One in Five Younger Patients Hospitalized for COVID-19 Require Intensive Care

By John Commins

Younger people hospitalized with COVID-19 have a one-in-five chance (21%) of ending up in the intensive care unit, according to a research letter published in JAMA Internal Medicine.

In addition, 10% of patients age 18-34 required mechanical ventilation and 2.7% died. By comparison, the death rate of those in the same age group hospitalized with heart attacks is half of that figure. The researchers also found that 57% of young people hospitalized for COVID-19 were Black or Hispanic.

“There was a significant rate of adverse outcomes,” said study first author Jonathan Cunningham, MD, a Cardiovascular Medicine fellow at the Brigham. “Even though a 2.7% death rate is lower than for older patients, it’s high for young people who typically do well even when hospitalized for other conditions.”

The Brigham and Women’s Hospital researchers used the Premier Healthcare Database to look at clinical records from 419 hospitals that treated 3,222 hospitalized COVID-19 patients aged 18-34.

Patients with cardiovascular risk factors represented 37% of the young people hospitalized, while 24.5% of patients had obesity and morbid obesity, 18.2% had diabetes and 16% had hypertension.

Patients with these comorbidities were also more likely to suffer adverse outcomes. For example, patients with morbid obesity comprised 41% of the hospitalized young adults who died or required mechanical ventilation.

For individuals with more than one of these conditions, risks for adverse outcomes were comparable to the risks faced by middle-aged adults, aged 35-64, who had none of these conditions, as observed in a study of 8,862 members of this population, the letter said.

The researchers stress that the dataset, which relies on hospital administrative claims, only lends insight into the adverse outcomes of hospitalized young people.

“We know nothing about the total denominator of patients who got an infection,” said corresponding author Scott Solomon, MD, director of noninvasive cardiology in the Division of Cardiovascular Medicine at the Brigham.

“We think the vast majority of people in this age range have self-limited disease and don’t require hospitalization. But if you do, the risks are really substantial,” he said.

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.