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What are the key risk groups for the novel coronavirus SARS-CoV-2 that causes COVID-19? See a data breakdown below.
There are several primary sources for risk information about COVID-19. The first, is the World Health Organization (WHO). WHO produced one of the first reports regarding the differential disease severity of COVID-19, and the data produced by them has so far held up in other countries outside of China. While the true number of confirmed cases of COVID-19 in China during the initial phases of the epidemic are likely to remain uncertain, the clinical information provided by the WHO about the severity of the disease continues to relatively accurate. Of course, as more countries had become engaged in a global pandemic, these statistics have varied from region to region based on region-specific demographics.
“WHO Figure 5.” One of the most critical pieces of data published by the WHO. From this, we can tell that a large percentage of COVID-19 cases become critical or severe, and that around 50% of these critical cases result in death. The combination of high critical rate, and high conversion of critical into fatality, is what has been driving the high case fatality rate seen in COVID-19.
The WHO descriptions of each grade of disease severity can be seen below.
“Most people infected with COVID-19 virus have mild disease and recover. Approximately 80% of laboratory confirmed patients have had mild to moderate disease, which includes non-pneumonia and pneumonia cases, 13.8% have severe disease (dyspnea, respiratory frequency ≥30/minute, blood oxygen saturation ≤93%, PaO2/FiO2 ratio <300, and/or lung infiltrates >50% of the lung field within 24-48 hours) and 6.1% are critical (respiratory failure, septic shock, and/or multiple organ dysfunction/failure). Asymptomatic infection has been reported, but the majority of the relatively rare cases who are asymptomatic on the date of identification/report went on to develop disease. The proportion of truly asymptomatic infections is unclear but appears to be relatively rare and does not appear to be a major driver of transmission.”
As noted by the WHO at this time, the proportion of asymptomatic cases was unknown at the time. Today, we have estimates of asymptomatic case rates as high as 50%. From this data, we can see the four levels of disease severity as classified here:
1. Mild to moderate disease - most recover, non-pneumonia and pneumonia cases.
2. Sever disease - dyspnea (difficult or labored breathing), hypoxia (lack of oxygen in body tissues), and lung infiltrates (e.g., Ground-glass opacity (GGO)).
3. Critical disease - respiratory failure, septic shock, multiple organ failure, mechanical ventilation required.
An archived copy of the WHO report is available from IIRESS servers here: WHO Final Report on China
From the WHO Joint Final Report on China, we can see that the highest risk group for COVID-19 is the elderly.
*† US now reports several fatalities in the age 0-9 category: US COVID-19 death toll grows to 3 for children in New York
Men are slightly more likely to die from COVID-19 than women.
|Sex||Case Fatality Rate (CFR)|
And finally, people with comorbidities are also at much higher risk.
|Pre-Existing Condition||Case Fatality Rate (CFR)|
|Chronic Respiratory Disease||6.3%|
|No pre-existing conditions||0.9%|
Much of this data has recently been corroborated by the CDC as US clinical cases have begun to resolve.
CDC Stats for COVID-19 Risk:
Estimated percent requiring hospitalization
Estimated percent requiring admission to intensive care unit
Estimated percent who died
Source: CDC Risks, Older Adults
US CDC list of high risk individuals:
People of all ages with underlying medical conditions including:
US CDC also notes that individuals with Asthma are at significantly higher risk than others and offers specific guidance to this group as seen below. This risk is also extended to immunocompromised or HIV positive/AIDS individuals.
US CDC - People with Moderate to Severe Asthma
US CDC - People with HIV
Recent articles on risk & comorbidities
News and Publications About Tobacco use and COVID-19
CDC Signs and Symptoms of Coronavirus disease 2019 (COVID-19)
Oregon Health Authority Weekly Report, Signs & Symptoms, Infection Risk, and Underlying Conditions 04/28/2020
Figure 1. provides information on signs and symptoms from all COVID-19 cases. Of all 2,345 cases, 87.4% (n=2,049) reported having signs and symptoms of COVID-19. The two most commonly reported symptoms are cough (n=1,617, 69.0%) and fever (n=1,149, 49.0%). Figure 2 provides information on risk factors from all COVID-19 cases. The two most common risk factors are having underlying medical conditions (n=1,033, 44.1%) and contact with a known COVID-19 case prior to symptom onset (n=809, 34.5%). It is important to note that each person may report more than one sign/symptom or risk factor. Figure 3 shows the sex distribution of all COVID-19 cases.
*Congregate living situations include, but are not limited to, long-term care facilities, group homes, prisons, shelters, etc. Data include people with confirmed cases who live or work in congregate living situations. Direct patient care is only asked if a case is a healthcare worker or volunteer. The denominator is the number of healthcare workers or volunteers. *Underlying medical conditions include cardiovascular disease, chronic liver disease, chronic lung disease, chronic renal disease, current or former smoker, diabetes mellitus, immunocompromised condition, neurologic/neurodevelopmental condition, obesity, or other chronic diseases.
Scientific Articles Focusing on Rare Warning Signs and Symptoms of COVID-19
Be aware of the symptoms
CDC Recommendations for reducing exposure risk of COVID-19:
Manage Anxiety and Stress
*Note: The information contained in this website does not constitute medical advice. If you are having a medical emergency please contact your local healthcare provider or dial 911. If you are concerned about your health risks related to Coronavirus, please consult a medical professional.
Non-Clinical Mask Info & Guides:
Guides and resources to best sexual health practices
Is COVID-19 Sexually Transmitted?
US CDC - Wear a cloth face covering in publich: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html
US CDC - People with HIV: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/hiv.html
US CDC - People with Moderate to Severe Asthma: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/asthma.html| US CDC - People with Moderate to Severe Asthma
US CDC Risks, Older Adults: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/older-adults.html
Ground Glass Opacity (CGO): https://www.itnonline.com/content/study-looks-ct-findings-covid-19-through-recovery