• Posted July 15, 2020

Young Adults May Face Higher Risk for Severe COVID Than Thought

With coronavirus infections soaring among young Americans, a new study shows they may be more vulnerable to serious complications than many believe.

Researchers found that about one-third of Americans ages 18 to 25 had risk factors that make them vulnerable to severe COVID-19. The most common was smoking, followed by asthma, obesity and immune system disorders like rheumatoid arthritis and lupus.

Experts said the findings should send a message to young adults who believe the coronavirus is no threat to them.

It's true that most deaths from COVID-19 are among older adults. But death is not the only dire consequence of the disease, said Dr. Panagis Galiatsatos, an assistant professor at Johns Hopkins University School of Medicine.

Youth, he stressed, does not shield people from falling quite ill, and even ending up in the intensive care unit.

And that can lead to lasting damage to the lungs and other organs, he said.

Galiatsatos, who was not involved in the study, is also a volunteer spokesperson for the American Lung Association.

Since June, there has been a surge in the number of younger Americans testing positive for SARS-CoV-2, the coronavirus that causes COVID-19. And while older adults are much more likely to end up in the hospital, that age gap is narrowing, said Dr. Charles Irwin, the senior researcher on the new study.

Based on federal government data, he said, hospitalizations among 18- to 29-year-olds quadrupled over just a couple months. For the week ending April 18, there were just under 9 hospitalizations for every 100,000 18- to 29-year-olds. By the week ending June 27, the rate had risen to roughly 35 per 100,000.

"That's still low, but it's a huge jump in a relatively short time," said Irwin, a professor at the University of California, San Francisco School of Medicine.

Some of those cases prove fatal. This week, officials at a Texas hospital said a 30-year-old patient died after becoming infected at a "COVID party" -- where young people gather to purposely expose themselves to the virus.

Irwin doubted that COVID parties are rampant, but said young people may falsely believe the virus poses little risk to them personally -- at least partly because of "muddled messages" from government officials.

But the new findings, published July 13 in the Journal of Adolescent Health, illustrate how vulnerable many young people may be.

Of more than 8,400 men and women ages 18 to 25 in a federal health survey, about one-third had at least one risk factor for severe COVID-19. Smoking, including e-cigarettes, was the most prevalent. When that one behavior was taken away, only 16% of the study group was considered medically vulnerable to a severe infection.

A big caveat, Galiatsatos said, is that even healthy nonsmokers can become seriously ill from COVID-19.

But given the link between smoking and severe illness, he said, now is a good time for smokers to talk to their doctor about help with quitting.

"It's a myth that this virus spares anyone," said Dr. Lawrence Kleinman, chief of the division of population health, quality and implementation science at Rutgers Robert Wood Johnson Medical School in New Brunswick, N.J.

Young adults are often prone to seeing themselves as "invincible" -- and that has been true during the pandemic, too, noted Kleinman, who was not involved in the study.

But beyond the fact that they can indeed become seriously ill, he said, there's also the risk of passing the virus on to someone else.

"There are different ways to think about risk," Kleinman said. "One is the risk to the individual, another is the risk to the community."

During this crisis, he said, young people can exert some control "not by rebelling," but by taking action to protect themselves and others. That includes frequent hand-washing, maintaining physical distance from people they do not live with, and wearing a mask in public settings.

"Those things will give them more control over their own fate," Kleinman said.

More information

The U.S. Centers for Disease Control and Prevention's COVID-19 page has advice on protecting yourself and others.

SOURCES: Charles Irwin Jr., M.D., professor, pediatrics, and director, division of adolescent and young adult medicine, University of California, San Francisco School of Medicine; Panagis Galiatsatos, M.D., assistant professor, medicine, director, Tobacco Treatment Clinic, Johns Hopkins University School of Medicine, Baltimore; Lawrence Kleinman, M.D., M.P.H., professor and vice chair, academic development, chief, division of population health, quality, and implementation science, department of pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, N.J.; Journal of Adolescent Health, July 13, 2020, online