Are young people dying from coronavirus?

What do we know about the results for young people hospitalized with SARS-CoV-2? Are young people at risk of dying from coronavirus?

The SARS-CoV-2 virus has had devastating effects worldwide since it was first introduced into circulation almost a year ago. The total number of deaths as a result of the pandemic has already risen well over 1.1 million and it cannot be said that the end of the spread is in sight. To date, the vast majority of deaths have occurred in older adults, especially adults with multiple comorbidities. This has led some people to perceive that the virus is relatively benign in young people. A new analysis published by JAMA Internal Medicine attempts to shed light on the risks of young people dying from coronavirus by compiling US hospital statistics (1).

The study used a large database covering 1,030 US hospitals and healthcare systems. The researchers collected data on everyone between the ages of 18 and 34 who had a confirmed diagnosis of COVID-19 at any of these facilities between April 1 and June 30, 2020. They excluded people such as pregnant women for whom COVID was not a reason for admission. The database also contained information on comorbidities, critical care, ethnicity, and race.

In total, the analysis included 3,222 young adults diagnosed with COVID-19 in 419 US hospitals. The mean age of the group was 28.3 years and just over 57% of them were men. Likewise, 57% were black or Spanish. In terms of comorbidities, obesity was by far the most common in the group. 36.8% were classified as obese, most of them were pathologically obese. About one in five suffered from diabetes and one in six from high blood pressure.

This group was analyzed to study their disease course and final results. Twenty-one percent of them had to undergo intensive treatment at some point, and one in ten required mechanical ventilation. In total, 88 of these young people died with coronavirus (2.7%). Among the survivors, 3% had to be discharged to an institution for further recovery. The mean length of hospital stay was four days.

Statistical analysis examined the effect of various comorbidities on a patient's trajectory / outcome. Morbid obesity and high blood pressure were the two risk factors with the highest risk of death or mechanical ventilation. Patients who were pathologically obese or suffered from high blood pressure died approximately 2.3 times more often or required mechanical ventilation. The male sex had a slightly higher risk of the same negative results (odds ratio = 1.53). The presence of multiple risk factors further increased the risk of negative outcomes.

The results of this analysis underline the significant risks that SARS-CoV-2 poses for young people. Ten percent of young adults admitted to hospital with COVID-19 required mechanical ventilation and over a fifth required intensive care. The results of the study suggest that nearly three out of every hundred young people hospitalized with the disease could die. This study also shows the importance of correctly expressing risk. As the virus continues to spread among younger people, the number of people who need to be hospitalized continues to grow. Three percent may seem like a small percentage, but when it gets to three percent of thousands or even hundreds of thousands, it means that many human lives are being lost.

However, there are a number of limitations in this study. For example, using electronic databases may not always be the most reliable method of capturing comorbidities and diagnoses. In addition, differences in patient outcomes in other countries have been linked to health care capacity. There is also the problem of improving disease knowledge to be considered. As we learn more about the disease, treatment options can be refined and patient outcomes improved. The results of this study would have to be confirmed before the specific numbers can be considered accurate. The overall result, however, remains the same – it shows the importance of preventing the spread among young people.

Written by Michael McCarthy

1. Cunningham JW, Vaduganathan M., Claggett BL, Jering KS, Bhatt AS, Rosenthal N. et al. Clinical results in young adults in the United States who were hospitalized with COVID-19. JAMA internal medicine. 2020.

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