This Is What It Looks Like to Be #HighRiskCOVID19

  • The hashtag #HighRiskCovid19 has been trending on Twitter with stories of people of all ages who are immunosuppressed.
  • About 20 percent of people who develop COVID-19 have severe or critical cases, according to data from China.
  • People with a weakened immune system have an increased risk of developing serious complications like pneumonia.

Around the globe, people who are at a higher risk for developing complications from COVID-19 have been making their voices heard.

The hashtag #HighRiskCovid19 has been trending on Twitter with stories of people of all ages who are immunosuppressed or have a risk factor — like diabetes, heart disease, or lung disease — for the viral respiratory infection.

The COVID-19 disease that develops from coronavirus (SARS-CoV-2) is fairly mild in the vast majority of people who get it. But nearly 20 percent of those who get COVID-19 can develop a much more severe illness and experience a range of serious complications.

Here’s why the risk is even higher for those with a weakened immune system, and what you can do to help:

The risk of those who are immunosuppressed

There’s a wide range of conditions that may cause someone’s immune system to be weaker, including transplant people who take immunosuppressant drugs, people over 60, people with cancer undergoing chemotherapy, and those with chronic disease like diabetes, pulmonary disease, or cystic fibrosis.

People with a weakened immune system have an increased risk of developing a more severe illness or complications like pneumonia because their immune system isn’t strong enough to fight diseases like COVID-19.

“In the event that someone is immunosuppressed, their immune system has slowed down and is not aggressive at recognizing other things as well, like outside infections from viruses and bacteria,” Dr. David Mulligan, the chief of transplant surgery and immunology for Yale Medicine and president of UNOS, told Healthline.

Allyson, a 20-year-old from northern Virginia, has a rare autoimmune disorder called Wegener’s disease.

The disease causes her cells to attack and inflame her blood vessels which can hurt her organ function. Allyson takes immunosuppressants, which she says, “causes the strength of my immune system to be lowered.”

Over the years, the disease has impaired her kidney and respiratory system along with her sinus tract.

It also puts her at a higher risk of not only developing COVID-19 but experiencing more severe symptoms, too.

“When we have new viruses that we don’t have medications to treat, and we don’t have a built-in immune system to protect against infections or a resistance to these types of infections, the new virus like COVID-19 can be more aggressive and have a more serious effect,” Mulligan explained.

Those who are more affected by the virus will likely need ICU-level care and ventilators to help people with severe symptoms maintain oxygenation, according to Dr. Jeffrey Linder, chief of general internal medicine and geriatrics at Northwestern University Feinberg School of Medicine and a Northwestern Medicine primary care physician.

Another consequence of a suppressed immune system is that the virus can multiply and reproduce more readily. This causes more of the virus to live in the system of those who are immunosuppressed, which increases the likelihood they’ll spread it to other people, according to Mulligan.

Not everyone who is immunosuppressed will have severe complications with COVID-19.

“It can have what seems like wildly different presentations in different people, and it’s a little unclear as to why that is,” Linder said.

We often see this variation in viruses that cause the common cold and influenza, Linder added. Many immunosuppressed individuals will have a milder infection and be able to recover at home.

We’ve never seen this virus before, and researchers are still working to understand exactly how the immune system reacts to the virus, Linder noted.

The fear immunosuppressed people face

Those who have a compromised immune system are understandably on edge right now.

Kirsty Muir, a 26-year-old in Glasgow, Scotland, has autoimmune hepatitis and takes immunosuppressant medication due to a liver transplant she had in 2013.

She’s worried that some people who aren’t at risk for COVID-19 won’t take the pandemic as seriously unless they personally know someone who has a heightened risk of developing complications.

“I’ve been in a coma in ICU on a ventilator before and I’m genuinely terrified of ending up there again and possibly having long-term lung damage or dying,” Muir told Healthline.

Kirsty is appreciative of all of the guidelines being shared to protect people who are at risk, but says it can feel “like being in a disposable nuisance group that people wouldn’t mind losing.”

She’s read comments online highlighting the mildness of the infection in most people that downplay the concern around older and at-risk individuals.

Like Kirsty, Allyson also wishes some people would take COVID-19 more seriously. Young people around the world are still going out to restaurants and bars — though they may not become seriously ill, they can still transmit it to others who will.

For now, Allyson is doing everything she can to lower her chance of being exposed to the virus.

“Don’t get me wrong this is a very scary time for someone like me but trying to maintain a calm approach knowing I’m doing everything I can is all I can really do,” Allyson said.

Protecting people with immunosuppression 

Mulligan and his team work hard to protect transplant patients who are immunosuppressed.

They’re often prescribed antibiotics to help reduce the impact of viral infections and lower the risk of bacterial infections. “It’s a lifelong process, and we always watch patients for infections after transplant,” Mulligan said.

The most important thing people can do right now is to stay home and keep a distance of about 6 feet from others.

This pertains to large group get-togethers and smaller ones as well — the goal is to avoid accidentally exposing others to anything we may cough up or sneeze out, says Mulligan.

“The social distancing is key for right now until we get a better handle [on COVID-19],” Linder said.

Frequent hand washing and avoiding touching our mouths, eyes, and noses will help reduce the spread as well.

Eventually, COVID-19 activity will settle down. But for now, a few easy steps can go a long way for those who are immunosuppressed and relying on those around them to help minimize its spread.

“I think people take their health for granted until something goes wrong and you wouldn’t wish a serious illness on anyone,” Kristy said. “Why not make a small temporary sacrifice to prevent people having to go through something horrific like that?”

The bottom line

Around the globe, people who are immunosuppressed and at a higher risk for developing complications from COVID-19 have been making their voices heard. Those who are immunosuppressed aren’t able to fight the virus as well — additionally, the virus can multiple more readily in their system which makes it easier for them to transmit it to others.

Social distancing is still the number one way to protect those who have a higher risk of infection. It’s a small step but people who have weakened immune systems are relying on others to reduce the spread of COVID-19.

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