Intended for healthcare professionals


Covid-19: risk factors for severe disease and death

BMJ 2020; 368 doi: (Published 26 March 2020) Cite this as: BMJ 2020;368:m1198

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  1. Rachel E Jordan, reader in epidemiology and primary care,
  2. Peymane Adab, professor of chronic disease epidemiology and public health,
  3. K K Cheng, professor of public health and primary care
  1. Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
  1. Correspondence to: R E Jordan r.e.jordan{at}

A long list is emerging from largely unadjusted analyses, with age near the top

As the covid-19 pandemic accelerates, governments are warning people at high risk to be particularly stringent in observing social distancing measures because if they become ill they are more likely to need critical care including ventilation, and to die.1 Most data on covid-19 are from China, and although most confirmed cases have been classified as mild or moderate, 14% are severe and 5% critical.2 Case fatality rates are difficult to assess with certainty but could be as high as 1%,34 which is much greater than seasonal influenza at about 0.1%.

Up to 25% of people in the United Kingdom are designated high risk—including all adults aged over 70 and those with underlying health conditions such as respiratory and cardiovascular disease, and cancer.5 Strict restrictions are now in place for everyone, reducing movement outside the home to an absolute minimum, except for essential workers.6 These measures will be in place for weeks, possibly months. Among vulnerable groups including older adults, such severe restrictions are …

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