Factors that put patients at high risk for progression to severe COVID-19^[1]

AIDS: acquired immunodeficiency syndrome; BMI: body mass index; CAR-T: chimeric antigen receptor T; HIV: human immunodeficiency virus.

• Active treatment for solid tumor and hematologic malignancies
• Hematologic malignancy (eg, chronic lymphocytic leukemia, non-Hodgkin lymphoma, multiple myeloma, acute leukemia) that has been associated with poor response to COVID-19 vaccines, regardless of the patient's current treatment
• Receipt of a solid organ or islet transplant and on immunosuppressive therapy
• Receipt of CAR T-cell therapy or a hematopoietic cell transplant and within 2 years of transplantation or receiving immunosuppressive therapy
• Moderate or severe primary immunodeficiency (eg, severe combined immunodeficiency, DiGeorge syndrome, Wiskott-Aldrich syndrome, common variable immunodeficiency disease)
• AIDS or untreated HIV infection (defined as people with HIV and CD4 T lymphocyte cell counts <200 cells/microL, a history of an AIDS-defining illness without immune reconstitution, or clinical manifestations of symptomatic HIV)
• Active treatment with high-dose corticosteroids (ie, ≥20 mg prednisone or equivalent per day when administered for ≥2 weeks), alkylating agents, antimetabolites, transplant-related immunosuppressive drugs, cancer chemotherapeutic agents classified as severely immunosuppressive, or immunosuppressive or immunomodulatory biologic agents (eg, B cell-depleting agents)

¶ High-risk conditions include:

• Obesity^◊ (BMI ≥95th percentile for age), especially severe obesity (BMI ≥120% of 95th percentile for age)
• Diabetes (type 1 or 2)
• Prematurity
• Chronic cardiac, neurologic, or pulmonary disease (excluding asthma)
• Chronic kidney, gastrointestinal, or liver disease
• Sickle cell disease
• Neurologic disabilities

Δ Prior immunity includes being up to date on COVID-19 vaccination and/or having known COVID-19 infection in the last 4 months.