
hochgradig
highly
To a very high degree or extent; used as an intensifier to strengthen a quality.
Diese Chemikalie ist hochgradig giftig und muss mit Vorsicht behandelt werden.
This chemical is highly toxic and must be handled with care.
highly / severe
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highly
To a very high degree or extent; used as an intensifier to strengthen a quality.
Diese Chemikalie ist hochgradig giftig und muss mit Vorsicht behandelt werden.
This chemical is highly toxic and must be handled with care.

severe
In a medical or technical context, describes a serious or advanced condition.
Bei dem Patienten wurde eine hochgradige Sehschwäche diagnostiziert.
The patient was diagnosed with severe visual impairment.
The word 'hochgradig' (highly/severe) is made up of 'hoch' (high) and 'Grad' (degree). Literally, it describes something that has a high degree or high level of a quality.
Das neue Material ist hochgradig feuerfest.
The new material is highly fire-resistant.
'Hochgradig' is almost always used as an adverb to intensify another adjective or participle. It stands directly before the word it intensifies.
Sein Verhalten war hochgradig unprofessionell.
His behavior was highly unprofessional.
'Hochgradig' belongs more to formal or written language. In everyday speech, people would often use 'sehr' (very), 'extrem' (extremely), or 'total' (totally) instead.
Der Plan ist mit hochgradigen Risiken verbunden.
The plan is associated with severe risks.
You can recognize the medical meaning from the context. When it is about diagnoses, illnesses, or physical limitations, 'hochgradig' usually means 'schwer' (severe) or 'stark fortgeschritten' (advanced).
Der Arzt stellte eine hochgradige Entzündung fest.
The doctor found a severe inflammation.
extreme
Extrem is a general intensifier for a very strong or severe manifestation. Hochgradig is used especially in medical or other technical statements as a precise term for a severe or advanced condition. Use extrem in general speech and hochgradig in technical descriptions.

Nach der Untersuchung stellte die Ärztin eine hochgradige Entzündung fest.
After the examination, the doctor found severe inflammation.
Nach dem Unfall hatte sie extrem starke Schmerzen.
She was in extreme pain after the accident.