Breakdown of severe COVID-19 cases in young adults provides warnings

Although older adults face the highest risk of being hospitalized with or dying from COVID-19, younger adults can also end up in the hospital (SN: 3/19/20). If they do, the outcome can be serious, and a new study is providing a look at just how severe the disease can be for those patients.

Of roughly 3,200 people ages 18 to 34 who were admitted to 419 U.S. hospitals from early April to the end of June, 21 percent, or 684 people, landed in intensive care and 10 percent, or 331 patients, ended up on ventilators. Almost 3 percent, or nearly 90 people, died, researchers report September 9 in JAMA Internal Medicine

Those numbers are “alarming figures given that COVID-19 outbreaks are rampant in many U.S. colleges that have opened for in-person learning,” says Aubree Gordon, an epidemiologist at the University of Michigan in Ann Arbor. Younger adults now make up nearly a quarter of U.S. coronavirus cases.

A 3 percent death rate is lower than what has been reported for hospitalized older adults with COVID-19 — which was more than 20 percent in two separate studies from the United States and Germany — but still higher than it is for some other illnesses. For instance, it’s more than twice the death rate for heart attacks in young adults, the researchers wrote.

Underlying conditions like severe obesity or high blood pressure were linked to more serious illness or death. And the team found that younger adults who have multiple underlying conditions can face similar risks of serious illness and death as people 35 to 64 years old without those conditions. More than half of the hospitalized young adults were Black or Hispanic, although race or ethnicity was not associated with an increased risk of death or needing a ventilator.

Seeing more severe disease in younger adults with underlying conditions mirrors findings from larger populations that include people from other age groups, says Aaron Milstone, a pediatric infectious disease specialist at Johns Hopkins University.

Because the study considered only hospitalized patients, it can’t say what the risk is for young adults in general who are infected with the coronavirus, he says. But “if you get hospitalized, your risk of complications is high, and that should be concerning for everyone whether they are a child, young adult or senior citizen,” Milstone says.

What’s more, 3 percent of the people who survived their hospital stay needed more care in a nursing facility afterward. It’s unknown whether any of the other patients discharged from the hospital suffered from lingering COVID-19 symptoms.

“Young people often shrug off their risk, citing their age,” Gordon says. But the findings underscore the fact that younger people at still at risk of severe symptoms, she says, particularly if they have other health conditions.

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