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Coronavirus Disease 2019 (COVID-19)
Section NavigationEvidence used to update the list of underlying medical conditions that increase a person’s risk of severe illness from COVID-1
Updated July 17, 2020
Updates to the list of underlying medical conditions that put individuals at increased risk for severe illness from COVID-19 were based on published reports, articles in press, unreviewed pre-prints, and internal data available between December 1, 2019 and May 29, 2020. This list is a living document that will be periodically updated by CDC, and it could rapidly change as the science evolves. Severe illness from COVID-19 was defined as hospitalization, admission to the ICU, intubation or mechanical ventilation, or death.
The level of evidence for each condition was determined by CDC reviewers based on available information about COVID-19. Conditions were added to the list (if not already on the previous underlying medical conditions list [originally released in March 2020]) if evidence for an association with severe illness from COVID-19 met any of the following criteria:
- Strongest and most consistent evidence: Defined as consistent evidence from multiple small studies or a strong association from a large study,
- Mixed evidence: Defined as multiple studies that reached different conclusions about risk associated with a condition, or
- Limited evidence: Defined as consistent evidence from a small number of studies. categorization for a condition’s association with severe illness from COVID-19, the condition was added to the list (if not already on the previous underlying medical conditions list [originally released in March 2020]).
Evidence used to update the list of underlying medical conditions that increase a person’s risk of severe illness from COVID-19
Level of Evidence | Condition | Evidence of Impact on COVID-19 Severity | Notes |
---|---|---|---|
Strongest and Most Consistent Evidence | Serious heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies | Cohort Study [1, 2] Meta Analyses [3, 4] Case Series [5] | On previous version of list as “Serious Heart Conditions” |
Cancer | Systematic Review [6] Cohort Study [7, 8] Case Series [9] | New to updated list as of July 17, 2020 | |
Chronic kidney disease | Case Series [6, 7, 8] Cohort Studies [9, 10, 11] | On previous version of list as “Chronic Kidney Disease Requiring Dialysis” | |
COPD | Meta Analyses [4, 12] Case Series [13] Cohort Study [10] | On previous version of list | |
Obesity (BMI> 30) | Cohort Studies [14, 15, 16, 17, 18] Cross-sectional [19] | On previous version of list as “Severe Obesity (BMI ≥40)” | |
Sickle cell disease | Case Series [20, 21, 22, 23, 24] | On previous version of list | |
Solid organ transplantation | Case Series [8, 25, 26, 27, 28, 29, 30] | New to updated list as of June 25, 2020 | |
Type 2 diabetes mellitus | Case Series [7] Longitudinal Study [31] Cohort Study [32, 33] Meta Analysis [34] | On previous version of list | |
Mixed Evidence | Asthma | Cohort Study [10, 35, 36, 37] Case Series [13] | On previous version of list |
Cerebrovascular disease | Meta Analysis [38, 39, 40, 41] Synthesis of Evidence [42] Cohort Study [1, 2, 43, 44, 45] | New to updated list as of June 25, 2020 | |
Hypertension | Cohort Study [1, 2, 45, 46, 47] Systematic Review [48] Meta Analyses [3, 4, 49] | New to updated list as of June 25, 2020 | |
Pregnancy | Systematic Review [50] Case Control Study [51] Case Series [52, 53, 54, 55] Cohort Study [56, 57, 58] | ||
Smoking | Meta Analyses [3, 59, 60, 61, 62] | On previous version of list | |
Use of corticosteroids or other immunosuppressive medications | Case Series [63, 64, 65] Cohort Study [66, 67] | On previous version of list | |
Limited Evidence | Bone marrow transplantation | Review [68] | On previous version of list |
HIV | Case Series [69, 70] | On previous version of list | |
Immune deficiencies | Case Series [71] Systematic Review [72] | On previous version of list | |
Inherited metabolic disorders | Cohort Study [43, 73] | New to updated list as of June 25, 2020; specific to pediatric populations at this time | |
Neurologic conditions | Cross-Sectional Study [74] Cohort Study [37, 45, 73] | New to updated list as of June 25, 2020; specific to pediatric populations at this time | |
Other chronic lung diseases | Meta Analysis [4] Case Series [13] Cohort Study [10, 75] | On previous version of list | |
Pediatrics | Systematic Review [84, 85] Cross-Sectional Study [82, 86] Cohort Study [77, 87, 88] | New to updated list as of July 17, 2020 | |
Liver disease | Meta Analysis [76] Cohort Study [77, 78] Literature Review [79] | On previous version of list | |
Type 1 diabetes mellitus | Case Series [7] Cohort Study [32, 33] Meta Analysis [34] | On previous version of list | |
Thalassemia | Case Series [80] Cross-Sectional Study [81] | On previous version of list |
Italicized citations indicate the reference is not peer reviewed
Non-bold, non-italicized citations indicate the reference is in press