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Health Guide / COVID-19

Who is most at risk of getting severe symptoms from COVID-19?

yael coopermanMike Bohl, MD, MPH, ALM

Reviewed by Yael Cooperman, MD, written by Mike Bohl, MD, MPH, ALM

Last updated: Nov 03, 2021
4 min read

table of contents

  1. Who is at greater risk for severe illness with COVID-19?
  2. Typical symptoms of COVID-19
  3. What about age?
  4. What are the symptoms of COVID-19?
  5. So, what should you do?

Important

Information about the novel coronavirus (the virus that causes COVID-19) is constantly evolving. We will refresh our novel coronavirus content periodically based on newly published peer-reviewed findings to which we have access. For the most reliable and up-to-date information, please visit the CDC website or the WHO’s advice for the public.

Chances are you’ve had a cold (or several) in your lifetime. You may have even experienced a more intense respiratory infection at some point, like the flu. If you have, you’ll know that respiratory infections can cause a whole host of symptoms, including fever, chest pain, congestion, cough, sneezing, shortness of breath, sore throat, body aches, fatigue, and more. But you don’t experience all of these symptoms every time you get sick, and maybe different people in your household caught the same infection you did but we’re up and at ‘em within 24 hours while you were bed-bound for a full week. 

That’s because not everybody experiences the same disease in the same way. Certain factors, such as your age or whether you have other medical conditions, can put you at a higher risk of developing serious disease. And this is especially important to keep in mind during the ongoing COVID-19 pandemic.

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

It is possible for anyone to develop severe symptoms. Just because you are young and healthy does not mean you are entirely protected from the disease. However, advanced age and certain medical conditions do put you at an increased risk.

Having any of the following underlying medical conditions is associated with developing severe disease from COVID-19 (CDC, 2021-a):

The CDC also offers more information for a few specific groups, including people with asthma, people with HIV, people who are pregnant or breastfeeding, and people who are experiencing homelessness (CDC, 2021-a). 

Typical symptoms of COVID-19

One study found that at least one third of people infected may be entirely asymptomatic, meaning they don’t experience any symptoms at all (and may not even know they have the virus) (Oran, 2021). Of those who do have symptoms, for most, they are relatively mild. Researchers found that more than 80% of people who experience symptoms have mild disease (NCIP Team, 2020).  

But there is another end of the spectrum. A study of over 44,000 people with confirmed COVID-19 found that 14% developed severe disease (based on how severely their breathing was affected), 5% developed critical disease (having respiratory failure, organ failure, or shock), and 2.3% died (Wu, 2020). While the exact fatality rate of COVID-19 differs depending on a variety of factors, the point is this: SARS-CoV-2 can cause such a range of disease that some are asymptomatic, while others are dying.

What about age?

You have likely heard that older adults are at increased risk of having severe symptoms and dying from COVID-19, and this is true. Multiple studies have shown that older age is associated with poorer outcomes. One study found that 31% of cases, 45% of hospitalizations, 53% of intensive care unit (ICU) admissions, and 80% of deaths associated with COVID-19 were in individuals aged 65 and over. It also found that the highest percentage of severe outcomes was in individuals aged 85 and over (Bialek, 2020).

To reiterate, eight out of 10 deaths in the United States from COVID-19 have been in individuals aged 65 and over. The CDC also offers specific information for adults over 65 (CDC, 2021-b).

What are the symptoms of COVID-19?

According to the Centers for Disease Control and Prevention (CDC), symptoms start showing up between 2–14 days after exposure (CDC, 2021-c). One study found that the average time before symptoms show up is 5.1 days, with 97.5% of infected people experiencing symptoms within 11.5 days (Lauer, 2020).

The most common symptoms of COVID-19 include (CDC, 2021-b):

  • Cough
  • Fever
  • Muscle pain
  • Headache
  • Shortness of breath
  • Sore throat
  • Diarrhea
  • Nausea/vomiting
  • Loss of smell
  • Loss of taste
  • Abdominal pain
  • Runny nose

So, what should you do?

No matter who you are and what medical conditions you have, there are several easy steps you can take to help prevent getting infected with coronavirus. If possible, avoid contact with people who are sick.

Vaccination is one of the best ways to protect not only yourself, but also the people around you. Contact your local pharmacy to find out where you can get vaccinated. If you are going to be around people who are not vaccinated, it’s best to make sure everyone has been tested for COVID and continues wearing face masks. Wash your hands frequently—especially before eating and touching your face. And if you have been exposed to someone who has tested positive for the coronavirus, or you have symptoms yourself, it’s important to get tested.

References

  1. Centers for Disease Control and Prevention. (2021-a, August 20). COVID-19: People With Certain Medical Conditions. Retrieved on Sept. 9, 2020 from https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html
  2. Centers for Disease Control and Prevention. (2021-b, August 2). COVID-19 Risks and Vaccine Information for Older Adults. Retrieved on Sept. 9, 2021 from https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html
  3. Centers for Disease Control and Prevention. (2021-bc, February 22). Symptoms of COVID-19. Retrieved on September. 9, 2021, from https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html
  4. Lauer, S. A., Grantz, K. H., Bi, Q., Jones, F. K., Zheng, Q., Meredith, H. R., et al. (2020). The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application. Annals of Internal Medicine, 172(9), 577–582. doi: 10.7326/M20-0504. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081172/
  5. Novel Coronavirus Pneumonia Emergency Response Epidemiology Team. (2020). [The Epidemiological Characteristics of an Outbreak of 2019 Novel Coronavirus Diseases (COVID-19) in China]. Zhonghua Liu Xing Bing Xue Za Zhi, 41(2), 145–151. doi: 10.3760/cma.j.issn.0254-6450.2020.02.003. Retrieved from  https://www.ncbi.nlm.nih.gov/pubmed/32064853
  6. Oran, D. P., & Topol, E. J. (2021). The Proportion of SARS-CoV-2 Infections That Are Asymptomatic : A Systematic Review. Annals of Internal Medicine, 174(5), 655–662. doi:10.7326/M20-6976. Retrieved from https://pubmed.ncbi.nlm.nih.gov/33481642/
  7. UpToDate. (2020, April 7). Coronavirus disease 2019 (COVID-19): Clinical features. Retrieved on June 29, 2020, from https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19?search=coronavrus&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
  8. Wu, Z., & Mcgoogan, J. M. (2020). Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China. JAMA, 323(13), 1239. doi: 10.1001/jama.2020.2648. Retrieved from https://jamanetwork.com/journals/jama/fullarticle/2762130
yael cooperman
Yael Cooperman, MD

Yael Cooperman is a physician and works as a Senior Manager, Medical Content & Education at Ro.

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