COVID 19 is not only an acute, potentially serious viral illness; it is also a chronic disease problem. Indeed, almost 90% of those hospitalized for COVID 19 have pre-existing diseases such as diabetes, hypertension, heart conditions, chronic obstructive lung disease (COPD), liver disease, or serious obesity. These diseases significantly elevate the risks for serious complications and dying if one develops COVID 19. Immune suppression is common in diabetes and obesity. COPD lowers the threshold for lung infection. Inflammation is a major player in acute and long-term COVID complications.