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A young woman is having a flu and using a tissue paper to sneeze

Flu & COVID Complications: Are You at Higher Risk?

Whether it’s coronavirus disease 2019 (COVID-19) or the seasonal flu, some people are considered at a higher risk of experiencing complications from one or both of these viruses. We talked to UNC Health family medicine physician Sarah Ruff, MD, to learn why and what can you do about it.

Who Is At High Risk of Complications from COVID-19?

Adults over the age of 65 are at a higher risk of becoming seriously ill from COVID-19. An analysis of more than 114,000 COVID-19 associated deaths during May–August 2020 found that 78 percent of the people who died were aged 65 and older.

“Those who are most vulnerable to complications are older than 65, and some would even argue older than 50,” Dr. Ruff says.

In addition, if you have a serious underlying medical condition or comorbidity, such as high blood pressure, diabetes or heart disease, you also are considered high risk. Obesity also seems to be a common risk factor.

“The higher the BMI, the more complications you’ll get,” Dr. Ruff says. “Those with a BMI over 30 tend to get sicker though even those with a BMI over 25 can be at a little higher risk.”

It’s important to note that some young people with no underlying health conditions can get very sick. And though rare, some young people have died from COVID-19.

“With COVID-19, a lot is not known, and a lot still doesn’t make sense,” Dr. Ruff says. “It’s a work in progress trying to figure it all out.”

Who Is At High Risk of Complications from the Flu?

“We’ve been talking a lot about COVID-19, but the flu can cause pneumonia and lead to hospitalization,” Dr. Ruff says. Tens of thousands of people die of complications from the flu each year in the United States.

People at higher risk of complications from the flu include children younger than 2, adults 65 and older, pregnant or immediately postpartum women, residents of nursing homes, people with chronic illnesses such as asthma, lung disease and heart disease, and those with chronic immune-suppressing conditions such as diabetes and cancer.

How to Stay Safe

The most important thing you can do to protect yourself and others from COVID-19 is to wear a mask, keep at least  6 feet from other people while in public and clean your hands often.

Also, be aware of your health and wellness on days when you have an activity planned, and make sure that you’re only going out when you’re feeling well.

Many of the safety measures you can take to prevent the spread of COVID-19 also will help prevent the spread of the flu. In addition, public health experts are urging everyone to get the flu vaccine this year, not only to protect themselves, but also to prevent hospitals from being overwhelmed with patients.

During the 2018-2019 flu season, the flu vaccine prevented an estimated 4.4 million flu illnesses and 3,500 flu-related deaths. That’s with only about half of the U.S. population getting the vaccine.

“It’s really not a good idea to add influenza to the list of potential respiratory problems you could have this year,” Dr. Ruff says.

The flu vaccine can reduce your risk of flu by 40 to 60 percent, “and even if you get the flu after getting a flu shot, you typically get a milder form of the illness and are sick for fewer days,” Dr. Ruff says.

Because they have such similar symptoms, you could have the flu and think it’s COVID-19 or vice versa.

“The more we can limit the chances that we’re going to get something that makes us think we have COVID, the better,” Dr. Ruff says, for both individuals and the healthcare system as a whole.


Need your flu shot? Call your primary care doctor or find one near you. If you are concerned that you may have symptoms of COVID-19, talk to your doctor or visit the UNC Health COVID-19 Resources page.