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October 19, 2020
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One in five young adults hospitalized for COVID-19 require intensive care

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Approximately one-fifth of young adults hospitalized with COVID-19 required intensive care, according to research published in JAMA Internal Medicine.

“We think the vast majority of people in this age range have self-limited disease and don't require hospitalization,” Scott Solomon, MD, director of noninvasive cardiology in the Division of Cardiovascular Medicine at the Brigham and Women’s Hospital, said in a press release. “But if you do, the risks are really substantial.”

COVID-19 mortality in young adults
Reference: Cunningham JW, et al. JAMA Intern Med. 2020;doi:10.1001/jamainternmed.2020.531.

Solomon and colleagues evaluated data from the Premier Healthcare Database, which includes 1,030 U.S. hospitals and health care systems, on adults aged 18 to 34 years with COVID-19 who were discharged from the hospital between April 1 and June 30.

They identified 3,222 young adults with COVID-19 who were hospitalized at 419 U.S. hospitals. Among them, 36.8% were obese, 24.5% were morbidly obese, 18.2% had diabetes and 16.1% had hypertension.

During their hospitalization, which was a median of 4 days, 21% of patients required intensive care, 10% required mechanical ventilation and 2.7% died.

Solomon and colleagues identified a greater risk for death or mechanical ventilation among patients with morbid obesity (adjusted OR = 2.30; 95% CI, 1.77-2.98) and hypertension (adjusted OR = 2.36; 95% CI, 1.79-3.12) compared with those without such conditions. They also found that male patients had a greater risk for death or mechanical ventilation compared with female patients (adjusted OR = 1.53; 95% CI, 1.20-1.95).

According to researchers, patients with multiple risk factors had similar COVID-19-related risks to adults aged 35 to 64 years with COVID-19 who did not have these conditions.

Researchers noted that although the observed mortality rate of 2.7% was lower than the rate reported in older adults with COVID-19, this rate was higher than the mortality rate for other conditions requiring hospitalization in young adults. For instance, they found the observed mortality rate among young adults hospitalized for COVID-19 was double the rate associated with acute MI among adults the same age.

In an editor’s note published alongside the study, Mitchell H. Katz, MD, president and CEO of NYC Health + Hospitals, said the findings provide more evidence that, unfortunately, “COVID-19 does not spare young people.”

He added that the study confirms the novel coronavirus “is a life-threatening disease in people of all ages and that social distancing, facial coverings and other approaches to prevent transmission are as important in young adults as in older persons.”

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