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COVID-19: Vulnerable groups at risk of severe illness

Written by Ada’s Medical Knowledge Team

Updated on


  • COVID-19 vulnerable groups are at a higher risk of hospitalization and death due to the coronavirus.
  • COVID-19 high-risk groups mainly consist of people with underlying medical conditions or a weakened immune system.
  • There’s a difference between a high risk of contracting COVID-19 and a high risk of getting severely ill due to COVID-19.
  • If you belong to a COVID-19 vulnerable group, then it’s likely that you are eligible for antiviral treatment. 

It’s important to know who is at a higher risk for severe illness from COVID-19 to minimize the impact that COVID-19 has on our society. Most people who get infected with the virus experience only mild to moderate symptoms, but some individuals are deemed extremely vulnerable to COVID-19. This article will provide an overview of the COVID-19 high-risk groups, so you can assess your risk, and be extra cautious around those more vulnerable. 

Which groups are at a higher risk of contracting COVID-19?

It’s important to understand that there is a distinction between a risk of getting COVID-19 and a risk of getting very sick from COVID-19. 

Whether or not you’ll get COVID-19 depends on some factors that have to do with the exposure to the virus, such as: 1

  • Length of time: the longer you are in contact with an infected person, the higher the possibility of getting infected too. 
  • Coughing or heavy breathing: if the person you’re with is infected with COVID-19 and is coughing, breathing heavily, shouting, or singing, you are at a higher risk of getting COVID-19 as there’s more probability that the virus is spread. 
  • Symptoms: if the person you’re with is experiencing symptoms of COVID-19, the odds of you getting COVID-19 significantly increase.
  • Masks: the best situation is for both you and the person you’re with to wear masks. If neither of you are masked, the risk of infection increases. 
  • Ventilation: The better the ventilation in the room, the slighter the odds of getting infected. Meeting others outdoors is preferred. 
  • Distance: the further away someone is, the lesser the chance of getting infected. 

Your risk of getting very sick from COVID-19 depends on whether or not you have underlying health issues and problems with your immune system. 

Who is at a higher risk for severe illness from COVID-19?

What puts someone at high risk for severe COVID-19 is the presence of certain risk factors, which increase the odds of getting severe complications that lead to hospitalization or death. Although most people only experience mild to moderate symptoms due to the coronavirus, a small number of patients develop severe symptoms.

The groups of people that are extremely vulnerable to COVID-19 mostly have underlying medical conditions, such as cancer, type 2 diabetes, heart conditions, chronic lung diseases such as asthma or COPD, or take medication that suppresses the immune system. 2

These factors all debilitate the immune system, which results in a weaker reaction when the body is confronted with a virus, such as the coronavirus. As the immune system doesn’t have sufficient strength to fight COVID-19, the coronavirus can replicate and spread more quickly, resulting in grave consequences such as hospitalization, the need for ventilation, and death. This article will further explain the most common risk factors for severe COVID-19. 3

COVID-19 and diabetes

Individuals with diabetes are at a higher risk for severe illness from COVID-19. Diabetes is even one of the most frequent comorbidities among patients that are hospitalized due to COVID-19. This condition has a negative effect on the outcome of the condition for a number of reasons: 4

  • Diabetes weakens the immune system, making it harder for the body to fight infections.
  • Diabetes causes high blood sugar levels, which are associated with inflammation and damage to the blood vessels throughout the body, including the lungs. Combined with COVID-19, this can easily result in respiratory complications, such as pneumonia
  • Diabetes type 2 often accompanies other underlying medical conditions, such as heart disease, obesity, and kidney disease. These conditions can also increase the risk of severe COVID-19 illness. 
  • Studies have also found that the coronavirus can cause damage to the pancreas, which could worsen high blood sugar levels and even induce diabetes. 

Check this page for more information about COVID-19 and diabetes. 

Obesity and COVID-19

Another vulnerable group for severe COVID-19 is obese people. If you’re obese or overweight, you have a higher risk of severe illness which could result in hospitalization or even death. This is mainly caused by: 5 6

  • Like people with type 2 diabetes, obesity often goes hand in hand with other underlying health conditions, which can increase your risk of severe COVID-19 infection. 
  • Besides that, obesity also weakens the immune system, which gives the coronavirus more opportunity to spread throughout the body and cause severe damage. 
  • Obesity also decreases lung capacity, which can make ventilation more difficult for those who end up in the hospital due to the infection. 

For more information about this vulnerable group, you can check our page about obesity and COVID-19

Smoking and COVID-19

People who smoke are also seen as a COVID-19 high-risk group. This is the case for those who used to smoke in the past, current active smokers, and people who inhale second-hand smoke regularly. 7 6

Smoking increases your risk for severe illness due to COVID-19 as it causes damage to the heart, the blood vessels, and the lungs, which causes an increased risk of lung disease in general. On top of that, tobacco also compromises the function of the immune system. This makes it harder for your body to fight off an infection with the coronavirus. 7

The combination of these issues caused by smoking increases your chances of hospitalization, the need for mechanical ventilation, and death due to the coronavirus.


COPD is another high-risk medical condition for COVID-19 which can increase your chances of hospitalization, ICU admission, and death. COPD (Chronic Obstructive Pulmonary Disease) is a respiratory condition that causes inflammation and irreversible lung damage. It can make you more vulnerable to severe illness due to COVID-19 in several ways: 8 9

  • People with COPD have a higher expression of angiotensin-converting enzyme receptors in the lung tissue, which makes it more likely for the coronavirus to be able to enter the cells.
  • Due to the issues caused by COPD, the immune system won’t work as efficiently against the coronavirus as it usually would. This causes a delayed response once the virus enters the body, allowing the coronavirus to replicate and spread quickly throughout the body.
  • COPD patients often have other underlying risk factors, such as cardiovascular disease, obesity, and diabetes. This also increases the odds of a worse COVID-19 outcome. 

Find more info about COVID-19 and COPD here.

Asthma and COVID-19

People who have asthma also run a high risk for COVID-19 complications. This is because asthma causes problems within the respiratory system, making it easier for the coronavirus to cause damage to the cells. There are a few groups of people with asthma who are particularly vulnerable to COVID-19 complications: 10

  • Those with non-allergic asthma
  • Those with moderate to severe asthma
  • Those with poorly managed asthma
  • Those with a weakened immune system due to the high doses of steroids they’re taking for their asthma management 
  • Those who have asthma combined with other underlying health conditions

For more information about COVID-19 and asthma, please follow this link

COVID-19 and the elderly 

Older adults are also a high-risk group for COVID-19, starting from the age of 50 and older, especially those who are older than 65 years. This is because the immune system is often weaker in older individuals, who usually already have other underlying medical conditions. 11

Treatment options and prevention for groups that are at higher risk of contracting COVID-19

The best way for people of COVID-19 vulnerable groups to protect themselves is to take preventative measures. These measures can consist of: 12

  1. Managing well the underlying health issues you're facing.
  2. Tackling issues such as obesity and smoking.
  3. Getting vaccinated and keeping your vaccination up-to-date.
  4. Washing your hands regularly and thoroughly with water and soap.
  5. Wearing a mask that fits well, covering both the nose and mouth. Masks can set a barrier for the particles you breathe, cough, or sneeze out. Respirators such as the N95 mask provide higher protection as they fit closely on the face and filter out particles, including the virus that causes COVID-19.
  6. Keeping a safe distance from others.
  7. Improving ventilation in indoor spaces by opening a window or moving indoor activities outdoors.
  8. Avoiding contact with those experiencing COVID-19 symptoms or who have tested positive.
  9. Getting tested for COVID-19 if you suspect infection and stay home if you think you have caught it.

Besides these preventative measures, it’s good to know that you may be eligible for COVID-19 antiviral treatment if you belong to one of these high-risk groups for COVID-19. Antiviral treatment can help decrease the possibility of hospitalization or death, as this medication will help lower the amount of virus present in your body while your immune system is fighting off the infection. 

However, It’s important to note that this medication needs to be prescribed by your doctor, who will first need to assess if you are at a higher risk for severe illness from COVID-19. This medication also needs to be taken as soon as possible to be effective, so it’s essential to contact your doctor immediately if you start noticing symptoms. 

Wrapping up

COVID-19 vulnerable groups usually have underlying medical conditions or a weakened immune system. COVID-19 vulnerable groups usually have underlying medical conditions or a weakened immune system. Those who are the most vulnerable to COVID-19 should take extra preventative measures and should be aware that they may be eligible for additional treatment which can help them avoid hospitalization and severe complications due to the infection with the coronavirus. 


Q: Is the COVID-19 vaccine recommended for high-risk groups?
A: Staying up-to-date with the COVID-19 vaccine is the best prevention of severe symptoms and hospitalization due to COVID-19, especially for vulnerable groups. 

Q: Which group is considered at highest risk for severe illness from COVID-19?
A: Older people are at the highest risk for severe illness from COVID-19, especially if they suffer from poorly managed underlying health conditions. 

Q: Who is considered high risk for COVID-19 complications? 
A: Those with underlying health conditions, a weakened immune system, older people, pregnant women, and smokers are all high-risk groups for COVID-19.