由 John R. Fischer
, Senior Reporter | October 13, 2020
Young patients are dying from COVID-19 twice as often as those in the same age group hospitalized with heart attacks.
That is just one of the adverse outcomes uncovered in a study at Brigham and Women’s Hospital on young people hospitalized with the novel coronavirus. Of those between 18 and 34 hospitalized, 2.7% died from the disease, compared to half of that figure for patients in the same age group hospitalized with heart attacks.
"There was a significant rate of adverse outcomes," said Dr. Jonathan Cunningham, a Cardiovascular Medicine fellow at Brigham and first author on the letter, in a statement. "Even though a 2.7 percent death rate is lower than for older patients, it's high for young people who typically do well even when hospitalized for other conditions."
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Researchers used the Premier Healthcare Database to study records from 419 hospitals and the clinical trajectories of 3,222 young, hospitalized COVID-19 patients. In addition to the death rate for this age group, they found that 21% required intensive care, while 10% needed mechanical ventilation. Another observation made was that 57% of the young people hospitalized for COVID-19 were black or Hispanic, which aligns with other reports about the disproportionate impact of the disease on different demographics.
Individuals with cardiovascular risk factors were overrepresented among the young people hospitalized, with 36.8% suffering from obesity and 24.5% with morbid obesity. An additional 18.2% had diabetes and 16.1% had hypertension. Patients with these comorbidities were more likely to experience adverse outcomes, with those suffering from morbid obesity making up 41% of the hospitalized young adults who died or needed mechanical ventilation. For individuals with more than one of these conditions, the risks for adverse outcomes were similar to those faced by middle-aged adults, aged 35-64, who had none of these conditions, as seen in a study of 8,862 members of this population.
"We know nothing about the total denominator of patients who got an infection," said corresponding author Dr. Scott Solomon, director of noninvasive cardiology in the Division of Cardiovascular Medicine at the Brigham, in a statement. "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."
The data set, which relies on hospital administrative claims, provides only insight into the adverse outcomes of hospitalized young people, according to the researchers.
The study had no funding organization, instead relying on grants from the National Heart, Lung, and Blood Institute and grants from industry outside of the submitted work.
The findings were published in a research letter in JAMA Internal Medicine