September 10, 2020

Young adults hospitalised with COVID-19 experienced substantial rates of adverse outcomes

By Denise Baez

NEW YORK -- September 10, 2020 -- A study of 3,222 young adults aged 18 to 34 years who were hospitalised for coronavirus disease 2019 (COVID-19) showed that 21% required intensive care, 10% required mechanical ventilation, and 2.7% died.

“This in-hospital mortality rate is lower than that reported for older adults with COVID-19, but approximately double that of young adults with acute myocardial infarction,” noted Jonathan W. Cunningham, MD, Brigham and Women’s Hospital, Boston, Massachusetts, and colleagues.

For the study, published in JAMA Internal Medicine, the researchers analysed data from a hospital-based, all-payer database that included 1,030 US hospitals and health care systems. Among 780,969 adults discharged between April 1, 2020, and June 30, 2020, a total of 3,222 were non-pregnant young adults (admitted to 419 hospitals). Of the patients, 57.6% were male, 57.0% were Black or Hispanic, 36.8% were obese, 24.5% were morbidly obese, 18.2% had diabetes, and 16.1% had hypertension.

“Morbid obesity, hypertension, and diabetes were common and associated with greater risks of adverse events,” the authors wrote. “Young adults with more than 1 of these conditions faced risks comparable with those observed in middle-aged adults without them.”

Patients who were morbidly obese had more than double the odds of death or mechanical ventilation compared with patients who were not obese (adjusted odds ratio [aOR] = 2.30; 95% confidence interval [CI], 1.79-3.12; P < .001). Patients with hypertension also had the increased risk (aOR = 2.36; 95% CI, 1.79-3.12; P < .001).

Of the patients who required mechanical ventilation (n = 331) or died (n = 88), 140 (41%) were morbidly obese.

Vasopressors or inotropes were used for 217 (7%) patients, central venous catheters for 283 (9%), and arterial catheters for 192 (6%). The median length of stay was 4 days. Among those who survived hospitalisation, 99 (3%) were discharged to a post-acute care facility.

The authors noted that COVID-19 diagnosis and comorbidities were identified using ICD-10 codes, which may be subject to misclassification. However, “given the sharply rising rates of COVID-19 infection in young adults, these findings underscore the importance of infection prevention measures in this age group,” they concluded.

SOURCE: JAMA Internal Medicine
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