If you have a chronic health condition, you may be at increased risk for severe complications from COVID-19. You also may be more likely to need care in a hospital if you get sick. Heart disease, high blood pressure, lung disease, diabetes and some cancers are examples of chronic health conditions.
Most people who become ill with COVID-19 have mild symptoms that can be managed at home by taking over-the-counter (OTC) medications. However, if you have a preexisting health condition, it’s important to be vigilant and take extra measures to stay healthy during the outbreak.
Why Are People with Chronic Health Conditions at Increased Risk of COVID-19 Complications?
Having an underlying health condition may weaken or compromise the immune system, making it harder to fight coronavirus infection. Some people with chronic health conditions also may have undergone a treatment or take medications that can weaken the immune system.
Partner with Your Health Care Provider to Manage Your Condition
If you have a chronic health condition, it’s important to maintain regular contact with your health care provider to best manage your condition. Here’s how to partner with your provider to stay healthy during the outbreak:
- Make sure you have at least a 30-day supply of medications. Ask your provider if you can get a 90-day supply.
- Tell your provider if you have new or worsening symptoms of your chronic condition.
- Work with your provider to develop a plan in case you get sick with COVID-19 or have an emergency.
- If you’re sick or think you may be sick with COVID-19, stay home and call your health care provider for advice.
“Most clinicians who are caring for patients with chronic health conditions are concerned about their patients being disconnected from their care,” says Marie E. McDonnell, MD, director of the Diabetes Management Program at Brigham and Women’s Hospital. “We encourage our patients to stay in touch with us by phone or email and to continue their usual, very important, daily care.”
Reduce Your Risk of Getting COVID-19
If you have a chronic health condition, here are ways to protect yourself from coronavirus infection:
- Stay home as much as possible. If you need to leave your home, stay at least 6 feet apart from other people.
- Ask a family member, friend or neighbor to help you shop for groceries or pick up your medicine at the pharmacy.
- If you’re an older adult, many stores have special hours for seniors. Consider buying food using grocery delivery services.
- Wash your hands with soap and water for at least 20 seconds after sneezing or coughing. If soap and water aren’t available, use an alcohol-based hand sanitizer with at least 60 percent alcohol.
- Avoid touching your eyes, nose and mouth.
- If you cough or sneeze, do it in a tissue and throw that tissue away.
- Clean and disinfect surfaces you touch frequently, including phones, remote controls, counters and doorknobs.
“Try to avoid touching surfaces in public,” advises Miranda Lam, MD, MBA, a radiation oncologist at the Brigham. “Use your elbow to avoid touching surfaces with your hands. If you can’t avoid touching objects like door knobs, elevator buttons or shopping carts, wash your hands as soon as possible or use hand sanitizer.”
Respiratory Disease: What You Need to Know
The coronavirus may cause severe complications for those living with chronic respiratory diseases (CRDs), or diseases of the airways, such as:
- Cystic fibrosis
- Chronic obstructive pulmonary disease (COPD), chronic bronchitis or emphysema
- Pulmonary hypertension
If you have a CRD:
- Practice physical distancing and avoid public places.
- Stay on your respiratory medication(s) as directed.
- Have at least a 30-day supply of medications on hand.
- Search nearby hospitals for respiratory specialists, in case of an emergency.
“If you have a chronic lung condition, viral pneumonia can be especially threatening, because it can further compromise lung function and, in some cases, cause severe illness or death. However, for most people, COVID-19 is a flu-like illness—it can be miserable but it’s survivable,” says Christopher Fanta, MD, a Brigham pulmonologist.
Heart Disease: What You Need to Know
Those with heart disease are more likely to have complications from COVID-19 infection for several reasons:
- A heart attack, stroke or high blood pressure can weaken the heart muscle, making it more vulnerable to the added stress of an infection, like COVID-19.
- If the heart is under increased stress, other organs, such as the kidneys or lungs, can also suffer leading to serious health problems.
- Patients with a heart condition are often older adults who may have age-related changes to their immune systems.
“It’s important to practice social distancing, use proper sanitization measures and hand hygiene, and get enough rest, but above all do not stop taking your heart medication,” says Mandeep R. Mehra, MD, medical director of the Brigham’s Heart & Vascular Center. “They are essential and the risk of COVID-19 is much lower than the risks that stopping your medication could bring, like worsening an underlying heart condition.”
If you are managing a heart condition during the outbreak, Dr. Mehra advises patients to get tested if you experience even minimal symptoms and avoid trying unproven medications or self-medicating with medications that your provider hasn’t approved.
Cancer: What You Need to Know
Patients who have cancer are at a higher risk of having serious complications from COVID-19, because many cancers and treatments used to treat them can weaken the immune system.
It’s important for cancer patients to avoid exposure to the coronavirus, particularly those who are receiving a cancer therapy, such as chemotherapy, immunotherapy or radiation therapy. Patients who’ve undergone a bone marrow transplant also need to be careful about preventing infection.
“Many cancer patients ask whether they should continue their treatment during the outbreak. That depends on the individual, diagnosis, cancer type, duration and intent of the treatment, but it’s best to reach out to your health care provider before going to your next treatment appointment and follow their guidance,” says Dr. Lam.
Diabetes: What You Need to Know
People living with diabetes aren’t at a higher risk for contracting COVID-19. Rather, the condition can make it harder to fight the infection for the following reasons:
- Diabetes can elevate levels of glucose (sugar) in the blood, which can damage blood vessels throughout the body, including in the heart and lungs. This makes many vital organs vulnerable to disease.
- It’s harder to treat a viral infection if blood sugar levels are rising and falling.
- Diabetes increases inflammation in the body, making it harder to fight infection.
“If you have diabetes, blood sugar is a very important factor as it relates to COVID-19,” says Dr. McDonnell. “If you have high levels of glucose in the blood, infection-fighting cells in the body can’t fight bacteria or viruses as effectively. That’s why it’s so important to check your blood sugar often and keep it well-controlled (an A1C below 7 or 7.5).”
If you’re managing diabetes, the International Diabetes Foundation (IDF) also recommends taking the following steps to stay healthy:
- Continue taking daily medications and have extra supplies of insulin or diabetes medications on hand.
- Stock up on simple carbs (e.g., hard candies, regular soda, honey) in case your blood sugar gets too low and you need to raise it quickly.
- Increase your fluid intake.
The most significant risk to the health of a person with diabetes is a rapid increase in blood sugar levels. To avoid this, consider making these healthy changes:
- Eliminate refined sugars in your diet.
- Eat more high-fiber foods like fruits and vegetables.
- Exercise daily, or most days, for a total of 150 minutes a week.
Dr. McDonnell adds that diabetes and some mental health conditions like depression can sometimes occur together. She advises patients to exercise regularly and get enough social interaction to help prevent depressive symptoms.
Stay Vigilant, Be Patient, Connect
“Many people with health conditions are feeling isolated, often because their loves ones are trying to protect them! Social distancing is one of the most important things we can do right now, but we also need to make sure to stay connected with people in our lives, especially those who are managing conditions,” says Dr. McDonnell.
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