Overview

Illnesses caused by respiratory viruses such as COVID-19, influenza and RSV can make anyone sick. However, there are a number of risk factors that can increase a person’s chances of becoming very ill (severe illness). In general, people are at higher risk of serious illness from respiratory viruses

Prevention is important

Prevention of respiratory disease and its potentially serious complications is especially important for people who are at higher risk of becoming very ill. Vaccination remains the most important tool for prevention. Talk to your healthcare provider about what is recommended for you.

Seek medical attention immediately if you feel ill

If you think you may have a respiratory virus (if you feel sick or test positive for one) and you have risk factors for serious illness, seek medical attention immediately for testing and/or treatment. If you have the flu or COVID-19, treatment may be an option to make your symptoms less severe and shorten the time you are sick. Treatment should be started within a few days of the onset of your symptoms.

Older adults

As people age, their immune systems can change and weaken over time, which can increase the risk of complications from respiratory diseases. Older adults are also more likely to have underlying health conditions. Most deaths from respiratory viruses occur in people over the age of 65, where the risk increases sharply with age. For more specific information by type of respiratory disease, read more:

The Elderly Care Locatora national resource funded by the Administration for Community Living, can help older adults find local vaccination clinics, connect with accessible transportation, and provide other assistance in accessing immunizations.

Small children

Young children, especially infants, have immune systems that are still developing. In addition, their lungs and airways are smaller, making viruses that affect the respiratory tract more of a threat. For more specific information by type of respiratory disease, read more:

Special considerations in connection with prevention and treatment

• Masks: Children under 2 should not wear masks due to the risk of suffocation.
• Treatment of covid-19: Paxlovid (nirmatrelvir-ritonavir) antiviral treatment for COVID-19 is not approved for use in children under 12 years of age. Remdesivir is a treatment option for children (birth to 18 years, weighing at least 1.5 kg) who are at high risk of serious disease. Talk to a healthcare provider about treatment options if your child develops respiratory symptoms.
• Influenza treatment: There are flu antiviral drugs recommended by the CDC for use in children. Oseltamivir (available as a generic version or under the trade name Tamiflu®) is approved for the treatment of influenza in children 14 days of age and older.

People with underlying health conditions

Certain medical conditions such as chronic lung disease, heart disease, diabetes or chronic kidney disease can increase your risk of getting very sick from respiratory viruses. These conditions can weaken the body’s ability to fight infections, or they affect organs that are also affected by the respiratory disease. For more specific information by type of respiratory disease, read more:

People with weakened immune systems

People with a weakened immune system (immunocompromised) have a lower defense against infections. Their bodies may have a harder time building lasting protection against previous immunization or infection. People can be immunocompromised either because of a medical condition or because they are receiving immunosuppressive drugs or treatments. Examples of medical conditions or treatments that may result in moderate to severe immunocompromise include, but are not limited to, cancer treatment, organ transplantation with immunosuppressive therapy, and primary immunodeficiency.

For more specific information by type of respiratory disease, read more:

When you are sick

It may take longer than average for people with weakened immune systems to recover from respiratory viruses. This includes a possible longer duration in which you can spread a respiratory virus to others. If you are immunocompromised, be aware of this when choosing precautions after you return to normal activities after being home sick.

People with disabilities

Some disabilities can increase a person’s risk of becoming very ill from respiratory viruses. For example, some people with disabilities are more likely to have underlying medical conditions, live in community settings, or experience factors and conditions that stem from social determinants of health. For more specific information by type of respiratory disease, read more:

The Disability Information and Access Line (DIAL) can help people with disabilities find local vaccination clinics, connect with accessible transportation, and provide other assistance in accessing COVID-19 vaccinations or setting up a vaccination appointment.

Special considerations in connection with prevention and treatment

• Masks: Some people with disabilities may find it difficult to wear a mask. When considering whether to use a mask, persons with disabilities or their caregivers may consider the person’s ability to wear a mask correctly (correct mask size and fit), to avoid frequent contact with the mask and face, and to remove the mask without assistance. For people who are deaf or hard of hearing, or people who spend time with someone who is deaf or hard of hearing, clear masks or masks with clear panels are an option.
• Work with support providers: People with disabilities who have direct support providers can also help protect themselves from respiratory viruses. For example, ask direct support providers if they experience symptoms of or have other reasons to believe they may have a respiratory virus. Ask direct service providers to use core and additional prevention strategies, such as taking steps to clean air as possible to reduce the amount of virus within indoor areas, practicing good hygiene or wearing a well-fitting mask.

Pregnancy

Changes in the immune system, heart and lungs during pregnancy can increase the risk of becoming very ill from respiratory viruses. Additionally, while immunizations received during pregnancy may provide protection to the pregnant woman, they may also help lower the risk to the baby after birth. For more specific information by type of infection, read more:

Treatment during pregnancy

• COVID-19 antiviral agents recommended for people at high risk of serious illness, including adults 65 and older, people with weakened immune systems, people with certain medical conditions, and pregnant women. That’s it not recommended to withhold COVID-19 treatment from pregnant or lactating women due to theoretical safety concerns. For more information on treating COVID-19 in pregnant women, see IDSA’s Initiation Guidelines remdesivir and nirmatrelvir/ritonavir (Paxlovid).
• Influenza antiviral agents recommended for certain people at high risk of complications from the flu, including pregnant women.
• To learn more about whether treatment is right for you, talk to a healthcare provider.