1 in 3 young adults may face severe COVID-19

Smoking habits trump asthma, obesity in risk factors for an otherwise healthy population.

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According to the CDC, while patients over 65 are significantly more likely to be hospitalized than younger people, the gap is narrowing.

A new study by researchers at UC San Francisco Benioff Children’s Hospitals determined the vulnerability by referencing indicators identified by the CDC.

They found that with increasing cases, youth may not shield people from severe disease.

The study considered referencing indicators such as heart conditions, diabetes, current asthma, immune conditions (such as lupus, gout, rheumatoid arthritis), liver conditions, obesity, and smoking within the previous 30 days. They also added e-cigarettes to tobacco and cigar use, as all these were associated with adverse effects on respiratory and immune function.

They assessed medical vulnerability according to each indicator, so that among smokers, for example, 100 percent were vulnerable for severe COVID-19.

Most notable among their results was that medical vulnerability stood at 16.1 percent for the 6,741 non-smokers, versus 31.5 percent for the full sample of 8,405 young adults, which included smokers.

The study looked at data drawn from a nationally representative sample of approximately 8,400 men and women ages 18 to 25 and concluded that overall “medical vulnerability” was 33 percent for males and 30 percent for females. The impact of smoking surpassed other less common risks.

First author Sally Adams, Ph.D., of the UCSF Division of Adolescent and Young Adult Medicine, said“Recent evidence indicates that smoking is associated with a higher likelihood of COVID-19 progression, including increased illness severity, ICU admission or death. Smoking may have significant effects on young adults, who typically have low rates for most chronic diseases.”

Senior author Charles Irwin Jr., MD, of the UCSF Division of Adolescent and Young Adult Medicine, said, “The risk of being medically vulnerable to severe disease is halved when smokers are removed from the sample. Efforts to reduce smoking and e-cigarette use among young adults would likely lower their vulnerability to severe disease.”

Gender differences were noted in five vulnerability indicators. Women were more likely to have asthma (10 percent versus 7.3 percent), to be obese (3.3 percent versus 2.6 percent), and to have immune conditions (3.2 percent versus 1.6 percent). But significantly fewer young women smoked, which resulted in an overall medical vulnerability of 29.7 percent compared with 33.3 percent for young men.

The study publishes in the Journal of Adolescent Health on July 13, 2020.