The World Health Organization (WHO) describes COVID-19 as an infectious disease caused by the most recently discovered coronavirus, a family of viruses known to cause respiratory infections in humans. This new virus and disease were unknown until the recent outbreak in Wuhan, China in December 2019 (1).
As of early July, over 11 million cases have been reported throughout the world. This steadily growing number does not take into full account the potentially high number of asymptomatic individuals and carriers.
The most common symptoms are fever, dry cough, flu-like aches, sore throat, fatigue, chest pain, shortness of breath, loss sense of taste and smell, and can range from mild to severe.
Most known cases have been mild to moderate and not life-threatening.
Infected persons fall into one or more of the following categories based on severity of symptoms: asymptomatic, mild, moderate, severe, and critical. Further details on asymptomatic and mild cases can be found here. Learn more about what coronavirus symptoms can look like on a day by day basis in the video below:
If you have an autoimmune disease, some of your autoimmune symptoms may mimic those of COVID-19. You may be wondering how to tell them apart. The data is still limited, and there’s no hard and fast rule about which symptoms – like shortness of breath, fever, and fatigue – would signal the virus and which would belong to an autoimmune flare-up.
Experiencing unusual symptoms that may be consistent with COVID-19? Call your healthcare provider. They may instruct you to visit a drive-up testing site. Other options are using the Center for Disease Control & Prevention (CDC) Coronavirus Self-Checker bot, or calling your area’s hotline number (may vary by state, province, region, etc.) for any concerns or questions about what to do in your particular situation.
In the case of emergency warning signs such as difficulty breathing, persistent chest pressure or pain, confusion, or bluish lips or face, the CDC recommends getting medical attention immediately.
According to the CDC, an exposure means spending at least 15 minutes of time in close proximity (within six feet) of someone with a confirmed or suspected case of COVID-19 (34).
Scientists are discovering that the less time you’re exposed to the virus, the more likely it is to remain in the nose and throat, instead of continuing into the lungs where the disease becomes serious (35). The respiratory tract, including the nose and throat, contains a clean-sweeping army of cilia and mucus to brush out potential pathogens before they have a chance to dig deeper into the body. With a lower viral exposure or load, the body is better able to use this system and manage the threat.
If you’ve been exposed to someone with COVID-19, you should self-monitor symptoms, take your temperature twice a day, stay away from people who are high-risk, and self-quarantine until 14 days after your last exposure.
Minimizing or eliminating contact with others for 14 days (incubation period for the virus is 2-14 days) will ensure that you have not been infected and will not infect others.
Although you’ve been exposed, the people you’ve been in physical contact with do not need to be in quarantine. If there is a lot of community spread in your area, however, your local public health officials may advise otherwise (2).
Coronavirus data is limited, and prevalence statistics are difficult to clearly define.
Mortality, hospitalization, and other rates are constantly being reevaluated, due to testing, diagnoses, population age and density, and strong indications that asymptomatic carriers and mild, undocumented occurrences account for more of the total COVID-19 cases than previously thought (24, 25, 26, 27). However, testing is imperfect and no one study or estimation will give us the all answers – there is still much to learn.
For a clearer picture of what the pandemic looks like in your particular country or region, stay informed through your local public health department.
If you’re also concerned about the rapid spread of misinformation, check out WHO’s list of coronavirus mythbusters.
High-risk individuals include those over age 65, and anyone with altered or compromised immune systems or underlying health conditions such as HIV, diabetes, obesity, heavy smokers, cancer, lung and heart disease, asthma, and other respiratory conditions.
The high-risk category may also include many autoimmune diseases or chronic inflammatory conditions (as any infection can cause severe flares), and especially individuals treated with immunosuppressants, corticosteroids, or chemotherapy.
Tip: scroll down to the Resources section for links to detailed articles on autoimmune disease and COVID-19
Primary Group (at increased risk)
Secondary Group (may be at increased risk)
Many people with autoimmune disease are likely to be high-risk, but some may not be. Certain autoimmune conditions may also be more susceptible to contracting the virus or developing severe symptoms than others. As we are still learning about this virus, there is simply not enough information out there to know for sure.
Physician-researchers at The Benaroya Institute emphasize that while there is still no clear connection between autoimmunity and the development of COVID-19, there are a few things people with autoimmune disease should know during this time, including the risks of stopping or continuing medications like steroids and what it means to have a compromised immune system.
At the end of the day, your personal risk depends on your unique situation, any medications you’re taking, if your disease is under control, and if you have multiple conditions. It is a determination to be made by both you and your doctor.
Whether you think you may be high-risk or not, physical distancing (more commonly known as social distancing) and heeding the advice of doctors and public health officials are absolutely critical. These efforts help to prevent high-risk individuals from becoming infected and from experiencing serious symptoms in a further effort to stem the flood of new cases in hospitals.
A Note on Face Masks
The CDC urges the use of cloth face covers when in public settings, regardless if you’re symptomatic or not. The WHO suggests reducing your risk by using masks in conjunction with proper and frequent hand cleaning and physical distancing.
Face masks are critical barriers for those who are sick with COVID-19, their caregivers, and healthcare workers. As many places haven been dealing with mask shortages, the CDC advises against the purchase of surgical masks or N-95 respirators for the general public. This saves them for use in hospitals, where the risk of infection is especially high (3).
As an alternative, use a homemade mask, bandana, or cloth from an old t-shirt to cover your nose and mouth.
The efficacy of homemade face coverings is an ongoing conversation, as they are not comparable to N-95 respirators or surgical masks. But the general consensus is that something is better than nothing. Wearing a thin, loose piece of cloth is not sufficient – the material and fit matter. The CDC’s face covering recommendation is a thick, double layer of cotton that fits tightly around the face.
While they are not a surefire way of completely filtering the air or preventing tiny droplets from escaping, cloth face covers do help to protect against fluids from coughing, sneezing, and speaking, and are another vital tool in slowing the spread of the virus. This is especially important in indoor spaces where physical distancing is more difficult, as well as in areas where there is strong community spread of the virus.
Cancelling events, closing businesses, washing hands often and disinfecting surfaces, staying home, and wearing a mask will slow down the rate of the epidemic.
Physical (or social) distancing is an especially vital tool epidemiologists employ to control outbreaks like COVID-19. This practice minimizes the risk of spreading the infection to immunocompromised individuals and of overwhelming the healthcare system.
If proper measures aren’t taken, hospitals can be bombarded with a swarm of new patients all at once, in addition to their current caseload. This means slower, lower quality care for individuals with the virus, as well as those with other serious conditions like autoimmune disease and cancer.
We’re encouraged to practice physical distancing not only to flatten the curve, but also to stop the spread. The graphic below explains how our attitudes and actions can help or hurt this situation.
Our fears about this unprecedented situation are 100% valid; however, they drive us to overreact in the hope of maintaining control – overbuying groceries, supplements, and supplies, obsessively sanitizing, holding our breath around others, letting our thoughts be consumed by coronavirus “what if’s”… It’s natural to feel this way, but it’s important to recognize when we’re tumbling into a panic.
Elevated stress, anxiety, and fear can keep our bodies in “fight or flight” mode. Research studies have repeatedly demonstrated the effects this state of being can have on our bodies – including our immune systems. The impacts of stress are especially important to all individuals with chronic conditions like autoimmune disease. A healthy stress response is one of many components (including sleep, nutrition, nature, social interaction, and emotional support) essential to controlling symptoms and keeping conditions stable.
There is a lot of uncertainty and that’s ok. We can’t do anything about that. What we can do is keep our gaze on the next small step ahead, follow the basic recommendations from public health officials, practice self-care, and simply stay informed.
Head over to Psychology Today for some helpful tips on managing COVID-19 anxieties. You can also call the Helpline from the National Alliance on Mental Illness (NAMI) at (800) 950-6264, or check out their comprehensive guide to navigate concerns like coronavirus anxiety, quarantine and isolation, and loved ones with mental illness.
Note: Always consult your psychologist with any mental health concerns.
The coronavirus pandemic is affecting the health and well-being of high-risk individuals, while simultaneously creating financial and logistical difficulties for families, hourly wage employees, and small businesses, among many challenged populations – not to mention potential economic crises and famine in developing countries all over the world.
During this time, it’s important to stay calm and connected to your support community, help each other, do your part in slowing the rate of infection, and know that we will move on from this crisis.
Q & A on Coronaviruses (COVID-19) (March 9, 2020). World Health Organization.
Dr. Azar, N. (March 12, 2020). What Constitutes a Compromised Immune System? MSNBC News.
Katella, Kathy. (March 17, 2020). 5 Things Everyone Should Know About the Coronavirus Outbreak Yale Medicine.
Kritz, Fran. (March 13, 2020). Coronavirus Symptoms: Defining Mild, Moderate, and Severe. National Public Radio.
Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19). (March 7, 2020). Centers for Disease Control and Prevention.
Coronavirus Disease 2019 (COVID-19) Situation Report 46. (March 6, 2020). World Health Organization.
Cassella, C. Pregnant? Current Corona Headlines Might Give You Some Peace of Mind. (March 13, 2020). Science Alert.
Wu, J., Leung, K., Bushman M., Kishore N., Niehus, R., Salazar, P., Cowling, B., Lipsitch, M., Leung, G. (March 19, 2020). Estimating clinical severity of COVID-19 from the transmission dynamics in Wuhan, China. Nature Medicine.
Begley, Sharon. (March 16, 2020). Lower death rate estimates for coronavirus, especially for non-elderly, provide glimmer of hope. Stat News.
Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19). (February 16-24, 2020). World Health Organization.
Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) – United States. (March 26, 2020). Centers for Disease Control and Prevention, CDC COVID-19 Response Team,
Li, R., Pei, S., Chen, B., Song, Y., Zhang, T., Tang, W., Shaman, J. (March 16, 2020). Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV2). Science. doi: 10.1126/science.abb3221
Lawton, Graham. (March 24, 2020). You Could Be Spreading the Coronavirus Without Realising You’ve Got It. NewScientist.
Bi, Q., Wu, Y., Mei, S., Ye, C., Zou, X., Zhang, Z., Liu, X., Wei, L., Truelove, S., Zhang, T., Gao, W., Cheng, C., Tang, X., Wu, X., Wu, Y., Sun, B., Huang, S., Sun, Y., Zhang, J., Ma, T., Lessler, J., Fend, T. (March 19, 2020). Epidemiology and Transmission of COVID-19 in Shenzhen China: Analysis of 391 cases and 1,286 of their close contacts. medRXiv. doi: https://doi.org/10.1101/2020.03.03.20028423
Cruz, A., Zeichner, S. (March 16, 2020). COVID-19 in Children: Initial Characterization of the Pediatric Disease. Pediatrics. doi: 10.1542/peds.2020-0834
Q&A on COVID-19, pregnancy, childbirth, and breastfeeding. (March 18, 2020). World Health Organization.
What to Do If You Are Sick. Centers for Disease Control and Prevention.
Gupta, S. (April 6, 2020). The Mystery of Why the Coronavirus Kills Some Young People. CNN Health.
Kaiser, J. (March 27, 2020). How Sick Will the Coronavirus Make You? The Answer May Be in Your Genes. Science Magazine.
Wu, X., Nethery, R. Exposure to Air Pollution and COVID-19 Mortality in the United States. Department of Biostatistics, Harvard T.H. Chan School of Public Heath.
Garg, S., Kim, L., Whitaker, M., et al. (April 8, 2020). Hospitalization Rates and Characteristics of Patients Hospitalized with Laboratory-Confirmed Coronavirus Disease 2019 — COVID-NET, 14 States, March 1–30, 2020. Centers for Disease Control and Prevention.
Liu, Y., Gayle, A., Wilder-Smith, A., Rocklov, J. (February 13, 2020). The reproductive number of COVID-19 is higher compared to SARS coronavirus. Journal of Travel Medicine, vol. 27, issue 2, March 2020, taaa021.
Platzer, R. (April 24, 2020). As Many as 50 Percent of People with COVID-19 Aren’t Aware They Have the Virus. Healthline.
Verity, R., Okell, L., Dorigatti, I., Winskill, P. Whittaker, C., Imai, N., et al. (March 30, 2020). Estimates of the severity of coronavirus disease 2019: a model-based analysis. The Lancet: Infectious Diseases. doi: https://doi.org/10.1016/S1473-3099(20)30243-7
Finley, A. The Bearer of Good Coronavirus News. (April 24, 2020). The Wall Street Journal.
LaVito, A., Brown, K., Clukey, K. (April 23, 2020). New York Finds Virus Marker in 13.9%, Suggesting Wide Spread. Bloomberg.
Ruiyun, L., Pei, S., Chen, B., Song, Y., Zhang, T., Yang, W., Shaman, J. (May 1, 2020). Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV-2). Science. doi: 10.1126/science.abb3221.
Wiles, S. (April 23, 2020). Siouxsie Wiles: What we know about children and Covid-19. The Spinoff.
Gold, J., Wong, K., Szablewski, C., et al. (April 29, 2020). Characteristics and Clinical Outcomes of Adult Patients Hospitalized with COVID-19 – Georgia, March 2020. Centers for Disease Control and Prevention.
Mortality Analyses. (June 1, 2020). Johns Hopkins Coronavirus Resource Center.
Basu, A. (May 7, 2020). Estimating The Infection Fatality Rate Among Symptomatic COVID-19 Cases In The United States. Health Affairs. https://doi.org/10.1377/hlthaff.2020.00455
COVID-19 Pandemic Planning Scenarios. (May 20, 2020). Centers for Disease Control and Prevention.
How COVID-19 Spreads. (June 1, 2020). Centers for Disease Control and Prevention.
Public Health Guidance for Community-Related Exposure. (June 5, 2020). Centers for Disease Control and Prevention.
Cyranoski, D. (May 4, 2020). Profile of a Killer Virus. Nature. doi: 10.1038/d41586-020-01315-7
COVID-19 Pandemic Planning Scenarios. (May 20, 2020). Centers for Disease Control and Prevention.
Coronavirus Disease 2019 Case Surveillance — United States, January 22–May 30, 2020. (June 19, 2020). Centers for Disease Control and Prevention.
Sign up for resources, insights, and updates on autoimmune disease and living with chronic illness.