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Weak immune system and COVID-19

Having a weak immune system may put you at a higher risk of serious illness from COVID-19 (coronavirus).

Many things can cause a weak immune system (immunosuppressed).

These include:

  • cancer treatment
  • some treatments for autoimmune diseases, such as rheumatoid arthritis, lupus, multiple sclerosis (MS) and inflammatory bowel diseases
  • HIV - if you're not on effective treatment
  • having an organ transplant or a bone-marrow transplant

Immunosuppressive treatments and steroids

Being on immunosuppressive treatments is not known to increase your risk of getting COVID-19.

Do not stop or change your medication unless your doctor advises you to. If you stop your medicine without your doctor's advice, you may be more likely to have a flare-up of your condition during this period.

Examples of immunosuppressive medicines are:

  • steroids
  • biologic agents
  • methotrexate
  • azathioprine


If you take steroid tablets every day, you should take extra care to avoid infection. This may include staying at home as much as possible. If you’re not sure, ask your GP if you need to cocoon. If you are an essential worker, phone your consultant or GP to discuss options for safe working.

With steroids, it is always important to take the lowest dose needed to control your condition. Check with your doctor if you have questions about the dose you are taking.

Keep taking your steroids unless your doctor tells you not to. Stopping steroids suddenly can make you very unwell.

If you become unwell due to COVID-19 or another infection, continue to take your steroids.

Never start taking steroids unless your doctor tells you to.

Steroid tablets include prednisolone - brand name: Deltacortril.

Other steroids, such as inhalers, do not usually cause immunosuppression. Continue to take these medicines as you normally would.

Immunosuppressive treatments (non-steroid)

There is currently no evidence that most other immunosuppressive treatments put you at higher risk of severe disease with COVID-19.

This includes:

  • biologic agents
  • methotrexate
  • azathioprine

However, other infections can cause severe illness in people who are on immunosuppressive treatment. You should take care to follow the advice on how to protect yourself from COVID-19.

This includes washing your hands regularly and properly, social distancing, avoiding crowded places and wearing a face covering.

There is not enough information available yet to be sure how COVID-19 affects people on medicines such as:

  • rituximab
  • cyclophosphamide
  • alemtuzumab
  • cladribine
  • ocrelizumab

If you take one of these medicines, you are at very high risk of getting very ill if you get COVID-19. You should take extra care to protect yourself from the virus. This may include staying at home as much as possible. If you’re not sure, ask your doctor if you need to cocoon. If you are an essential worker, phone your consultant or GP to discuss options for safe working.

If you were previously on immunosuppressants, you may still be immunosuppressed. This can last for months after stopping treatment.

Attend any planned treatment or blood tests unless you are told not to. But phone your hospital before you go - some hospital services are disrupted.

If you get COVID-19

If you get COVID-19, ask your GP or consultant if they recommend any changes to your treatment. Do this before taking your next dose of treatments.

Looking after your mental health

It is difficult living with any medical condition during the current uncertainty.

Read advice on minding your mental health during the COVID-19 pandemic

Related topics

People at higher risk from COVID-19

Staying safe if you are at very high risk

Dealing with fake health information

Last updated: 03 March 2021 at 3.00pm

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