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Underlying Conditions and the Higher Risk for Severe COVID-19 | COVID-19 | CDC
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<time class="cdc-page-title-bar__item cdc-page-title-bar__item--date" datetime="2025-02-06 05:00:00"> February 6, 2025 </time> <div data-alt-langs class="cdc-page-title-bar__item cdc-page-title-bar__item--languages"> <a class="cdc-page-title-bar__item" href="https://espanol.cdc.gov/enes/covid/hcp/clinical-care/underlying-conditions.html">Español</a> </div> </section> <div class="cdc-page-title cdc-page-offset syndicate"> <h1>Underlying Conditions and the Higher Risk for Severe COVID-19</h1> </div> <div id="content" class="cdc-page-content cdc-page-offset syndicate container"> <div class="cdc-dfe-body "> <div class="cdc-dfe-body__top "> <div class="dfe-section dfe-section--page-summary summary-blurb summary-list" data-section="cdc_generic_summary"> <div class="dfe-section__header"> <h2 class="editor-block--title" id="heading-lhje4unujz">At a glance</h2> </div> <div class="dfe-section__content"> <ul class="nested-list"> <li class="level-1">An updated list of high-risk underlying conditions, along with their associated evidence, is provided below. The conditions are grouped by the level of evidence, with the highest level shown in the top section.<ul> </ul> </li> <li class="level-1">The list of underlying medical conditions is not exhaustive and will be updated as the science evolves.<ul> </ul> </li> <li class="level-1">This list should not be used to exclude people with underlying conditions from recommended measures for prevention or treatment of COVID-19.<ul> </ul> </li> </ul> <div class="dfe-section__nav hide" id="dfe-section__nav"> <div class="dfe-section__nav__header" id="dfe-section__nav__header"> </div> <div class="dfe-section__nav-links" id="dfe-section__nav-links"> </div> </div> </div> </div> </div> <div class="cdc-dfe-body__center "> <div class="dfe-section" data-section="cdc_generic_section_1"> <a class="onThisPageAnchor" id="cdc_generic_section_1-what-you-need-to-know" name="What%20you%20need%20to%20know" title="What you need to know"><!-- --></a><h2 class="editor-block--title" id="heading-fple94pcvu">What you need to know</h2> <p>This web page provides an evidence-based resource for healthcare professionals caring for patients with underlying medical conditions who are at higher risk of experiencing severe outcomes of COVID-19. Severe outcomes of COVID-19 are defined as hospitalization, admission to the intensive care unit (ICU), intubation or mechanical ventilation, or death.</p> <div class="dfe-block cdc-callout cdc-callout--message"><div class="cdc-callout__icon" aria-hidden="true" role="img"></div> <h3 class="cdc-callout__heading">Information for the General Public</h3> <div class="cdc-callout__body"><div class="cdc-callout__content"><p>Find a list of underlying medical conditions that might cause severe COVID-19 and information on ways to prevent illness.</p> <div class="cdc-callout__button"><a href="/covid/risk-factors/index.html" class="btn btn-outline-cyan">People with Certain Medical Conditions and COVID-19</a></div></div> </div></div> <p>This page summarizes data from published reports, scientific articles in press, unreviewed pre-prints, and internal data that were included in literature reviews conducted by subject matter experts. Evidence used to inform the list of underlying conditions was determined by CDC reviewers based on available literature about COVID-19 at time of review. The information reflects evidence regarding underlying medical conditions and is intended to help healthcare professionals make informed decisions about patient care and to increase the awareness of risk among their patients.</p> <p>The methods used to assess the conditions have changed during the pandemic as the amount of literature and types of studies increased. For instance, preliminary versions of this list focused on providing the latest information based on descriptive data. As the literature grew, CDC investigators categorized the literature by study design.</p> <p>Since May 2021, the process has been updated to include a CDC-led review process that uses rigorous systematic review methods. To learn more about the process of CDC’s systematic reviews, see <a href="/library/researchguides/systematicreviews.html" class="">CDC systematic review process</a>.</p> </div> <div class="dfe-section" data-section="cdc_generic_section_2"> <a class="onThisPageAnchor" id="cdc_generic_section_2-background" name="Background" title="Background"><!-- --></a><h2 class="editor-block--title" id="heading-raooqxes9y">Background</h2> <p>Age is the strongest risk factor for severe COVID-19 outcomes. Patients with one or multiple certain underlying medical conditions are also at higher risk.<sup>(</sup><sup>1-3)</sup></p> <p>Additionally, <a href="https://covid.cdc.gov/covid-data-tracker/#vaccine-effectiveness%20" class="">being unvaccinated</a> or not being up to date on <a href="/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html" class="">COVID-19 vaccinations</a> also increases the risk of severe COVID-19 outcomes.</p> <p>Providers should consider the patient's age, presence of underlying medical conditions and other risk factors, and vaccination status in determining the risk of severe COVID-19-associated outcomes for any patient.</p> </div> <div class="dfe-section" data-section="cdc_generic_section_3"> <a class="onThisPageAnchor" id="cdc_generic_section_3-demographic-factors" name="Demographic%20Factors" title="Demographic Factors"><!-- --></a><h2 class="editor-block--title" id="heading-j5bdhv1hnc">Demographic Factors</h2> <p>Studies have shown that COVID-19 does not affect all population groups equally. Three important factors are age, race, and ethnicity.</p> <h3 id="heading-bxxmuz8shr">Age</h3> <p>Age remains the strongest risk factor for severe COVID-19 outcomes, with risk of severe outcomes increasing markedly with increasing age. Based on data from the National Vital Statistics System (NVSS) at NCHS (<a href="https://www.cdc.gov/nchs/nvss/covid-19.htm" class="">Risk for COVID-19 Infection, Hospitalization, and Death By Age Group</a>), compared with ages 18–29 years, the risk of death is 25 times higher in those ages 50–64 years, 60 times higher in those ages 65–74 years, 140 times higher in those ages 75–84 years, and 340 times higher in those ages 85+ years. Notably, these data include all deaths in the United States that occurred throughout the pandemic, from February 2020 to July 1, 2022, including deaths among unvaccinated individuals.</p> <p>Risk of severe outcomes is increased in people of all ages with certain underlying medical conditions and in people who are 50 years and older, with risk increasing substantially at ages >65 years.<sup>4,5</sup> Residents of long-term care facilities are also at increased risk, making up less than 1% of the U.S. population but accounting for more than 35% of all COVID-19 deaths.<sup>6-10</sup></p> <h3 id="heading-b9b3daz4ak">Race and Ethnicity</h3> <p>The COVID-19 pandemic has highlighted <a href="/covid/php/health-equity/index.html">racial, ethnic, and socioeconomic disparities</a> in COVID-19 illnesses, hospitalizations, and deaths.<sup>11-13</sup> Some racial and ethnic minority groups are also more likely to face multiple barriers to accessing health care including lack of insurance, transportation, child care, or ability to take time off from work.</p> <p>Studies have identified racial and ethnic differences in at-home COVID-19 test use, vaccination coverage, and access to outpatient therapeutics.<sup>14-16</sup> Data has shown that compared to non-Hispanic White people, people from racial and ethnic minority groups are more likely to be infected with SARS-CoV-2 (the virus that causes COVID-19). Once infected, people from racial and ethnic minority groups are more likely to be hospitalized, be admitted to the ICU, and die from COVID-19 at younger ages.<sup>17</sup></p> <p>We are still learning about how the environments where <a href="/about/priorities/why-is-addressing-sdoh-important.html?CDC_AAref_Val=https://www.cdc.gov/about/sdoh/index.html" class="">people live, learn, and work</a> can influence the risk for infection and severe COVID-19 outcomes.</p> </div> <div class="dfe-section" data-section="cdc_generic_section_4"> <a class="onThisPageAnchor" id="cdc_generic_section_4-summary-of-conditions-with-evidence" name="Summary%20of%20Conditions%20with%20Evidence" title="Summary of Conditions with Evidence"><!-- --></a><h2 class="editor-block--title" id="heading-4hyowfdsok">Summary of Conditions with Evidence</h2> <p>Evidence used to inform the list of underlying medical conditions that increase a person's risk of severe illness from COVID-19 is presented in alphabetical order by study design section. Conditions are categorized as higher risk, suggestive higher risk, and mixed evidence.</p> <h3 id="heading-9y04fm42f7">Higher Risk (conclusive)</h3> <p>Higher risk is defined as an underlying medical condition or risk factor that has a published meta-analysis or systematic review or underwent the <a href="https://www.cdc.gov/library/researchguides/systematicreviews.html">CDC systematic review process</a>. The meta-analysis or systematic review demonstrates a conclusive increase in risk for at least one severe COVID-19 outcome.</p> <div class="dfe-block cdc-callout cdc-callout--disclaimer"><div class="cdc-callout__icon" aria-hidden="true" role="img"></div> <h3 class="cdc-callout__heading">Notice</h3> <div class="cdc-callout__body"><div class="cdc-callout__content"><p>* Indicates presence of evidence for pregnant and non-pregnant women</p> <p>‡ Underlying conditions for which there is evidence in pediatric patients</p> <p>^ Risk may be further increased for people receiving dialysis</p> </div> </div></div> <div class="dfe-block dfe-block--cdcmodule cdc_table_module dfe-block--width-standard"><div class="dfe-block__inner"><div class="cdc-dfe-content-table"> <div class="right-mask"></div> <div class="cdc-content-table header-row" role="table" aria-label="table"> <div role="rowgroup"> <div class="row cdc-header" role="row"> <div class="col-4"> <div role="cell"> <p>Condition</p> </div></div> <div class="col-8"> <div role="cell"> <p>Evidence of Impact on COVID-19 Severity [Reference number]</p> </div></div> </div> <div class="row" role="row"> <div class="col-4"> <div role="cell"> <p>Asthma</p> </div></div> <div class="col-8"> <div role="cell"> <p>CDC Systematic Review [K]</p> </div></div> </div> <div class="row alternate-bg" role="row"> <div class="col-4"> <div role="cell"> <p>Cancer</p> <ul class="false"> <li>Hematologic Malignancies</li> </ul> </div></div> <div class="col-8"> <div role="cell"> <p>CDC Systematic Review [O]<br> Meta-Analysis/ Systematic Review <sup>18-22</sup><br> Cohort Study <sup>23-25</sup><br> Case Series <sup>26-28</sup><br> Case Control Study <sup>29</sup></p> </div></div> </div> <div class="row" role="row"> <div class="col-4"> <div role="cell"> <p>Cerebrovascular disease</p> </div></div> <div class="col-8"> <div role="cell"> <p>Meta-Analysis <sup>30-33</sup><br> Synthesis of Evidence <sup>34</sup><br> Cohort Study <sup>35-37</sup></p> </div></div> </div> <div class="row alternate-bg" role="row"> <div class="col-4"> <div role="cell"> <p>Chronic kidney disease*</p> <ul class="false"> <li>People receiving dialysis <sup>38,39</sup> <strong><sup>^</sup></strong></li> </ul> </div></div> <div class="col-8"> <div role="cell"> <p>Meta-Analysis <sup>33,40</sup><br> Cohort Studies <sup>36,41-62, 63</sup>*<br> Case Series <sup>64-66</sup></p> </div></div> </div> <div class="row" role="row"> <div class="col-4"> <div role="cell"> <p>Chronic lung diseases limited to:</p> <ul> <li>Bronchiectasis</li> <li>COPD (Chronic obstructive pulmonary disease)</li> <li>Interstitial lung disease</li> <li>Pulmonary embolism</li> <li>Pulmonary hypertension</li> </ul> </div></div> <div class="col-8"> <div role="cell"> <p> </p> <ul class="list-none"> <li>CDC Systematic Review [A]</li> <li>CDC Systematic Review [L]</li> </ul> <ul class="list-none"> <li>CDC Systematic Review [D]</li> <li>CDC Systematic Review [G]</li> <li>CDC Systematic Review [G]</li> </ul> </div></div> </div> <div class="row alternate-bg" role="row"> <div class="col-4"> <div role="cell"> <p>Chronic liver diseases limited to:</p> <ul> <li>Cirrhosis</li> <li>Non-alcoholic fatty liver disease</li> <li>Alcoholic liver disease</li> <li>Autoimmune hepatitis</li> </ul> </div></div> <div class="col-8"> <div role="cell"> <p>CDC Systematic Review [B] <sup>211</sup></p> </div></div> </div> <div class="row" role="row"> <div class="col-4"> <div role="cell"> <p>Cystic fibrosis</p> </div></div> <div class="col-8"> <div role="cell"> <p>CDC Systematic Review [M]</p> </div></div> </div> <div class="row alternate-bg" role="row"> <div class="col-4"> <div role="cell"> <p>Diabetes mellitus, type 1</p> </div></div> <div class="col-8"> <div role="cell"> <p>Meta-Analysis <sup>67</sup><br> Case Series <sup>65</sup><br> Cohort Study <sup>35,68-73</sup></p> </div></div> </div> <div class="row" role="row"> <div class="col-4"> <div role="cell"> <p>Diabetes mellitus, type 2*</p> </div></div> <div class="col-8"> <div role="cell"> <p>Meta-Analysis <sup>74</sup><br> Systematic Review <sup>75</sup>*<br> Gestational Diabetes Systematic Review <sup>76</sup>*<br> Case Series <sup>65</sup><br> Longitudinal Study <sup>77</sup><br> Cohort Study <sup>67,71,77-82</sup></p> </div></div> </div> <div class="row alternate-bg" role="row"> <div class="col-4"> <div role="cell"> <p>Disabilities‡, including Down syndrome</p> <p>For the list of all conditions that were part of the review, see the module below</p> </div></div> <div class="col-8"> <div role="cell"> <p>CDC Systematic Review [C]</p> </div></div> </div> <div class="row" role="row"> <div class="col-4"> <div role="cell"> <p>Heart conditions (such as heart failure, coronary artery disease, or cardiomyopathies)</p> </div></div> <div class="col-8"> <div role="cell"> <p>Meta-Analysis <sup>83-85</sup><br> Cohort Study <sup>35,36</sup></p> </div></div> </div> <div class="row alternate-bg" role="row"> <div class="col-4"> <div role="cell"> <p>HIV (Human immunodeficiency virus)</p> </div></div> <div class="col-8"> <div role="cell"> <p>Meta-Analysis/ Systematic Review <sup>86</sup><br> Cohort Study <sup>54</sup><sup>,</sup><sup>87-89</sup><br> Case Series <sup>90-92</sup></p> </div></div> </div> <div class="row" role="row"> <div class="col-4"> <div role="cell"> <p>Mental health conditions limited to:</p> <ul> <li>Mood disorders, including depression</li> <li>Schizophrenia spectrum disorders</li> </ul> </div></div> <div class="col-8"> <div role="cell"> <p>Meta-Analysis/ Systematic Review <sup>93</sup><sup>,</sup><sup>94</sup></p> </div></div> </div> <div class="row alternate-bg" role="row"> <div class="col-4"> <div role="cell"> <p>Neurologic conditions limited to dementia‡ and Parkinson’s Disease</p> </div></div> <div class="col-8"> <div role="cell"> <p>Meta-Analysis/ Systematic Review <sup>95-98, 208</sup><br> Cohort Study <sup>36</sup></p> </div></div> </div> <div class="row" role="row"> <div class="col-4"> <div role="cell"> <p>Obesity (BMI <u>></u>30 kg/m<sup>2</sup> or <u>></u>95<sup>th</sup> percentile in children)</p> </div></div> <div class="col-8"> <div role="cell"> <p>Meta-Analysis <sup>101-103</sup><br> Systematic Review <sup>75</sup>*<br> Cohort <sup>46</sup><sup>,</sup><sup>104-112,</sup><sup>63,113-116</sup>*</p> </div></div> </div> <div class="row alternate-bg" role="row"> <div class="col-4"> <div role="cell"> <p>Physical inactivity</p> </div></div> <div class="col-8"> <div role="cell"> <p>CDC Systematic Review [E]</p> </div></div> </div> <div class="row" role="row"> <div class="col-4"> <div role="cell"> <p>Pregnancy and recent pregnancy</p> </div></div> <div class="col-8"> <div role="cell"> <p>Meta-Analysis/ Systematic Review <sup>75,117</sup><br> Case Control <sup>118</sup><sup>,</sup><sup>119</sup><br> Case Series <sup>120-122</sup><br> Cohort Study <sup>123-126</sup></p> </div></div> </div> <div class="row alternate-bg" role="row"> <div class="col-4"> <div role="cell"> <p>Primary immunodeficiencies</p> </div></div> <div class="col-8"> <div role="cell"> <p>CDC Systematic Review [F]</p> </div></div> </div> <div class="row" role="row"> <div class="col-4"> <div role="cell"> <p>Smoking, current and former</p> </div></div> <div class="col-8"> <div role="cell"> <p>Meta-Analysis <sup>83,127</sup><sup>,</sup><sup>128-135</sup></p> </div></div> </div> <div class="row alternate-bg" role="row"> <div class="col-4"> <div role="cell"> <p>Solid organ or blood stem cell transplantation</p> </div></div> <div class="col-8"> <div role="cell"> <p>Meta-Analysis <sup>108</sup><br> Case Series <sup>136-147</sup><br> Cohort <sup>148-151</sup></p> </div></div> </div> <div class="row" role="row"> <div class="col-4"> <div role="cell"> <p>Tuberculosis</p> </div></div> <div class="col-8"> <div role="cell"> <p>CDC Systematic Review [H]</p> </div></div> </div> <div class="row alternate-bg" role="row"> <div class="col-4"> <div role="cell"> <p>Use of corticosteroids or other immunosuppressive medications</p> </div></div> <div class="col-8"> <div role="cell"> <p>Meta-Analysis/ Systematic Review <sup>152</sup><br> Cohort Study <sup>153</sup><br> Cross-Sectional <sup>154</sup><br> Case Series <sup>155-157</sup></p> </div></div> </div> </div> </div> </div></div></div><h3 id="heading-gxxni5jsu4">Complete List of Disabilities from CDC’s Systematic Review Process</h3> <ul class="nested-list"> <li class="level-1">Attention-deficit/hyperactivity disorder (ADHD)<ul> </ul> </li> <li class="level-1">Autism<ul> </ul> </li> <li class="level-1">Cerebral palsy<ul> </ul> </li> <li class="level-1">Charcot foot<ul> </ul> </li> <li class="level-1">Chromosomal disorders<ul> </ul> </li> <li class="level-1">Chromosome 17 and 19 deletion<ul> </ul> </li> <li class="level-1">Chromosome 18q deletion<ul> </ul> </li> <li class="level-1">Cognitive impairment<ul> </ul> </li> <li class="level-1">Congenital hydrocephalus<ul> </ul> </li> <li class="level-1">Congenital malformations<ul> </ul> </li> <li class="level-1">Deafness/hearing loss<ul> </ul> </li> <li class="level-1">Disability indicated by Barthel Index<ul> </ul> </li> <li class="level-1">Down syndrome<ul> </ul> </li> <li class="level-1">Fahr's syndrome<ul> </ul> </li> <li class="level-1">Fragile X syndrome<ul> </ul> </li> <li class="level-1">Gaucher disease<ul> </ul> </li> <li class="level-1">Hand and foot disorders<ul> </ul> </li> <li class="level-1">Learning disabilities<ul> </ul> </li> <li class="level-1">Leber's hereditary optic neuropathy (LHON) or Autosomal dominant optic atrophy (ADOA)<ul> </ul> </li> <li class="level-1">Leigh syndrome<ul> </ul> </li> <li class="level-1">Limitations with self-care or activities of daily living<ul> </ul> </li> <li class="level-1">Maternal inherited diabetes and deafness (MIDD)<ul> </ul> </li> <li class="level-1">Mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) and risk markers<ul> </ul> </li> <li class="level-1">Mobility disability<ul> </ul> </li> <li class="level-1">Movement disorders<ul> </ul> </li> <li class="level-1">Multiple disability (referred to in research papers as "bedridden disability")<ul> </ul> </li> <li class="level-1">Multisystem disease<ul> </ul> </li> <li class="level-1">Myoclonic epilepsy with ragged red fibers (MERRF)<ul> </ul> </li> <li class="level-1">Myotonic dystrophy<ul> </ul> </li> <li class="level-1">Neurodevelopmental disorders<ul> </ul> </li> <li class="level-1">Neuromuscular disorders<ul> </ul> </li> <li class="level-1">Neuromyelitis optica spectrum disorder (NMOSD)<ul> </ul> </li> <li class="level-1">Neuropathy, ataxia, and retinitis pigmentosa (NARP)<ul> </ul> </li> <li class="level-1">Perinatal spastic hemiparesis<ul> </ul> </li> <li class="level-1">Primary mitochondrial myopathy (PMM)<ul> </ul> </li> <li class="level-1">Progressive supranuclear palsy<ul> </ul> </li> <li class="level-1">Senior-Loken syndrome<ul> </ul> </li> <li class="level-1">Severe and complex disability (referred to in research papers as "polyhandicap disability")<ul> </ul> </li> <li class="level-1">Spina bifida and other nervous system anomalies<ul> </ul> </li> <li class="level-1">Spinal cord injury<ul> </ul> </li> <li class="level-1">Tourette syndrome<ul> </ul> </li> <li class="level-1">Traumatic brain injury<ul> </ul> </li> <li class="level-1">Visual impairment/blindness<ul> </ul> </li> <li class="level-1">Wheelchair use<ul> </ul> </li> </ul> <h3 id="heading-v7lusjmuh6">Suggestive Higher Risk</h3> <p>Suggestive higher risk is defined as an underlying medical condition or risk factor that did not have a published meta-analysis or systematic review or did not undergo the <a href="https://www.cdc.gov/library/researchguides/systematicreviews.html" class="">CDC systematic review process</a>. The evidence is supported by mostly cohort, case-control, or cross-sectional studies. (Systematic reviews are available for some conditions for children with underlying conditions.)</p> <div class="dfe-block dfe-block--cdcmodule cdc_table_module dfe-block--width-standard"><div class="dfe-block__inner"><div class="cdc-dfe-content-table"> <div class="right-mask"></div> <div class="cdc-content-table header-row" role="table" aria-label="table"> <div role="rowgroup"> <div class="row cdc-header" role="row"> <div class="col-4"> <div role="cell"> <p><strong>Condition</strong></p> </div></div> <div class="col-8"> <div role="cell"> <p><strong>Evidence of Impact on COVID-19 Severity [Reference number]</strong></p> </div></div> </div> <div class="row" role="row"> <div class="col-4"> <div role="cell"> <p>Children with certain underlying conditions</p> <p><strong>Read More:</strong> <a href="/covid/hcp/clinical-care/for-pediatric-hcp.html">Information for Pediatric Healthcare Providers</a></p> </div></div> <div class="col-8"> <div role="cell"> <p>Systematic Review <sup>158,159</sup><br> Cross-Sectional Study <sup>99</sup><sup>,</sup><sup>160,161</sup><br> Cohort Study <sup>99,100</sup><sup>,</sup><sup>162-169</sup><br> Case Series <sup>170,171</sup></p> </div></div> </div> <div class="row alternate-bg" role="row"> <div class="col-4"> <div role="cell"> <p>Epilepsy</p> </div></div> <div class="col-8"> <div role="cell"> <p>Cohort Study<sup>209</sup></p> </div></div> </div> <div class="row" role="row"> <div class="col-4"> <div role="cell"> <p>Hemophilia</p> </div></div> <div class="col-8"> <div role="cell"> <p>Cohort Study<sup>210</sup></p> </div></div> </div> <div class="row alternate-bg" role="row"> <div class="col-4"> <div role="cell"> <p>Overweight (BMI <u>></u>25 kg/m<sup>2 </sup>but <30 kg/m<sup>2</sup>)</p> </div></div> <div class="col-8"> <div role="cell"> <p>Cohort Study<sup>111</sup><br> Case Series<sup>110</sup></p> </div></div> </div> <div class="row" role="row"> <div class="col-4"> <div role="cell"> <p>Sickle cell disease</p> </div></div> <div class="col-8"> <div role="cell"> <p>Cohort<sup>170-173</sup><br> Case Series <sup>170,173-188</sup></p> </div></div> </div> <div class="row alternate-bg" role="row"> <div class="col-4"> <div role="cell"> <p>Substance use disorders</p> </div></div> <div class="col-8"> <div role="cell"> <p>Case-Control Study <sup>189-191</sup><br> Cohort Study <sup>192,193</sup></p> </div></div> </div> </div> </div> </div></div></div><h3 id="heading-v_knexqij0">Mixed Evidence (inconclusive: no conclusions can be drawn from the evidence)</h3> <p>Mixed evidence is defined as an underlying medical condition or risk factor that has a published meta-analysis or systematic review or underwent the <a href="https://www.cdc.gov/library/researchguides/systematicreviews.html" class="">CDC systematic review process</a>. The meta-analysis or systematic review is inconclusive, either because the aggregated data on the association between an underlying condition and severe COVID-19 outcomes are inconsistent in direction or there are insufficient (or limited) data on the association between an underlying condition and severe COVID-19 outcomes.</p> <ul class="nested-list"> <li class="level-1">Limited: The evidence consists of one study, or several small studies with no comparison group, limiting the conclusions that can be drawn.<ul> </ul> </li> <li class="level-1">Inconsistent: The evidence suggests no clear direction of association, meaning no firm conclusions can be drawn.<ul> </ul> </li> </ul> <div class="dfe-block cdc-callout cdc-callout--disclaimer"><div class="cdc-callout__icon" aria-hidden="true" role="img"></div> <h3 class="cdc-callout__heading">Notice</h3> <div class="cdc-callout__body"><div class="cdc-callout__content"><p>* Indicates presence of evidence for pregnant and non-pregnant women</p> <p>‡ Underlying conditions for which there is evidence in pediatric patients</p> <p>^ Risk may be further increased for people receiving dialysis</p> </div> </div></div> <div class="dfe-block dfe-block--cdcmodule cdc_table_module dfe-block--width-standard"><div class="dfe-block__inner"><div class="cdc-dfe-content-table"> <div class="right-mask"></div> <div class="cdc-content-table header-row" role="table" aria-label="table"> <div role="rowgroup"> <div class="row cdc-header" role="row"> <div class="col-4"> <div role="cell"> <p><strong>Condition</strong></p> </div></div> <div class="col-8"> <div role="cell"> <p><strong>Evidence of Impact on COVID-19 Severity [Reference number]</strong></p> </div></div> </div> <div class="row" role="row"> <div class="col-4"> <div role="cell"> <p>Alpha 1 antitrypsin deficiency</p> </div></div> <div class="col-8"> <div role="cell"> <p>Limited: CDC Systematic Review [I]</p> </div></div> </div> <div class="row alternate-bg" role="row"> <div class="col-4"> <div role="cell"> <p>Bronchopulmonary dysplasia</p> </div></div> <div class="col-8"> <div role="cell"> <p>Limited: CDC Systematic Review [J]</p> </div></div> </div> <div class="row" role="row"> <div class="col-4"> <div role="cell"> <p>Hepatitis B</p> </div></div> <div class="col-8"> <div role="cell"> <p>Inconsistent: CDC Systematic Review [B]</p> </div></div> </div> <div class="row alternate-bg" role="row"> <div class="col-4"> <div role="cell"> <p>Hepatitis C</p> </div></div> <div class="col-8"> <div role="cell"> <p>Limited: CDC Systematic Review [B]</p> </div></div> </div> <div class="row" role="row"> <div class="col-4"> <div role="cell"> <p>Hypertension*</p> </div></div> <div class="col-8"> <div role="cell"> <p>Inconsistent<br> Meta-Analysis <sup>83,194-197</sup><br> Systematic Review <sup>198</sup><sup>, </sup><sup>75</sup>*<br> Cohort Study <sup>35,36,41,199-205</sup><br> Case Series <sup>206</sup></p> </div></div> </div> <div class="row alternate-bg" role="row"> <div class="col-4"> <div role="cell"> <p>Thalassemia</p> </div></div> <div class="col-8"> <div role="cell"> <p>Limited: CDC Systematic Review [N]</p> </div></div> </div> </div> </div> </div></div></div> </div> <div class="dfe-section" data-section="cdc_generic_section_5"> <a class="onThisPageAnchor" id="cdc_generic_section_5-actions-healthcare-professionals-can-take" name="Actions%20Healthcare%20Professionals%20Can%20Take" title="Actions Healthcare Professionals Can Take"><!-- --></a><h2 class="editor-block--title" id="heading-xnrbii05ey">Actions Healthcare Professionals Can Take</h2> <ul class="nested-list"> <li class="level-1">Recommend vaccination with approved and authorized COVID-19 vaccines (updated 2024-2025 COVID-19 vaccine), which are safe and effective. Check out the <a href="/vaccines/covid-19/clinical-considerations/interim-considerations-us.html" class="">Interim Clinical Considerations for Use of COVID-19 Vaccines</a> as well as <a href="/covid/vaccines/stay-up-to-date.html">Stay Up to Date with Your Vaccines</a> and <a href="/covid/vaccines/getting-your-covid-19-vaccine.html" class="">locations for COVID-19 vaccination for patients</a> for more information.<ul> </ul> </li> <li class="level-1">Prescribe antivirals, which have been shown to significantly decrease the risk of hospitalization and death when treating patients with mild or moderate illness and risk factors for severe illness. Outcomes are improved if therapeutics are started within the first 5-7 days of symptom onset.<ul> </ul> </li> <li class="level-1">Consider Pemivibart (Pemgarda™), a monoclonal antibody for COVID-19 <a href="/covid/hcp/clinical-care/outpatient-treatment.html#cdc_cg_special_populations_risks-treatment-options-for-covid-19">pre-exposure prophylaxis</a> in people who are moderately or severely immunocompromised and unlikely to mount an adequate immune response to COVID-19 vaccination and who meet the <a href="https://www.fda.gov/media/177067/download?attachment" class="tp-link-policy" rel="noreferrer" data-domain-ext="gov">FDA-authorized conditions for use<span class="visually-hidden sr-only" aria-label=" external icon" role="img"></span><span class="cdc-icon-external cdc-link-icon" aria-hidden="true" alt="external icon"></span></a>. Pemivibart is an IV-infusion monoclonal antibody that is authorized for pre-exposure prevention of COVID-19 for individuals (12 years of age and older weighing at least 40 kg). Pemivibart may provide another layer of protection against COVID-19 in addition to vaccination and can be given at least 2 weeks after receiving a COVID-19 vaccine. Healthcare providers should consult the <a href="https://www.fda.gov/media/177067/download?attachment" class="tp-link-policy" rel="noreferrer" data-domain-ext="gov">Pemivibart EUA Fact Sheet<span class="visually-hidden sr-only" aria-label=" external icon" role="img"></span><span class="cdc-icon-external cdc-link-icon" aria-hidden="true" alt="external icon"></span></a> and <a href="https://www.fda.gov/media/177066/download?attachment" class="tp-link-policy" rel="noreferrer" data-domain-ext="gov">EUA Frequently Asked Questions<span class="visually-hidden sr-only" aria-label=" external icon" role="img"></span><span class="cdc-icon-external cdc-link-icon" aria-hidden="true" alt="external icon"></span></a> for the FDA-authorized conditions under which Pemivibart may be used. CDC is monitoring variants and how commonly they occur to understand if they might affect how well Pemivibart works. <a href="https://content.govdelivery.com/accounts/USFDA/bulletins/3b1344f" class="ce-selection tp-link-policy" rel="noreferrer" data-domain-ext="com">The FDA will provide additional updates<span class="visually-hidden sr-only" aria-label=" external icon" role="img"></span><span class="cdc-icon-external cdc-link-icon" aria-hidden="true" alt="external icon"></span></a> to the EUA materials, as appropriate, if new information emerges. This is the only preventive option available for COVID-19 for the immunocompromised community, as described above, at the present time.<ul> </ul> </li> <li class="level-1">Remind older patients and those with underlying medical conditions that <a href="/respiratory-viruses/prevention/masks.html" class="">wearing a mask is an additional prevention strategy</a> they can choose to further protect themselves.<ul> </ul> </li> <li class="level-1">Encourage patients to keep appointments for routine care and adhere to treatment regimens for their medical conditions.<ul> </ul> </li> <li class="level-1">Consider use of telehealth when appropriate.<ul> </ul> </li> <li class="level-1">Check out <a href="/covid/risk-factors/index.html" class="">additional information for your patients</a>.<ul> </ul> </li> </ul> <h3 id="heading-985egwpeoe">Considerations for Patients Within Racial and Ethnic Minority Groups</h3> <ul class="nested-list"> <li class="level-1">Ask patients about their concerns about vaccines and therapy. Consider using an evidence-based and culturally sensitive approach, such as <a href="/vaccines/covid-19/hcp/engaging-patients.html">motivational interviewing</a>. Try to provide trusted sources of information and other resources.<ul> </ul> </li> <li class="level-1">Encourage nucleic acid amplification tests (NAATs), including PCR tests, as well as early treatment for patients who are eligible.<ul> </ul> </li> <li class="level-1">Facilitate access to culturally and linguistically appropriate resources.<ul> </ul> </li> <li class="level-1">Reduce barriers to accessing current outpatient treatments.<ul> </ul> </li> </ul> <p>CDC strongly encourages healthcare professionals, patients and their advocates, and health system administrators to regularly consult the <a href="https://www.idsociety.org/practice-guideline/covid-19-guideline-treatment-and-management/" class="tp-link-policy" rel="noreferrer" data-domain-ext="org">Infectious Diseases Society of America (IDSA) COVID-19 Treatment Guidelines<span class="visually-hidden sr-only" aria-label=" external icon" role="img"></span><span class="cdc-icon-external cdc-link-icon" aria-hidden="true" alt="external icon"></span></a>.</p> </div> <div class="dfe-section" data-section="cdc_generic_section_6"> <a class="onThisPageAnchor" id="cdc_generic_section_6-key-findings-from-one-large-cross-sectional-study" name="Key%20Findings%20from%20One%20Large%20Cross-Sectional%20Study" title="Key Findings from One Large Cross-Sectional Study"><!-- --></a><h2 class="editor-block--title" id="heading-qn3wl2o1vb">Key Findings from One Large Cross-Sectional Study</h2> <p>Underlying Medical Conditions and Severe Illness Among 540,667 Adults Hospitalized With COVID-19, March 2020–March 2021</p> <p>This <a href="https://www.cdc.gov/pcd/issues/2021/21_0123.htm" class="">study</a> used data from the Premier Healthcare Database, which represents approximately 20% of all inpatient admissions in the United States since 2000. This cross-sectional study of 540,667 adults hospitalized with COVID-19 included both inpatients and hospital-based outpatients with laboratory-diagnosed COVID-19 from March 1, 2020, through March 31, 2021. The database included reports from 592 acute care hospitals in the United States. The study was designed to examine risk factors associated with severe outcomes of COVID-19 including admission to an ICU or stepdown unit, invasive mechanical ventilation, and death.</p> <p><strong>Main Findings:</strong></p> <ul class="nested-list"> <li class="level-1">Certain underlying medical conditions were associated with an increased risk for severe COVID-19 illness in adults.<ul> </ul> </li> <li class="level-1">Having multiple conditions was also associated with severe COVID-19 illness.<ul> </ul> </li> <li class="level-1">Obesity, diabetes with complications, and anxiety and fear-related disorders had the strongest association with death.<ul> </ul> </li> <li class="level-1">The number of frequent underlying medical conditions (present in ≥10.0% of patients) increased with age.<sup>207</sup><ul> </ul> </li> </ul> <figure class="dfe-image dfe-image__large"><div class="links-options"><span class="file-view d-none d-sm-inline image-modal"><a href="#">View Larger</a></span><span class="file-download"><a href="/covid/media/images/ComorbiditiesAge-Underlying_Conditions_1185x938.png" download="download" target="_blank">Download<span aria-label=" png icon" role="img" class="sr-only"></span><span class="cdc-link-icon cdc-link-icon--png" aria-hidden="true"></span></a></span></div><div class="image-container calculated-ratio-4-3 aspect-ratio-16-9"><img src="/covid/media/images/ComorbiditiesAge-Underlying_Conditions_1185x938.png" alt="This figure shows the adjusted risk ratios of death among adults hospitalized with COVID-19, by age and underlying conditions. Conditions with complications were associated with a higher risk of death and those 85 and older had the highest risk ratio of death." title="ComorbiditiesAge Underlying_Conditions_1185x938"></div> <div class="dfe-image-caption-container"><figcaption class="dfe-image-caption" id="caption-1734-67a4ed031a8c5">COVID-19 Death Risk Ratio (RR) for Select Age Groups and Comorbid Conditions.</figcaption></div></figure> <p><strong>Adapted from</strong><strong> Sources:</strong></p> <ul class="nested-list"> <li class="level-1">Kompaniyets L, Pennington AF, Goodman AB, Rosenblum HG, Belay B, Ko JY, et al. Underlying Medical Conditions and Severe Illness Among 540,667 Adults Hospitalized With COVID-19, March 2020–March 2021. To learn more, visit the <em>Preventing Chronic Disease</em> article: <a href="https://www.cdc.gov/pcd/issues/2021/21_0123.htm">https://www.cdc.gov/pcd/issues/2021/21_0123.htm</a><ul> </ul> </li> <li class="level-1">Pennington AF, Kompaniyets L, Summers AD, Danielson ML, Goodman AB, Chevinsky JR, Preston LE, Schieber LZ, Namulanda G, Courtney J, Strosnider HM, Boehmer TB, Mac Kenzie WR, Baggs J, Gundlapalli AV, Risk of Clinical Severity by Age and Race/Ethnicity Among Adults Hospitalized for COVID-19—United States, March–September 2020, <em>Open Forum Infectious Diseases</em>, Volume 8, Issue 2, February 2021. To learn more, visit: <a href="https://doi.org/10.1093/ofid/ofaa638" class="tp-link-policy" rel="noreferrer" data-domain-ext="org">https://doi.org/10.1093/ofid/ofaa638<span class="visually-hidden sr-only" aria-label=" external icon" role="img"></span><span class="cdc-icon-external cdc-link-icon" aria-hidden="true" alt="external icon"></span></a><ul> </ul> </li> </ul> <figure class="dfe-image dfe-image__large"><div class="links-options"><span class="file-view d-none d-sm-inline image-modal"><a href="#">View Larger</a></span><span class="file-download"><a href="/covid/media/images/ComorbidConditionsNumber_1185x938.png" download="download" target="_blank">Download<span aria-label=" png icon" role="img" class="sr-only"></span><span class="cdc-link-icon cdc-link-icon--png" aria-hidden="true"></span></a></span></div><div class="image-container calculated-ratio-4-3 aspect-ratio-16-9"><img src="/covid/media/images/ComorbidConditionsNumber_1185x938.png" alt="This figure shows the adjusted risk ratios of death by the number of underlying medical conditions among adults hospitalized with COVID-19. Risk of death increased the more underlying conditions they had." title="ComorbidConditionsNumber_1185x938"></div> <div class="dfe-image-caption-container"><figcaption class="dfe-image-caption" id="caption-1735-67a4ed031ba45">Death risk ratio (RR) increases as the number of underlying medical conditions increases among adults hospitalized with COVID-19.</figcaption></div></figure> <p><strong>Source: </strong>Kompaniyets L, Pennington AF, Goodman AB, Rosenblum HG, Belay B, Ko JY, et al. Underlying Medical Conditions and Severe Illness Among 540,667 Adults Hospitalized With COVID-19, March 2020–March 2021. To learn more, visit the <em>Preventing Chronic Disease</em> article: <a href="https://www.cdc.gov/pcd/issues/2021/21_0123.htm" class="ce-selection">https://www.cdc.gov/pcd/issues/2021/21_0123.htm</a></p> </div> <div class="dfe-section" data-section="cdc_generic_section_7"> <a class="onThisPageAnchor" id="cdc_generic_section_7-more-information" name="More%20Information" title="More Information"><!-- --></a><h2 class="editor-block--title" id="heading-qxg_a7qnk6">More Information</h2> <ul class="nested-list"> <li class="level-1"><a href="/covid/media/pdfs/2024/07/Brief-Methods-UC-ICD-10.pdf" class="" target="_blank">Methods for the Underlying Conditions ICD-10 List [PDF, 2 pages, 112K]<span aria-label=" pdf icon" role="img" class="sr-only"></span><span class="cdc-link-icon cdc-link-icon--pdf" aria-hidden="true"></span></a><ul> </ul> </li> <li class="level-1"><a href="https://aspr.hhs.gov/COVID-19/Therapeutics/Pages/default.aspx" class="tp-link-policy" rel="noreferrer" data-domain-ext="gov">COVID-19 Therapeutics<span class="visually-hidden sr-only" aria-label=" external icon" role="img"></span><span class="cdc-icon-external cdc-link-icon" aria-hidden="true" alt="external icon"></span></a><ul> </ul> </li> <li class="level-1"><a href="/covid/hcp/clinical-care/covid19-presentation.html" class="">Clinical Presentation</a><ul> </ul> </li> <li class="level-1"><a href="/covid/hcp/clinical-care/management-and-treatment.html" class="">COVID-19 Treatment in Outpatients</a><ul> </ul> </li> <li class="level-1"><a href="https://covid.cdc.gov/covid-data-tracker/#cases_casesper100klast7days">United States COVID-19 Deaths, Emergency Department (ED) Visits, and Test Positivity by Geographic Area</a><ul> </ul> </li> <li class="level-1"><a href="https://covid.cdc.gov/covid-data-tracker/#demographics" class="">Demographic Trends of COVID-19 Deaths in the US Reported to NVSS</a><ul> </ul> </li> <li class="level-1"><a href="/covid/php/health-equity/index.html" class="">Health Equity: Promoting Fair Access to Health </a><ul> </ul> </li> <li class="level-1"><a href="/vaccines/covid-19/index.html" class="">COVID-19 Vaccination Clinical & Professional Resources</a><ul> </ul> </li> </ul> </div> <div class="dfe-section" data-section="cdc_generic_section_8"> <a class="onThisPageAnchor" id="cdc_generic_section_8-references" name="References" title="References"><!-- --></a><h2 class="editor-block--title" id="heading-gzqna2lp3v">References</h2> <h3 id="heading-ql_tqir_hn">See CDC Systematic Review References</h3> <ol class="nested-list nested-list--letters "> <li class="level-1">Stone EC, Weissman D, Mazurek J, et al. <a href="/covid/media/pdfs/science-briefs/A-Bronchiectasis-Review_Final.pdf" class="" target="_blank">Brief Summary of Findings on the Association Between Underlying Bronchiectasis and Severe COVID-19 Outcomes. [print only, 476K, 18 pages]<span aria-label=" pdf icon" role="img" class="sr-only"></span><span class="cdc-link-icon cdc-link-icon--pdf" aria-hidden="true"></span></a> CDC COVID-19 Scientific Brief. October 2021.<ol> </ol> </li> <li class="level-1">Stone EC, Hofmeister M, Okasako-Schmucker DL, et al. <a href="/covid/media/pdfs/2025/02/B-ChronicLiverReview_Final.pdf" class="" target="_blank">Brief Summary of Findings on the Association Between Underlying Liver Diseases and Severe COVID-19 Outcomes. [print only, 1462K, 111 pages]<span aria-label=" pdf icon" role="img" class="sr-only"></span><span class="cdc-link-icon cdc-link-icon--pdf" aria-hidden="true"></span></a> CDC COVID-19 Scientific Brief. October 2021.<ol> </ol> </li> <li class="level-1">So CN, Ryerson AB, Yeargin-Allsopp M, Kristie EN et al. <a href="/covid/media/pdfs/2025/02/C-Disability-Review.pdf" target="_blank">Brief Summary of Findings on the Association Between Disabilities and Severe COVID-19 Outcomes. [1984K, 165 pages]<span aria-label=" pdf icon" role="img" class="sr-only"></span><span class="cdc-link-icon cdc-link-icon--pdf" aria-hidden="true"></span></a> CDC COVID-19 Scientific Brief.<ol> </ol> </li> <li class="level-1">Okasako-Schmucker DL, Weissman D, Mazurek J et al. <a href="/covid/media/pdfs/2025/02/D-Interstitial-Lung-Disease-Review_Final.pdf" class="" target="_blank">Brief Summary of Findings on the Association Between Interstitial Lung Diseases and Severe COVID-19 Outcomes. [print only, 837K, 67 pages]<span aria-label=" pdf icon" role="img" class="sr-only"></span><span class="cdc-link-icon cdc-link-icon--pdf" aria-hidden="true"></span></a> CDC COVID-19 Scientific Brief. October 2021.<ol> </ol> </li> <li class="level-1">Hill AL, Whitfield G, Morford M et al. <a href="/covid/media/pdfs/2025/02/Brief-Summary-of-Findings-on-the-Association-Between-Physical-Inactivity-and-Severe-COVID-19-Outcomes.pdf" class="" target="_blank">Brief Summary of Findings on the Association Between Physical Inactivity and Severe COVID-19 Outcomes. [931 KB, 63 pages]<span aria-label=" pdf icon" role="img" class="sr-only"></span><span class="cdc-link-icon cdc-link-icon--pdf" aria-hidden="true"></span></a> CDC COVID-19 Scientific Brief.<ol> </ol> </li> <li class="level-1">Morford M, Green RF, Drzymalla E et al. <a href="/covid/media/pdfs/2024/07/F-Primary-Immunodeficiency-Review.pdf" class="" target="_blank">Brief Summary of Findings on the Association Between Underlying Primary Immunodeficiency and Severe COVID-19 Outcomes. [print only, 705K, 41 pages]<span aria-label=" pdf icon" role="img" class="sr-only"></span><span class="cdc-link-icon cdc-link-icon--pdf" aria-hidden="true"></span></a> CDC COVID-19 Scientific Brief.<ol> </ol> </li> <li class="level-1">Wassef M, Weissman D, Mazurek J et al. <a href="/covid/media/pdfs/science-briefs/G-Pulmonary-Embolism-Pulmonary-Hypertension-Review_Final.pdf" class="" target="_blank">Brief Summary of Findings on the Association Between a History of Pulmonary Embolism or Pulmonary Hypertension and Severe COVID-19 Outcomes. [print only, 506K, 16 pages]<span aria-label=" pdf icon" role="img" class="sr-only"></span><span class="cdc-link-icon cdc-link-icon--pdf" aria-hidden="true"></span></a> CDC COVID-19 Scientific Brief. October 2021.<ol> </ol> </li> <li class="level-1">Kumasaka JK, Jereb JA, Stone E et al. <a href="/covid/media/pdfs/science-briefs/H-TB-Review_Final.pdf" class="" target="_blank">Brief Summary of Findings on the Association Between Tuberculosis and Severe COVID-19 Outcomes. [print only, 443K, 17 pages]<span aria-label=" pdf icon" role="img" class="sr-only"></span><span class="cdc-link-icon cdc-link-icon--pdf" aria-hidden="true"></span></a> CDC COVID-19 Scientific Brief. October 2021.<ol> </ol> </li> <li class="level-1">Morford M, Weissman, D, Mazurek J, et al. <a href="/covid/media/pdfs/science-briefs/I-Alpha1-Deficiency-Review_Final.pdf" class="" target="_blank">Brief Summary of Findings on the Association Between Alpha-1 Antitrypsin Deficiency and Severe COVID-19 Outcomes. [print only, 533K, 27 pages]<span aria-label=" pdf icon" role="img" class="sr-only"></span><span class="cdc-link-icon cdc-link-icon--pdf" aria-hidden="true"></span></a> CDC COVID-19 Scientific Brief. October 2021.<ol> </ol> </li> <li class="level-1">Henry MC, Weissman D, Mazurek J, et al.<a href="/covid/media/pdfs/science-briefs/J-Brochopulmonary-Review_Final.pdf" class="" target="_blank">Brief Summary of Findings on the Association Between Underlying Bronchopulmonary Dysplasia (BPD) and Severe COVID-19 Outcomes. [print only, 375K, 12 pages]<span aria-label=" pdf icon" role="img" class="sr-only"></span><span class="cdc-link-icon cdc-link-icon--pdf" aria-hidden="true"></span></a> CDC COVID-19 Scientific Brief. October 2021.<ol> </ol> </li> <li class="level-1">Okasako-Schmucker DL, Cornwell C, Mirabelli M, et al. <a href="/covid/media/pdfs/2025/02/K-Brief-Summary-of-Findings-on-the-Association-Between-Asthma-and-SevereCOVID-19-Outcomes-508_1.pdf" class="" target="_blank">Brief Summary of Findings on the Association Between Asthma and Severe COVID-19 Outcomes. [print only, 2,000KB, 142 pages]<span aria-label=" pdf icon" role="img" class="sr-only"></span><span class="cdc-link-icon cdc-link-icon--pdf" aria-hidden="true"></span></a> CDC COVID-19 Scientific Brief. June 2022.<ol> </ol> </li> <li class="level-1">Kumasaka JK, Weissman D, Mazurek J, et al. <a href="/covid/media/pdfs/2025/02/L-Brief-Summary-of-Findings-on-the-Association-Between-Underlying-COPD-and-Severe-COVID-19-Outcomes-508.pdf" class="" target="_blank">Brief Summary of Findings on the Association Between COPD and Severe COVID-19 Outcomes. [print only, 2,000KB, 176 pages]<span aria-label=" pdf icon" role="img" class="sr-only"></span><span class="cdc-link-icon cdc-link-icon--pdf" aria-hidden="true"></span></a> CDC COVID-19 Scientific Brief. June 2022.<ol> </ol> </li> <li class="level-1">So CN, Green RF, Drzymalia E, et al. <a href="/covid/media/pdfs/2025/02/M-CysticFibrosis-print.pdf" class="" target="_blank">Brief Summary of Findings on the Association Between Cystic Fibrosis and Severe COVID-19 Outcomes. [print only, 788K, 54 pages]<span aria-label=" pdf icon" role="img" class="sr-only"></span><span class="cdc-link-icon cdc-link-icon--pdf" aria-hidden="true"></span></a> CDC COVID-19 Scientific Brief. June 2022.<ol> </ol> </li> <li class="level-1">Hill AL, Payne AB, Schieve LA, et al. <a href="/covid/media/pdfs/science-briefs/Thalassemia_review.pdf" class="ce-selection" target="_blank">Brief Summary of Findings on the Association Between Thalassemia and Severe COVID-19 Outcomes. [print only, 619 KB, 26 pages]<span aria-label=" pdf icon" role="img" class="sr-only"></span><span class="cdc-link-icon cdc-link-icon--pdf" aria-hidden="true"></span></a> CDC COVID-19 Scientific Brief. June 2022.<ol> </ol> </li> <li class="level-1">Morford M, <a href="/covid/media/pdfs/2025/02/DraftAppendix-HemaMalig-Citing-FullyCleaned-508_1.pdf" target="_blank">Brief Summary of Findings on the Association Between Hematologic Malignancy and Hematopoietic Stem Cell Transplant/Hematopoietic Cell Transplant and Severe COVID-19 Outcomes [886KB – 78 pages]<span aria-label=" pdf icon" role="img" class="sr-only"></span><span class="cdc-link-icon cdc-link-icon--pdf" aria-hidden="true"></span></a> CDC COVID-19 Clinical Care. January 2023.<ol> </ol> </li> <li class="level-1">Supplement: Morford M, Koumans E, Giovanni J, et al. <a href="/covid/media/pdfs/science-briefs/DraftAppendix-SecondaryImmuno-Citing-FullyCleaned-508.pdf" class="" target="_blank">Brief Summary of Findings on the Association Between Secondary Immunosuppression from B-Cell-Depleting Therapy and Severe COVID-19 Outcomes [482 KB – 28 pages]<span aria-label=" pdf icon" role="img" class="sr-only"></span><span class="cdc-link-icon cdc-link-icon--pdf" aria-hidden="true"></span></a> CDC COVID-19 Clinical Care. January 2023.<ol> </ol> </li> </ol> <h3 id="heading-hk1ikqxjbo">See All References</h3> <ol class="nested-list nested-list--letters "> <li class="level-1">Rosenthal N, Cao Z, Gundrum J, Sianis J, Safo S. Risk Factors Associated With In-Hospital Mortality in a US National Sample of Patients With COVID-19. <em>JAMA Network Open</em>. 2020;3(12):e2029058-e2029058. <a href="https://pubmed.ncbi.nlm.nih.gov/33301018/" class="tp-link-policy" rel="noreferrer" data-domain-ext="gov">doi:10.1001/jamanetworkopen.2020.29058<span class="visually-hidden sr-only" aria-label=" external icon" role="img"></span><span class="cdc-icon-external cdc-link-icon" aria-hidden="true" alt="external icon"></span></a><ol> </ol> </li> <li class="level-1">De Giorgi A, Fabbian F, Greco S, et al. Prediction of in-hospital mortality of patients with SARS-CoV-2 infection by comorbidity indexes: an Italian internal medicine single center study. <em>Eur Rev Med Pharmacol Sci</em>. Oct 2020;24(19):10258-10266. <a href="https://dx.doi.org/10.26355/eurrev_202010_23250" class="ce-selection tp-link-policy" rel="noreferrer" data-domain-ext="org">doi:10.26355/eurrev_202010_23250<span class="visually-hidden sr-only" aria-label=" external icon" role="img"></span><span class="cdc-icon-external cdc-link-icon" aria-hidden="true" alt="external icon"></span></a><ol> </ol> </li> <li class="level-1">Dominguez-Ramirez L, Rodriguez-Perez F, Sosa-Jurado F, Santos-Lopez G, Cortes-Hernandez P. The role of metabolic comorbidity in COVID-19 mortality of middle-aged adults. The case of Mexico. 2020:2020.12.15.20244160. <a href="https://www.medrxiv.org/content/10.1101/2020.12.15.20244160v2" class="tp-link-policy" rel="noreferrer" data-domain-ext="org">doi:10.1101/2020.12.15.20244160 %J medRxiv<span class="visually-hidden sr-only" aria-label=" external icon" role="img"></span><span class="cdc-icon-external cdc-link-icon" aria-hidden="true" alt="external icon"></span></a><ol> </ol> </li> <li class="level-1">Ahmad FB, Cisewski JA, Minino A, Anderson RN. Provisional Mortality Data – United States, 2020. <em>MMWR Morb Mortal Wkly Rep</em>. Apr 9 2021;70(14):519-522. <a href="https://pubmed.ncbi.nlm.nih.gov/33830988/" class="tp-link-policy" rel="noreferrer" data-domain-ext="gov">doi:10.15585/mmwr.mm7014e1<span class="visually-hidden sr-only" aria-label=" external icon" role="img"></span><span class="cdc-icon-external cdc-link-icon" aria-hidden="true" alt="external icon"></span></a><ol> </ol> </li> <li class="level-1">Prevention CDC. CDC COVID Data Tracker. <a href="https://covid.cdc.gov/covid-data-tracker/#demographics">https://covid.cdc.gov/covid-data-tracker/#demographics</a><ol> </ol> </li> <li class="level-1">Abrams HR, Loomer L, Gandhi A, Grabowski DC. Characteristics of US Nursing Homes with COVID-19 Cases. <em>Journal of the American Geriatrics Society</em>. 2020. <a href="https://pubmed.ncbi.nlm.nih.gov/32484912/" class="tp-link-policy" rel="noreferrer" data-domain-ext="gov">doi:10.1111/jgs.1661<span class="visually-hidden sr-only" aria-label=" external icon" role="img"></span><span class="cdc-icon-external cdc-link-icon" aria-hidden="true" alt="external icon"></span></a><ol> </ol> </li> <li class="level-1">Grabowski DC, Mor V. 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Aug 25 2020;6(3):e20872. <a href="https://pubmed.ncbi.nlm.nih.gov/32750009/" class="tp-link-policy" rel="noreferrer" data-domain-ext="gov">doi:10.2196/20872<span class="visually-hidden sr-only" aria-label=" external icon" role="img"></span><span class="cdc-icon-external cdc-link-icon" aria-hidden="true" alt="external icon"></span></a><ol> </ol> </li> <li class="level-1">Killerby ME, Link-Gelles R, Haight SC, et al. Characteristics Associated with Hospitalization Among Patients with COVID-19 – Metropolitan Atlanta, Georgia, March-April 2020. <em>MMWR Morb Mortal Wkly Rep</em>. Jun 26 2020;69(25):790-794. <a href="https://pubmed.ncbi.nlm.nih.gov/32584797/" class="tp-link-policy" rel="noreferrer" data-domain-ext="gov">doi:10.15585/mmwr.mm6925e1<span class="visually-hidden sr-only" aria-label=" external icon" role="img"></span><span class="cdc-icon-external cdc-link-icon" aria-hidden="true" alt="external icon"></span></a><ol> </ol> </li> <li class="level-1">Chen R, Yang J, Gao X, et al. Influence of blood pressure control and application of renin-angiotensin-aldosterone system inhibitors on the outcomes in COVID-19 patients with hypertension. <em>J Clin Hypertens (Greenwich)</em>. Nov 2020;22(11):1974-1983. <a href="https://pubmed.ncbi.nlm.nih.gov/33006442/" class="tp-link-policy" rel="noreferrer" data-domain-ext="gov">doi:10.1111/jch.14038<span class="visually-hidden sr-only" aria-label=" external icon" role="img"></span><span class="cdc-icon-external cdc-link-icon" aria-hidden="true" alt="external icon"></span></a><ol> </ol> </li> <li class="level-1">Kompaniyets L, Pennington AF, Goodman AB, et al. Underlying Medical Conditions and Severe Illness Among 540,667 Adults Hospitalized With COVID-19, March 2020-March 2021. <em>Preventing chronic disease</em>. Jul 1 2021;18:E66. <a href="https://pubmed.ncbi.nlm.nih.gov/34197283/" class="ce-selection tp-link-policy" rel="noreferrer" data-domain-ext="gov">doi:10.5888/pcd18.210123<span class="visually-hidden sr-only" aria-label=" external icon" role="img"></span><span class="cdc-icon-external cdc-link-icon" aria-hidden="true" alt="external icon"></span></a><ol> </ol> </li> <li class="level-1">Khoshnood R, Zali A, Tafreshinejad A, et al. Parkinson's disease and COVID-19: a systematic review and meta-analysis. November 2021. <em>Neurological Sciences. </em><a href="https://link.springer.com/content/pdf/10.1007/s10072-021-05756-4.pdf" class="ce-selection tp-link-policy" target="_blank" rel="noreferrer" data-domain-ext="com">doi:10.1007/s10072-021-05756-4<span aria-label=" pdf icon" role="img" class="sr-only"></span><span class="cdc-link-icon cdc-link-icon--pdf" aria-hidden="true"></span><span class="visually-hidden sr-only" aria-label=" external icon" role="img"></span><span class="cdc-icon-external cdc-link-icon" aria-hidden="true" alt="external icon"></span></a><ol> </ol> </li> <li class="level-1">Ufongene C, Van Hyfte G, Agarwal P, et al. Older adults with epilepsy and COVID-19: Outcomes in a multi-hospital health system. January 2024. <em>Seizure: European Journal of Epilepsy</em>. <a href="https://doi.org/10.1016/j.seizure.2023.11.018" class="ce-selection tp-link-policy" rel="noreferrer" data-domain-ext="org">doi:10.1016/j.seizure.2023.11.018<span class="visually-hidden sr-only" aria-label=" external icon" role="img"></span><span class="cdc-icon-external cdc-link-icon" aria-hidden="true" alt="external icon"></span></a><ol> </ol> </li> <li class="level-1">Sharathkumar A, Wendt L, Ortman C, et al. COVID-19 outcomes in persons with hemophilia: results from a US-based national COVID-19 surveillance registry. January 2024. <em>Journal of Thrombosis and Haemostasis</em>. <a href="https://doi.org/10.1016/j.jtha.2023.04.040" class="ce-selection tp-link-policy" rel="noreferrer" data-domain-ext="org">doi:10.1016/j.jtha.2023.04.040<span class="visually-hidden sr-only" aria-label=" external icon" role="img"></span><span class="cdc-icon-external cdc-link-icon" aria-hidden="true" alt="external icon"></span></a><ol> </ol> </li> <li class="level-1">Kurniawan A, Hariyanto, TI. Non-alcoholic fatty liver disease (NAFLD) and COVID-19 outcomes: A systematic review, meta-analysis, and meta regression. April 2023. <em>Narra J</em>. <a href="https://pubmed.ncbi.nlm.nih.gov/38450034/" class="tp-link-policy" rel="noreferrer" data-domain-ext="gov">doi:10.52225/narra.v3i1.102<span class="visually-hidden sr-only" aria-label=" external icon" role="img"></span><span class="cdc-icon-external cdc-link-icon" aria-hidden="true" alt="external icon"></span></a><br><ol> </ol> </li> </ol> </div> </div> <div class="cdc-dfe-body__right page-right-rail"> <aside class="page-right-rail__static noindex" role="complementary"> <div class="on-this-page " data-sid=""> <h2 class="on-this-page__heading"> On This Page </h2> <div class="card-body"> <ul> <li><a href="#cdc_generic_section_1-what-you-need-to-know">What you need to know</a></li> <li><a href="#cdc_generic_section_2-background">Background</a></li> <li><a href="#cdc_generic_section_3-demographic-factors">Demographic Factors</a></li> <li><a href="#cdc_generic_section_4-summary-of-conditions-with-evidence">Summary of Conditions with Evidence</a></li> <li><a href="#cdc_generic_section_5-actions-healthcare-professionals-can-take">Actions Healthcare Professionals Can Take</a></li> <li><a href="#cdc_generic_section_6-key-findings-from-one-large-cross-sectional-study">Key Findings from One Large Cross-Sectional Study</a></li> <li><a href="#cdc_generic_section_7-more-information">More Information</a></li> <li><a href="#cdc_generic_section_8-references">References</a></li> </ul> </div> </div> </aside> <aside class="page-right-rail__dynamic noindex" role="complementary"> <div data-related-nav></div> </aside> </div> </div> <div data-journey-next></div> <section class="container page-mobile-bar"> <time class="page-mobile-bar__item page-mobile-bar__item--date" datetime="2025-02-06 00:00:00"> February 6, 2025 </time> </section> <div class="page-content-sources noindex"> <div class="page-content-sources__header"> <a data-action="summary" class="collapsed" href="#content-sources" role="button" data-bs-toggle="collapse" aria-expanded="false" aria-controls="content-sources" data-cs-toggle="">Sources</a> <a data-action="print" href="#print" class="d-none d-md-block" aria-label="print this page" onclick="window.print()">Print</a> <a data-action="share" href="#share" data-bs-toggle="dropdown" aria-label="share this page" aria-expanded="false">Share</a> <div class="dropdown-menu page-share-bar" data-popper-placement="bottom-start"> <a href="#" class="page-share-facebook"><span class="cdc-icon-facebook"></span></a> <a href="#" class="page-share-linkedin"><span class="cdc-icon-linkedin"></span></a> <a href="#" class="page-share-twitter"><span class="cdc-icon-twitter"></span></a> <a href="#" class="page-share-syndication"><span class="cdc-icon-rss"></span></a> </div> </div> <div class="page-share-container"> <div class="page-share-popup" id="page-share-popup" role="dialog"> <a target="_blank" title="Share to Facebook" rel="noreferrer noopener" class="page-share-facebook metrics-share-facebook" href="https://www.facebook.com/sharer/sharer.php?u=https%3A%2F%2Fwww.cdc.gov"> <span class="sr-only">Facebook</span> <span class="cdc-icon-facebook-inverse"></span> </a> <a target="_blank" title="Share to LinkedIn" rel="noreferrer noopener" class="page-share-linkedin metrics-share-linkedin" href="https://www.linkedin.com/shareArticle?url=https%3A%2F%2Fwww.cdc.gov&title=Living%20with%20High%20Blood%20Pressure"> <span class="sr-only">LinkedIn</span> <span class="cdc-icon-linkedin-inverse"></span> </a> <a target="_blank" title="Share to Twitter" rel="noreferrer noopener" class="page-share-twitter metrics-share-twitter" href="https://twitter.com/share?url=https%3A%2F%2Fwww.cdc.gov&text=Living%20with%20High%20Blood%20Pressure"> <span class="sr-only">Twitter</span> <span class="cdc-icon-twitter-inverse"></span> </a> <a target="_blank" title="Embed this Page" rel="noreferrer noopener" class="page-share-syndication metrics-share-syndicate" href="https://tools.cdc.gov/medialibrary/index.aspx#/sharecontent/https://https://www.cdc.gov/covid/hcp/clinical-care/underlying-conditions.html"> <span class="sr-only">Syndicate</span> <span class="fi cdc-icon-syndication-round"></span> </a> </div> </div> <div id="content-sources" class="page-content-sources__body accordion-collapse collapse"> <div class="callout callout-content-source" role="status"> <div class="callout-heading">Content Source:</div> <a class="cdc-block-link" href="/ncird/index.html">National Center for Immunization and Respiratory Diseases</a>; 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