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Hospital outcomes for young adults with COVID-19
Brian S Williams1,2,3, Thomas M Piasecki1,4, Michael C Fiore1,4
1Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health.
Insights
Young adults hospitalized with COVID-19 experienced significant illness, with cancer history increasing death risk. Vaccination offered protection against severe outcomes like ICU admission.
Area of Science:
- Infectious Diseases
- Public Health
- Epidemiology
Background:
- Older adults face higher COVID-19 risks, but young adult outcomes are less understood.
- Young adults have experienced high COVID-19 infection rates.
- Comorbidities exacerbate severe COVID-19 outcomes.
Purpose of the Study:
- To determine outcomes for young adults hospitalized with COVID-19.
- To assess rates of oxygen use, mortality, ICU admission, and intubation.
- To identify factors associated with adverse COVID-19 outcomes in young adults.
Main Methods:
- Retrospective cohort study using EHR data from 21 US health systems.
- Included 18-29-year-olds hospitalized with COVID-19 (March 2020 - January 2022).
- Oxygen need identified symptomatic cases; outcomes compared between symptomatic and asymptomatic groups.
Main Results:
- 35% of 9871 hospitalized young adults required oxygen.
- Mortality: 2.6%; ICU admission: 27.7%; Intubation: 15.8%.
- Cancer history increased death odds (2.1x); vaccination reduced ICU odds (>40%).
Conclusions:
- COVID-19 caused significant morbidity and mortality in hospitalized young adults needing oxygen.
- A history of cancer was linked to a higher risk of death.
- Vaccination demonstrated a protective effect against severe COVID-19 illness.
Background:
Older adults are at higher risk of severe outcomes from COVID-19 with comorbidities increasing such risk. Much less is known about the outcomes of young adults with COVID-19 despite their having had high infection rates.
Objectives:
Our objective was to determine outcomes of hospitalized young adults with COVID-19 infection including rates of oxygen use, mortality, ICU admission, intubation, duration of hospitalization, and factors associated with adverse outcomes.
Study Design:
This retrospective cohort study included EHR data from 21 health systems in the United States on 18-29-year-olds hospitalized with COVID-19 from March 1, 2020 - January 31, 2022. Oxygen need was used to identify symptomatic COVID-19. Rates for mortality, ICU admission, and intubation were calculated for the symptomatic and asymptomatic groups. Effects of demographic and health characteristics on outcomes were assessed as were changes in hospital outcomes over time.
Results:
Our sample included 9871 young adults hospitalized with COVID-19; 35% required oxygen. Of those who required oxygen, 53.5% were female, 23.7% had an anxiety disorder, 2.6% died (n = 89), 27.7% were admitted to the ICU (n = 955), and 15.8% were intubated (n = 547). A past-year history of any cancer was associated with a 2.1 times increased odds of death. Vaccination was associated with a >40% reduction in the odds of ICU admission. Mortality rates did not change significantly across the study period.
Conclusions:
COVID-19 caused significant morbidity and mortality in hospitalized young adults who required oxygen. A cancer history was associated with increased risk of death. Vaccination appeared to have had a protective effect on illness severity.
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