Since the COVID-19 pandemic began, public health experts have learned a lot about who is most at risk of infection. They’ve also learned who is more likely to become severely ill or even die from its effects.

This article will explore some common risk factors for developing severe COVID-19. We’ll also discuss how you might be able to lower your risk if you fall into one of the categories.

The virus that causes COVID-19 has gone through many mutations and variants. Some are more easily transmitted than others, and some can lead to more severe disease. But despite all of these mutations, public health experts have identified a number of COVID-19 risk factors. These risk factors appear to increase your chances of severe illness, hospitalization, or even death.

Older age

As you age, your immune system, like many other body systems, begins to lose some efficiency. Your immune system may take longer to respond or may not create as strong of a response as it once did. You may also be affected by an autoimmune condition.

The age at which these changes happen varies. But a 2022 study suggests people over 50 years old have an increased risk of severe COVID-19. According to the Centers for Disease Control and Prevention (CDC), more than 81 percent of COVID-19 deaths have occurred in people over 65 years old.

Weakened immune system

Your immune system is a gatekeeper when it comes to guarding you against infection. This system is responsible for recognizing and protecting against bacteria, viruses, and other foreign substances that enter your body.

Your immune system may be naturally weak because of a disease or other condition, or medically weak through some type of therapy. If so, it may not be able to recognize or destroy the virus that causes COVID-19.

Some conditions or medications that can contribute to a weakened immune system and increase your risk of severe COVID-19 include:

Pregnancy

During pregnancy, your body goes through a lot of changes. Every system in your body, including your immune system, is affected in some way by pregnancy. According to the CDC, people who are pregnant or have been pregnant in the last 6 weeks are at an increased risk of more severe illness from COVID-19.

Autoimmune diseases

Autoimmune diseases occur when your immune system is not working properly. With most autoimmune diseases, your body attacks its own cells or tissues.

People with autoimmune conditions may lose some immune system protection from the condition itself. But in many cases, the treatments for these conditions can lower protections, too. Many autoimmune diseases are treated with medications that weaken the immune system in order to reduce its attacks on your own body.

Examples of autoimmune diseases that can increase your risk of severe COVID-19 include:

Not all autoimmune systems present the same level of risk, though. Celiac disease, for example, has not been linked to an increased risk of severe COVID-19. Your risk of severe COVID-19 depends on the condition you have and the treatment you are receiving.

Blood disorders

Your blood is a major player in your immune function. Blood carries the white blood cells and other immune cells that travel through your body to detect and fight infections.

According to the National Institutes of Health (NIH), COVID-19 can increase the risk of blood clots and other complications. People with blood clotting disorders may be at a higher risk of severe illness from COVID-19.

Some of these conditions include:

Cancer

Cancer is the general name for a number of conditions where fast-growing cancer cells take over healthy cells and tissue. When this happens, cancer cells prevent the affected body part from carrying out its usual function, causing a cascade of symptoms.

Some cancers, like leukemia, can directly weaken your immune system and raise your risk of severe COVID-19. Other cancers usually affect the immune system, too, either by direct damage or through treatment. Chemotherapy and radiation can effectively eliminate many types of cancer cells, but they also usually destroy immune cells in the process.

Diabetes

Type 1 diabetes is an autoimmune condition that reduces the function of your pancreas, the organ that helps manage your blood sugar by producing insulin. Type 2 diabetes is acquired, often through lifestyle factors like diet.

Both these conditions have been found to increase the risk of severe COVID-19. But according to a 2021 study, type 1 diabetes may present the higher risk.

Disabilities

There are several reasons why people with certain physical or developmental disabilities may also be at a heightened risk for a severe course of COVID-19. According to the CDC, people with disabilities may be prone to other chronic conditions that increase their risk. They may also live in group settings, where there’s a higher chance of exposure.

Having certain disabilities is known to put you at particular risk of severe COVID-19, including:

Heart disease

People with heart and cardiovascular diseases are particularly at risk of getting very sick from COVID-19. The virus itself takes a large toll on cardiovascular health. Many people develop cardiovascular complications after COVID-19, so having an impaired system to begin with sets the stage for more severe disease.

Examples of heart or cardiovascular conditions that can increase your risk of severe COVID-19 include:

Hypertension

Hypertension, or high blood pressure, has been found in more people with severe COVID-19, but data isn’t entirely clear on why. People with hypertension often have other conditions that present their own increased risk of severe COVID-19, like heart disease and obesity.

Hypertension can also raise your risk of stroke. And blood clotting problems in people with COVID-19 can increase this risk even more.

Kidney disease

According to the National Kidney Foundation, COVID-19 increases your risk of kidney injury, either from the virus itself or from treatment. If you have chronic kidney disease or some other renal disorder before COVID-19, it can increase your risk of developing kidney injuries and other severe complications.

Liver disease

Your liver has many functions, including:

  • producing blood cells and hormones
  • regulating cholesterol and fat metabolism
  • filtering waste from your body

A 2021 study suggests that COVID-19 can damage your liver, either directly or through treatment medications.

People with the following liver conditions may be particularly at risk of developing severe COVID-19:

Lung disease

Of all the effects COVID-19 has on your body, its effect on your lungs is perhaps the most profound. COVID-19 usually leads to a type of pneumonia, where mucus coats the surfaces in your lungs. These surfaces help move air in and out of your bloodstream.

According to the American Lung Association, if you have a lung condition that makes it harder to breathe, it can be that much more difficult for your lungs to withstand the stress of COVID-19. Examples of such conditions include:

Mental health conditions

Mental health conditions like depression and schizophrenia may play a role in developing more severe COVID-19. While these conditions themselves don’t really pose a higher infection risk, people with mental health conditions often have other physical health conditions that can increase their risk of severe infection.

People with mental health conditions are often likely to experience gaps in finding or receiving adequate medical care. They also may have difficulty completing their necessary daily health activities.

Neurological conditions

Neurological conditions often impair a person’s ability to care for themselves. This can lead to a higher risk of infection. Living in group homes or skilled care settings also puts people with neurological disorders at a higher risk.

Examples of these conditions that may increase risk include:

Obesity or overweight

Being overweight or having obesity can increase your risk of developing severe COVID-19, as does a lack of physical activity. According to the CDC, your risk of severe illness from COVID-19 increases with your body mass index (BMI).

Transplant

People who have received organ or tissue transplants are at a particularly high risk of contracting all types of infections, including the virus that causes COVID-19, and becoming severely ill.

After a transplant, you’ll need to take medications for the rest of your life. These medications prevent your body from rejecting the transplanted tissue. They suppress your immune system to create a welcoming environment for the transplanted tissue, but they can also make it easy for infections to take hold.

Lifestyle factors

A number of lifestyle factors have been linked to more severe COVID-19. These behaviors may lead to health conditions that are known risk factors. Some activities associated with the highest risk of severe COVID-19 are:

Coronavirus infection and hospitalization rates were initially much lower for children than for adults. But that may have been due to the steps communities took to prevent children from catching the virus. But as usual activities resume, the CDC says rates among children are increasing.

Infants and toddlers are at a higher risk than older children. Their immune systems aren’t as fully developed yet.

Children’s self-care abilities and exposure to others in school or daycare settings can also increase infection risk.

Children with certain diseases or disabilities are particularly at risk. Some conditions and their treatments can affect your child’s overall health and immune function.

Specific conditions linked to more severe infection in children include:

  • Down syndrome
  • congenital irregularities
  • diabetes
  • asthma
  • immunodeficiency disorders
  • gastrointestinal diseases

If you have multiple health conditions, overall poor health, or one of the specific conditions mentioned above, you can take steps to lower your chances of serious illness.

These include:

One of the most important things to do is to get vaccinated against COVID-19. Even with the underlying conditions mentioned above, the vaccine is safe for the vast majority of people.

If you’re immunocompromised, you may need an extra dose of the vaccine, according to the CDC.

Learn about what to expect from the vaccine if you have an underlying condition.