. This includes above all
- Patients with an autoimmune disease, e.g. inflammatory rheumatic diseases, in which the immune system attacks the body's own tissue
- Organ transplant patients who need medication to prevent the immune system from rejecting the transplanted organs
How much the drugs downregulate the immune system depends on the active ingredient and the respective dose. It is important not to discontinue or reduce the medication under any circumstances without consulting your doctor. The negative health consequences can be serious.
Liver and kidney disease
The Robert Koch Institute counts people with liver disease, such as cirrhosis or hepatitis, among the risk patients for a severe course of Covid-19. In fact, increasing liver values are observed in some infected people, even if they were not previously liver disease. This is generally not uncommon for infectious diseases.
So far, however, there is no evidence that such a reaction of the liver is more severe or dangerous than usual for people with liver disease. Reports from China and Italy as well as the University Hospital Hamburg showed no higher disease risk for liver patients.
The situation is similar for patients with kidney damage. The Robert Koch Institute also counts them among the people at risk. However, it has not yet been proven that they become more seriously ill or even die from Covid-19. Current studies show that patients suffering from Covid-19 are more likely to have kidney dysfunction and impaired kidney function. How this affects an existing kidney disease does not yet appear to be any data.
men
Men and women get Covid-19 at about the same rate. However, the risk of fatal outcome for men is 31 to 47 percent higher. In Germany, 3.1 percent of known infected men died, but only 2.7 percent of women. There are various possible reasons for this. The cells of men are equipped with more ACE2 receptors through which the virus penetrates the cells. In addition, the immune system of women is fundamentally more active and therefore better equipped against infections.
Pregnant women
Severe courses are also observed more frequently in pregnant women. Possibly because the immune system shuts down during pregnancy to tolerate the fetus. Vaccination is therefore recommended for pregnant women with pre-existing conditions such as diabetes or obesity.
Obese
People who are very overweight (obese) are also more likely to get seriously ill with Covid-19. One possible reason is the poorer ventilation of the lungs, because they cannot stretch sufficiently due to the increased fat tissue in the abdomen. In addition, the adipose tissue produces more inflammatory messenger substances, which have an unfavorable influence on the course of the disease.
