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Increasing impact of COVID-19 on young adults: evidence from hospitalisations in Brazil
R Guimarães1, D A M Villela1, D R Xavier1
1Fiocruz COVID-19 Observatory, Oswaldo Cruz Foundation, Brazil.
Insights
COVID-19 hospitalizations in Brazil shifted towards younger adults (18-49 years) starting in early 2021, while older adults (≥70 years) saw a decline. This trend may be linked to vaccination success in older groups and increased exposure in younger populations.
Area of Science:
- Epidemiology
- Public Health
- Infectious Diseases
Background:
- Severe COVID-19 cases in Brazil raised concerns about younger populations.
- This study investigates hospitalization trends in distinct age groups during the pandemic.
Purpose of the Study:
- To analyze changes in COVID-19 hospitalizations among adults aged 18-49 years and ≥70 years in Brazil.
- To identify demographic shifts in severe COVID-19 cases.
Main Methods:
- Utilized a longitudinal study design with secondary data from the SIVEP-Gripe database.
- Employed statistical control charts to analyze hospitalization data from March 2020 to June 2021.
Main Results:
- Initially, older adults had higher COVID-19 hospitalizations, while younger adults saw a decrease.
- From early 2021, hospitalizations increased significantly in younger adults (up to 44.9%) while decreasing in older adults (down to 17.3%).
Conclusions:
- Rising COVID-19 hospitalizations in younger adults may be attributed to prioritized vaccination of older individuals and increased exposure to variants.
- Potential long-term impacts include reduced life expectancy and increased post-COVID-19 conditions in the younger demographic.
Objectives:
Concerns about the increasing impact of severe COVID-19 in younger individuals in Brazil came after a recent synchronised country-wide wave of cases in Brazil. This communication analyses how hospitalisations due to COVID-19 changed in the age groups 18-49 years and ≥70 years.
Study Design:
Longitudinal study based on secondary data.
Methods:
Data from SIVEP-Gripe, a public and open-access database of Severe Acute Respiratory Illness records (including COVID-19 notifications), were used in this study. Statistical control charts examined changes in the magnitude and variation of younger (18-49 years) and older (≥70 years) adults who were hospitalised between 15th March 2020 and 19th June 2021.
Results:
During the few first weeks of the pandemic in Brazil, the number of COVID-19 hospitalisations increased in older adults but decreased in younger adults. Subsequently, hospitalisations reached statistical control zones in epidemiological weeks (EW) 19-48 of 2020 (EW 19-48/2020) and EW 03-05/2021 (18-49 y, mean = 26.1%; ≥70 y, mean = 32.8%). Between EW 49/2020 and EW 02/2021, the number of hospitalisations of younger adults dropped to levels below the lower control limit. In contrast, the number of hospitalisations of older adults surpassed the upper limit of the corresponding statistical control zones. However, from EW 06/2021, numbers of hospitalisations changed from statistical control zones, with hospitalisations of younger adults increasing and reaching 44.9% in EW 24/2021 and hospitalisations of older adults decreasing until EW 19/2021 (14.1%) and reaching 17.3% in EW 24/2021.
Conclusions:
An increasing number of COVID-19 hospitalisations were observed in younger adults from EW 06/2021. This could be a result of the successful vaccination programme in older adults, who were initially prioritised, and possibly an increased exposure to highly transmissible variants of COVID-19 in younger adults who had to go to work in the absence of social protection (i.e. government financial support). Potential consequences of COVID-19 hospitalisations in younger adults could include a reduced life expectancy of the population and an increased number of people unable to perform daily activities due to post-COVID-19 conditions.
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