Nearly 40% of Those Hospitalized for COVID-19 Are Under 55

• Older adults and people with other health conditions are most at risk for severe COVID-19 complications, but new data shows younger adults aren’t invulnerable to the virus.
• In France, 50 percent of the country’s COVID-19 patients in intensive care are under the age of 60.
• Around 14 percent of COVID-19 cases are severe, according to the WHO.

Initial data from China found that the people most at risk for severe COVID-19 complications are older adults and those with other health conditions.

While this is still true, younger people aren’t as invulnerable as previously thought.

In the United States, among almost 2,500 patients with COVID-19 with a known age, 29 percent were 20 to 44 years old, according to the Centers for Disease Control and Prevention (CDC).

In a group of 500 patients hospitalized, about 20.8 percent were between the ages of 20 and 44, and 18 percent were between 45 and 54.

Of patients in the ICU, about 12 percent were below the age of 45. Few died.

Jérôme Salomon, France’s director general for health, announced that more than 50 percent of the country’s COVID-19 patients in intensive care are under the age of 60, according to CNN reports. He did not specify the age range for this group.

Younger adults still at risk

One younger adult admitted to the ICU with COVID-19 is a 40-something emergency room doctor at EvergreenHealth in Kirkland, Washington.

Another is Clement Chow, PhD, an assistant professor of genetics at the University of Utah. He tweeted Sunday that he had a low-grade fever for a couple of days, followed by a bad cough that turned into respiratory failure. He was hospitalized and placed on supplemental oxygen in the ICU.

“Important point: we really don’t know much about this virus. I’m young and not high risk, yet I am in [the] ICU with a very severe case,” tweeted Chow.

Dr. Koushik Kasanagottu, an internal medicine resident at Johns Hopkins Bayview in Baltimore, cautions against drawing conclusions based on occasional tweets and news reports.

“So far, we are seeing the majority of severe illnesses with regards to COVID-19 in the elderly and immunocompromised,” he said.

However, “there is no absolute age cutoff,” he added. “There are, of course, several cases of severe illness for patients under 60 years old.”

According to the World Health Organization (WHO), most people with COVID-19 develop mild or uncomplicated illness. However, around 14 percent develop severe disease and need to be hospitalized, and 5 percent end up in the ICU.

Kasanagottu says evidence from around the world suggests that younger people without other health conditions — such as diabetes, kidney disease, or heart failure — tend to do well even if they develop COVID-19.

In China, the death rate from COVID-19 was highest for people over age 60, reaching 14.8 percent in people 80 years or older, reports the CDC.

A similar trend was seen in Italy.

Dr. Craig Coopersmith, former Society of Critical Care Medicine president and acting director of the Emory Critical Care Center at Emory University School of Medicine, points out the death rates for COVID-19 are based on data for entire populations. But low rates for certain age groups doesn’t mean the risk to individuals is nonexistent.

“In general, patients who are older and patients who have comorbidities do worse,” he said. “That doesn’t mean that if you’re young and healthy, you’re 100 percent guaranteed to have a good outcome.”

The same is seen with the seasonal flu, which last season caused 2,450 deaths in Americans aged 18 to 49 years.

Even the very young aren’t entirely free of risk due to the new coronavirus. Scientists in China report in the journal Pediatrics that 5.9 percent of pediatric COVID-19 cases in the country were severe or critical.

In adults, it was 18.5 percent.

However, they report that most cases in children were mild. Only one child died.

Social distancing important for all ages

As scientists gather more data, they gain a better understanding of the risks of COVID-19 for different ages and groups.

However, without a complete review of patients’ medical charts, it’s difficult to know why certain young people have more severe disease.

One possibility is that some younger people may have undiagnosed health problems that puts them at risk.

The CDC reports that 10.5 percent of people with cardiovascular disease and 7 percent of people with diabetes who developed COVID-19 died. Compare this with the rate for people without existing medical conditions, which was less than 1 percent.

Dr. Nora Volkow, director of the National Institute on Drug Abuse, has also raised concerns that people who smoke tobacco or marijuana or who vape may have a higher risk for COVID-19 complications due to existing lung damage.

Kasanagottu says younger adults shouldn’t be overly alarmed about COVID-19, but he says they should still practice social distancing, regular handwashing, and take other steps to protect themselves and those who are most vulnerable.

Coopersmith urges people to follow the recommendations of public health officials.

“Everybody should consider that they are at risk of getting the disease,” he said. “Everybody should also consider that they are also at risk of transmitting the disease if they are asymptomatic and have it without knowing it.”

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