https://www.kff.org/global-health-policy/issue-brief/how-many-adults-are-at-risk-of-serious-illness-if-infected-with-coronavirus/

Published: Mar 13, 2020

How Many Adults Are at Risk of Serious Illness If Infected with Coronavirus?

To view and download a PDF, click here.

As the number of people in the U.S. with coronavirus disease (COVID-19) continues to grow, there is increasing concern for adults who have a higher risk of developing serious illness if they are infected. The majority of people who become infected are expected to be asymptomatic or recover without needing special treatment, according to the World Health Organization. However, based on the most current information made available by the Centers for Disease Control and Prevention (CDC), older people and younger adults with serious medical conditions, such as heart disease, diabetes and lung disease, have a greater risk of becoming severely ill if they get infected with coronavirus. CDC has issued specific guidance for people who fall into these categories.

To inform discussions about the challenges associated with coronavirus in the U.S., we analyzed data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS) to estimate the total number of adults nationwide, and by state, who have an elevated risk of serious illness if they are infected with coronavirus. We recognize that our collective understanding of risk factors will continue to evolve as the disease spreads, and as CDC and others learn more about its effects on different populations. Based on information currently available, our definition of high risk includes older adults (ages 60 or older) and younger adults between the ages of 18 and 59 with heart disease, cancer, chronic obstructive pulmonary disease (COPD) or diabetes. We were unable to include hypertension as a risk factor because it is not tracked by the survey.

Key Findings

About four in ten adults (41%) ages 18 and older in the U.S. (105.5 million people) have a higher risk of developing serious illness if they are infected with coronavirus, due to their older age (60 and older) or health condition (Figure 1; Table 1).

Most of those at higher risk of developing a serious illness are older (72.4% or 76.3 million adults); however, the remaining 29.2 million adults ages 18-59 are at risk due to an underlying medical condition.

The share of adults ages 18 and older who have a higher risk of developing a more serious illness varies across the country, ranging from 31 percent (Washington, D.C.) to 51 percent (West Virginia). In Washington State, California and New York, some of the states hardest hit by COVID-19 thus far, the share of adults at high risk is 40 percent, 37 percent and 40 percent respectively.

An estimated 5.7 million adults who are at higher risk of getting a serious illness if they become infected with coronavirus are uninsured, including 3.9 million adults under age 60 and 1.8 million who are ages 60-64.

**interactive maps on website**

Discussion
The majority of people who become infected with coronavirus are not expected to become seriously ill, but a large segment of the U.S. adult population – 41 percent of adults ages 18 and older – have a higher risk of serious illness if they do become infected due to their age or underlying medical condition. One group particularly at risk are the 1.3 million people living in nursing homes in the US. As the number of people who test positive for coronavirus continues to rise, and as more is learned about the progression of illness and treatment among those who become seriously ill, the current set of risk factors available to estimate the size of the at-risk population is likely to be refined. Given the paucity of data at this stage of the pandemic, and the high stakes involved for people who do get seriously ill, these estimates confirm the need to take unprecedented efforts to minimize the spread of the coronavirus.