“COVID-19 does not spare young people,” wrote Mitchell H. Katz, MD, president and CEO of the NYC Health + Hospitals, the largest municipal health system in the U.S.

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In fact, a new study says that the disease is spreading rapidly among adults between 18 and 34 years old. Similarly, another study suggests that adults between 20 and 39 years old likely contributed to community spread of COVID-19 in Southern states where a rise in the percentage of positive tests in that age group was followed by a rise in positive test results in adults 60 years and older in the ensuing days and weeks.

“While young adults are much less likely than older persons to become seriously ill, if they reach the point of hospitalization, their risks are substantial,” Dr. Katz wrote in an JAMA Internal Medicine Editor’s Note commenting on a study by researchers at Brigham and Women’s Hospital

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Morbidity substantial for young adults

The researchers used a national all-payer hospital database to identify 3,222 nonpregnant adults aged 18–34 who were admitted to U.S. hospitals for COVID-19 between April 1 and June 30. Of those, 21% required intensive care, 10% required mechanical ventilation and 2.7% died.

“This in-hospital mortality rate is lower than that reported for older adults with COVID-19, but approximately double that of young adults with acute myocardial infarction,” the Brigham and Women’s research wrote in the study, published in JAMA Internal Medicine

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As in the general population, mortality was higher among men and those who had obesity and hypertension.

“Young adults with more than one of these conditions faced risks comparable with those observed in middle-aged adults without them,” the study says. “More than half of these patients requiring hospitalization were Black or Hispanic, consistent with prior findings of disproportionate illness severity in these demographic groups.”

The median length of stay for the group was four days.

“Given the sharply rising rates of COVID-19 infection in young adults, these findings underscore the importance of infection-prevention measures in this age group,” the researchers wrote.

Noting that obesity and hypertension are preventable and treatable conditions, Dr. Katz wrote that “reducing the risk of serious COVID 19 illness should be added to the already long list of reasons to increase medical and public health efforts in young adults to promote healthful diets and increased exercise.”

Learn about the six things doctors wish patients knew about masks.

Median age plummets

In a separate study, researchers with the Centers for Disease Control and Prevention (CDC) COVID-19 Response Team found that the median age of COVID-19 cases dropped from 46 years in May to a low of 37 years in July. In addition, the highest incidence for the disease was for adults ages 20 to 29, who accounted for more than 20% of confirmed COVID-19 cases from June through August.

The study, “Changing Age Distribution of the COVID-19 Pandemic—United States, May–August 2020,” published in the CDC’s Morbidity and Mortality Weekly Report, noted the rapidly rising incidence of COVID-19 among young adults, the lowering of the national median age for COVID-19 infection, and that—over the summer, in Southern states—a rising percentage of positive test rates in young adults was typically followed by a rising percentage among older age groups.

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“Strict adherence to community-mitigation strategies and personal preventive behaviors by younger adults is needed to help reduce their risk for infection and minimize subsequent transmission of SARS-CoV-2 to persons at higher risk for severe COVID-19,” the CDC researchers wrote.

Here’s how to help patients navigate their concerns about COVID-19 risk.

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