Who is most at risk of developing a serious coronavirus case?

For many, coronavirus symptoms are akin to having a cold or mild flu. But the disease does pose a greater threat to some people – this is what you need to know.

Months into the coronavirus pandemic, experts are identifying the groups within our communities who may be more likely to develop serious complications if they contract the disease.

Statistics so far clearly show that people older than 80 and those with existing chronic diseases are at most risk from COVID-19. It is estimated that about 15 per cent of people over 80 who become infected will die.

This is mostly because as we age, our immune system becomes less able to fight infections, says Associate Professor Hassan Vally, an epidemiologist with experience in infectious disease epidemiology at La Trobe University’s School of Public Health.

But it’s not only the elderly who are at risk. These are the other factors that may increase likelihood of a more serious case of coronavirus:

Underlying health issues

“Based on the data we have, people with cardiovascular disease and those with diabetes, chronic respiratory conditions, hypertension and cancer are at greater risk of developing severe symptoms and have a greater chance of dying,” says Dr Vally.

These conditions increase susceptibility to the virus.

An analysis of 99 coronavirus patients in China, published in The Lancet, found the disease was more likely to affect older men with other underlying diseases.

In the US, a Centers for Disease Control and Prevention review of more than 7000 cases found about 78 per cent of coronavirus patients in intensive care units, and 71 per cent of all coronavirus patients admitted to hospital, had one or more underlying health condition.


Researchers at the University of NSW believe smokers may also be at increased risk from COVID-19 due to poorer lung health or chronic obstructive pulmonary disease (COPD).

“We know that when you have lung inflammation present already, you are more likely to be prone to invasion and severe damage from other causes of lung inflammation,” says respiratory expert Professor Christine Jenkins.

“Smokers may also be more vulnerable through bringing their hands to their mouths and inhaling repeatedly.”

The virus can be spread from infected droplets on hands being transferred to the face and mouth.

Heart disease

Underlying cardiovascular or heart disease seems to present the greatest risk for COVID-19.

The death rate for people without pre-existing chronic conditions is 1 per cent, but cardiovascular disease increases this rate to 10.5 per cent, says Dr Vally.

Exactly how and why COVID-19 can have serious effects on those with cardiovascular disease is not yet clearly understood, though it may damage heart muscle.

“Injury to heart muscle can happen in any patient with or without heart disease, but the risk is higher in those who already have heart disease,” says Prof Mohammad Madjid, of McGovern Medical School at the University of Texas.

In a study of 416 coronavirus patients in China, researchers found that the risk of dying was around 10 times higher in those who had a cardiac injury.


People with poorly controlled diabetes may experience more severe symptoms through diabetes depressing immune function, says Dr Vally.

The death rate for coronavirus patients with diabetes is 7.3 per cent – second only to those with heart disease.

Higher glucose or blood sugar levels may also provide an environment that the virus likes, says Dr Vally.

Chronic lung disease or severe asthma

The US Centers for Disease Control and Prevention says people with chronic lung disease and moderate-to-severe asthma are also in the higher-risk group.

That’s because COVID-19 can affect the respiratory tract and cause an asthma attack, pneumonia and acute respiratory disease.

Asthma Australia says while it is not yet clear whether asthmatics are at higher risk of actually contracting COVID-19, respiratory infections – including coronavirus – are a common trigger for asthma flare-ups. So people with asthma may be at more risk of developing a serious COVID-19 infection.

Compromised immune systems

Those with cancer will be on treatments that suppress their immune system, including chemotherapy and radiotherapy, placing them at increased risk. Tragically, three of Victoria’s coronavirus death victims were blood cancer patients at The Alfred hospital.

The Australian Government also advises that people of any age with significant immunosuppression may face higher risks of infection.

This includes people on disease-modifying anti-rheumatic drugs, post-transplant patients, people with primary or acquired immunodeficiency including HIV, and people on high-dose corticosteroids.

However the Australasian Society of Clinical Immunology and Allergy says it is unknown whether people with immunodeficiencies are at risk of more severe symptoms if they do contract COVID-19.

How to protect yourself against coronavirus if you are at risk

“The best way to try and protect people from this virus, and to reduce its impacts, is to carefully follow health department advice,” says Dr Vally.

“If you are at heightened risk, stay at home, and ask family not to visit when they are ill.”

The Centers for Disease Control and Prevention recommends that people with underlying health conditions keep a 30-day supply of medication as well as a two-week supply of food.

It’s important to know the symptoms of COVID-19, including fever, sore throat, coughing, fatigue and shortness of breath. Unexplained loss of smell may also be a sign.

What to do if you are worried you have coronavirus

If you are experiencing symptoms of coronavirus, call the 24/7 hotline on 1800 675 398. You can also use the Healthdirect symptom checker.

Instant Consult offers on-the-spot online GP consultations and can issue medical certificates, prescriptions, radiology and pathology requests and specialist referrals.

Information, news and government guidance on COVID-19 changes regularly.

For the latest official health and government advice, visit:

Written by Sarah Marinos.