One in three young adults may face severe COVID-19, study shows
Smoking habits trump asthma, obesity in risk factors for otherwise
healthy population

Date:
July 13, 2020
Source:
University of California - San Francisco
Summary:
As the number of young adults infected with the coronavirus surges
throughout the nation, a new study indicates that youth may not
shield people from serious disease.



FULL STORY ==========================================================================
As the number of young adults infected with the coronavirus surges
throughout the nation, a new study by researchers at UCSF Benioff
Children's Hospitals indicates that youth may not shield people from
serious disease.


==========================================================================
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, the UCSF
researchers reported in their study, which publishes in the Journal of Adolescent Health on July 13, 2020.

Data from the U.S. Centers for Disease Control and Prevention (CDC),
not included in the UCSF study, indicates that while patients over 65
are significantly more likely to be hospitalized than younger people,
the gap is narrowing. For the week ending April 18, there were 8.7 hospitalizations per 100,000 of the population for the 18-to-29 age
bracket, compared with 128.3 per 100,000 of the population for patients
over 65. By the week ending June 27, the figures were 34.7 and 306.7 respectively, representing a 299 percent increase in hospitalizations
for young adults, versus a 139 percent increase in hospitalizations for
older adults.

The researchers, led by first author Sally Adams, PhD, of the UCSF
Division of Adolescent and Young Adult Medicine, determined vulnerability
by referencing indicators identified by the CDC. These included heart conditions, diabetes, current asthma, immune conditions (such as lupus,
gout, rheumatoid arthritis), liver conditions, obesity and smoking within
the previous 30 days.

Additionally, the researchers added e-cigarettes to tobacco and cigar
use, which the CDC had included, stating that all three were associated
with adverse effects on respiratory and immune function.

Since there was no data on the relative impact of each of the CDC risk
factors, the researchers used an overall medical vulnerability estimate
of having at least one of the indicators as the outcome variable, rather
than a cumulative score of indicators. Thus, medical vulnerability was
assessed 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.



========================================================================== Smoking Linked to Progression of COVID-19 "Recent evidence indicates that smoking is associated with a higher likelihood of COVID-19 progression, including increased illness severity, ICU admission or death," said
Adams. "Smoking may have significant effects in young adults, who
typically have low rates for most chronic diseases." Recent research
also shows that young adults are starting to smoke at higher rates than adolescents, a reversal of previous trends, she noted.

The study, which used data from the National Health Interview Survey,
found that over the previous 30 days, 10.9 percent had smoked a cigarette,
4.5 percent had smoked a cigar product and 7.2 percent had smoked an e-cigarette.

The number of smokers -- 1,664 or 19.8 percent -- was higher than the
number of people with asthma (8.6 percent), obesity (3 percent) and
immune disorders (2.4 percent). Additionally, 1.2 percent had diabetes,
0.6 percent had a liver condition and 0.5 percent had a heart condition.

"The risk of being medically vulnerable to severe disease is halved
when smokers are removed from the sample," said senior author Charles
Irwin Jr., MD, of the UCSF Division of Adolescent and Young Adult
Medicine. "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 overall medical vulnerability of 29.7 percent compared with 33.3 percent for young men.

Co-Authors: M. Jane Park, MPH, Jason Schaub, MPH, and Claire Brindis,
DrPH, of UCSF.

Funding: The study is supported by grants from the Health Resources
ands Services Administration of the U.S. Department of Health and Human Services.


========================================================================== Story Source: Materials provided by
University_of_California_-_San_Francisco. Original written by Suzanne
Leigh. Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Sally H. Adams, M. Jane Park, Jason P. Schaub, Claire D. Brindis,
Charles
E. Irwin. Medical Vulnerability of Young Adults to Severe COVID-19
Illness--Data From the National Health Interview Survey. Journal
of Adolescent Health, 2020; DOI: 10.1016/j.jadohealth.2020.06.025 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/07/200713104344.htm

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