The new coronavirus causes a disease called COVID-19. People who are immunosuppressed are more at risk of becoming severely ill with coronavirus.

WHAT DOES IT MEAN TO BE IMMUNOSUPPRESSED?

Being ‘immunosuppressed’ means that your immune system, which fights off illnesses, does not work as well as it should, and is therefore less able to fight infections – like coronavirus. People are immunosuppressed for many reasons, including health conditions, poor diet, or because of medicines they are taking.

At the moment, there is no specific data available about whether people in these categories are at risk, because coronavirus is such a new disease, meaning there is lots of research about it left to do. However, we know that immunosuppressed people are at more risk from other viruses, so it is very likely that they will also be at increased risk from coronavirus.

WHAT SHOULD I DO IF I AM IMMUNOSUPPRESSED?

In some countries, for example the UK, people who are very immunosuppressed have been advised to ‘shield’ themselves. This means not leaving their house at all, and limiting all contact with other people as much as possible. However, this is obviously not possible for everyone. It is important that if you are taking immunosuppressive medication, including steroids, you continue to do so, unless told otherwise by your doctor. This is because if you stop taking your medication, it could cause a flare up of your condition which could also increase your risk of becoming very unwell if you catch coronavirus. You should seek advice about your particular needs from your doctor and should seek general advice from your national or local government, including advice about physical (social) distancing and lockdowns. You should keep washing your hands with soap (or 60% alcohol hand sanitiser). You can read more about social distancing and why it is important here: https://rightforeducation.org/2020/04/08/social-distancing/

WHAT CAUSES IMMUNOSUPPRESSION?

• HIV/AIDS. HIV is a virus that attacks the immune system. If HIV infection is not treated, the person’s immune system will be severely weakened, and they will develop the condition called AIDS. People with AIDS have very damaged immune systems, and are at very high risk from infections. However, with good treatment, the HIV virus can be controlled before the person develops AIDS. Therefore not all people with HIV are immunosuppressed.
• TB (tuberculosis). TB does not cause immunosuppression. However, active TB (this means TB that is causing symptoms) is a sign that a person has a weaker immune system due to another reason.
• Malnourishment. Not getting enough nutrients weakens the body, including the immune system. Therefore, malnourished people may be at higher risk of complications from coronavirus.
• Drug and alcohol abuse.
• Cancers of the bone marrow and white blood cells, such as leukemia and lymphoma.
• Steroids. Oral steroids (not steroid inhalers) are an important treatment for some medical conditions, like asthma and inflammatory bowel disease. While steroids are important to control these diseases, they also weaken the immune system. If you have been advised to take steroids by your doctor, do not stop taking them. Especially if you have been taking steroids for a long time, stopping them suddenly can be very dangerous and even fatal.
• Immunosuppressive medications. Several other types of medicine, as well as steroids, weaken the immune system. However these medicines can be life-saving. People who may need to take immunosuppressants include people with cancer (chemotherapy), people who have had an organ transplant, and people with autoimmune diseases (where the immune system attacks their own body). Between 2% and 7% of the global population have an autoimmune disease, such as multiple sclerosis, type I diabetes, lupus, and rheumatoid arthritis.

This is one of the groups most at risk of complications from coronavirus infection. However, other groups are also still badly affected: see this article.