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COVID-19: Precautions for Immune-compromised Patients

Cancer Patients and the Elderly Should Take Special Precautions, Cedars-Sinai Experts Say

Although some people who come down with COVID-19 experience few or no symptoms, others may not be as resilient, especially if they have longstanding health issues.

Cedars-Sinai experts say the following groups should take extra care in trying to avoid developing COVID-19:

Cancer Patients--“Cancer patients are not at a higher-risk for contracting COVID-19,” said Karen Reckamp, MD, MS, director of the Division of Medical Oncology at Cedars-Sinai Cancer. “However, some cancer patients with weakened immune systems may develop more serious symptoms from any viral illness.”

Reckamp recommends remaining at home with limited social contact during a community outbreak. Washing hands frequently and limiting close contact with others are useful precautions also.

And, as she explains, Cedars-Sinai is continually monitoring updated information and adapting plans as needed. The highest-risk group remains those who have traveled in areas that have high numbers of coronavirus infections and those with contact to individuals who have been exposed.

Pediatric Patients--Priya Soni, MD, assistant professor of Pediatric Infectious Diseases says healthy children – newborn through 20 years old – are not at higher risk of developing the virus than members of other age groups. However, families with higher-risk children, including those who are immunocompromised, on immune suppressive medications, high-dose steroids or chemotherapy should take extra precautions to protect themselves.

“My top recommendation is to take social distancing seriously,” said Soni. “What we do within the next few weeks will influence the inflection point of this pandemic and the long-term impact of this virus on our vulnerable pediatric patients. It will also help in limiting the stress on our healthcare system.”

Soni says stay at home, rest and use the downtime to spend time with loved ones.

“This alone can make a massive difference if done in solidarity for our high-risk populations,” said Soni.

Pregnant Women--According to Sarah Kilpatrick, MD, PhD, chair of Cedars-Sinai's Department of Obstetrics and Gynecology, it’s unclear whether pregnant women are at higher risk of developing COVID-19. However, Kilpatrick says that pregnant women who get the flu seem to get sicker than those who aren't pregnant, which is why the seasonal flu vaccine for pregnant women is so highly recommended.

“Since we are unclear on how likely pregnant women are to get COVID-19, it’s critically important to follow guidelines set by the CDC to reduce possible exposure to any airborne virus,” Kilpatrick said.

The Elderly--“While the CDC continues to learn about COVID-19, current information suggests that older people are at higher risk of developing more serious illness from the virus,” said Sonja Rosen, MD, chief of Geriatric Medicine at Cedars-Sinai.

“That’s because older people’s immune systems tend to weaken as they age, and they likely have other underlying health conditions that make them more susceptible to severe illness.”

Additionally, the CDC recently recommended that elderly people practice “social distancing” to decrease exposure to the disease, as well as avoiding public places where large crowds are gathered. They also recommended that older adults avoid traveling for non-essential trips – including airplane and cruise ship travel.

Furthermore, for California residents over the age of 65, Gov. Gavin Newsom recommended on Sunday, March 15, that they stay home and self-isolate.

“Social distancing can be socially isolating, especially in older persons,” said Rosen. “Try to stay in touch with family and friends via telephone, email and video visits like Facetime for your emotional health as well.”

The CDC also recommends elderly people delay routine check-ups and elective procedures. However, if any individual has an urgent concern, it is recommended to first call your physician. “Most importantly, do not panic,” said Rosen. “Call your healthcare provider if you are concerned about symptoms or exposure. And, make sure you get vaccinated against other much more common illnesses, like the flu and pneumonia.”

And Cedars-Sinai experts agree on the importance of everyone adhering to the following safety precautions outlined by the CDC:

  • Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom, before eating and after blowing your nose, coughing, or sneezing.
  • If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.
  • Do not touch your face, nose, eyes or mouth.
  • Sanitize frequently touched surfaces such as doorknobs and keyboards.
  • Cough or sneeze into a tissue, not onto your hand.
  • Stay home if you have a fever or other viral respiratory symptoms like a cough.