You've probably seen this term used in coronavirus headlines, so we asked doctors to explain it.

By Claire Gillespie
March 11, 2020
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People around the world are taking precautions to protect themselves from the coronavirus. But some people are at a much higher risk for serious complications from the virus than others, including the elderly and people who are immunocompromised. But what does it mean to be immunocompromised, exactly? Here’s what you need to know about immunocompromised patients and COVID-19.

William Li, MD, physician scientist and author of Eat To Beat Disease: The New Science of How Your Body Can Heal Itself, tells Health that when a person is immunocompromised (sometimes referred to as immunosuppressed), it means their immune defenses are weakened and not functioning normally.  

“These defenses, made of an army of cells with unique weapons that destroy invaders in the body, protect you against the common cold, bacteria, and viruses, and even cancer,” explains Dr. Li. “When the defenses are low, an individual becomes highly vulnerable to infection.”

This immune system compromise can be temporary or permanent, depending on the underlying cause, Melinda Ring, MD, executive director of Northwestern Medicine's Osher Center for Integrative Medicine, tells Health. “It also can involve many different aspects of our body’s defense system, such as a lack of white blood cells that phagocytose (basically ‘eat’) and kill microbes, or problems making adequate antibodies in response to exposure to foreign organisms,” she says.

What are the most common causes of a compromised immune system? 

Chronic conditions that affect the immune system include heart disease, lung disease, lupus, and diabetes. Other conditions that can leave a person immunocompromised include cancer, HIV/AIDS, malnutrition, and some rare genetic disorders, says Dr. Li. Chemotherapy and steroids can also lower immunity. “They suppress the body’s ability to activate its immune defenses by destroying immune cells or by blunting the cell’s ability to spot and kill bacteria,” Dr. Li explains.

There are different levels of immunosuppression. “Some people may just be more susceptible to infections or have more severe or longer lasting infections,” says Dr. Ring. “On the other hand, some people are at ongoing high risk, in which case exposure to infection needs to be aggressively avoided, as these individuals are more susceptible to unusual pathogens and even common infections like pneumonia can become life-threatening.” 

A person with compromised immunity is more at risk for infection because their immune system may not mount the usual obvious reactions to threats, such as a fever or swelling. “This can lead to infections being missed early on and allow them to become more deeply seated in the body before a person realizes there is a need to seek help from a health care professional,” explains Dr. Ring. 

Immunocompromised patients may also lack the ability to respond appropriately to vaccination. That may mean they don't develop immunity, and they mistakenly assume they are protected against an illness when they are not. “When the immune system isn’t working at full capacity, it doesn’t have the army of immune cells and mediators ready to mount a defense at the first sign of attack,” says Dr. Ring. “This means infections may progress more rapidly from a mild virus into sepsis, a widespread infection leading to malfunction of the body’s organs.” 

Immunocompromised people need to be careful not to weaken their immune system even further, says Dr. Li. “Emotional stress, lack of sleep, and physical exhaustion can all depress immunity, making an immunocompromised patient more susceptible to disease,” he explains. As well as taking steps to relieve stress and getting plenty of sleep, Dr. Li advises eating a healthy diet consisting of foods that boost immunity.

If you’re an immunocompromised person and think you might have COVID-19, it’s crucial that you stay at home and call your doctor right away. If you need emergency help (for example, if you have difficulty breathing, shortness of breath, or persistent pain or pressure in your chest), get immediate medical attention. Otherwise, follow your doctor’s instructions for taking care of yourself at home, which will help prevent other people from getting exposed or infected. 

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDCWHO, and their local public health department as resources.

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