September 14, 2020

How dangerous is Covid-19 for young adults? Here's what a new study shows.

Daily Briefing

    For a study recently published in JAMA Internal Medicine, researchers reviewed data on 3,222 young adults who were hospitalized with Covid-19 and found that a sizable percentage required intensive care—and certain risk factors were tied with higher rates of mechanical ventilation or death among such patients.

    Map: Where young Americans are dying from Covid-19

    Study details

    For the study, researchers from Brigham and Women's Hospital analyzed data on 63,103 patients who were hospitalized with an ICD-10 code for Covid-19 among 419 hospitals between April 1 and June 30. The data came from the Premier Healthcare database, which includes information on more than eight million annual inpatient admissions at over 1,000 hospitals.

    The researchers found that 3,222 of those patients, or 5%, were nonpregnant adults ages 18 to 34, with a mean age of 28.3 years. Of those 3,222 patients, 21% required intensive care, 10% required mechanical ventilation, and 2.7% died.

    According to the researchers, there were significant racial disparities among the patients who were hospitalized or died, with Black and/or Hispanic patients comprising 57% of those who were hospitalized and 49.3% of those who died or required ventilation.

    Having diabetes, hypertension, or obesity—all of which are risk factors for developing a severe case of Covid-19—was associated with an increased risk of ventilation and/or death from Covid-19, the researchers found. For example, young adult Covid-19 patients with morbid obesity or hypertension were more than twice as likely to require ventilation or to die as young adult Covid-19 patients without those conditions.

    In fact, the researchers found that 41% of the 140 patients who required ventilation or died had morbid obesity.

    Patients with two or more of the high-risk conditions had significantly higher rates of ventilation and death than patients without any those risk factors, the researchers found. According to the researchers, young adult Covid-19 patients with two or more of the conditions (diabetes, hypertension, and/or obesity), had a similar rate of ventilation and death as adults ages 35 to 64 with Covid-19 who did not have any of those risk factors.

    Discussion

    In an editor's note accompanying the study, Mitchell Katz of NYC Health and Hospitals, who is a deputy editor of JAMA Internal Medicine, wrote that the study shows Covid-19 "does not spare young people" and is "a life-threatening disease in people of all ages."

    "[W]hile young adults are much less likely than older persons to become seriously ill, if they reach the point of hospitalization, their risks are substantial," Katz wrote.

    Katz added that, because obesity and hypertension are preventable and treatable, "reducing the risk of serious Covid-19 illness should be added to the already long list of reasons to increase medical and public health efforts in young adults to promote healthful diets and increased exercise" (Owens, "Vitals," Axios, 9/10; Walker, MedPage Today, 9/9; Katz, JAMA Internal Medicine,  9/9; Cunningham et al., JAMA Internal Medicine, 9/9).

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