Young adults with high blood pressure or obesity at serious risk with COVID19

New from 10.1001/jamainternmed.2020.5415

New evidence suggests that obesity and high blood pressure are severe risk factors for critical cases of COVID19, even with young adults.

“Older age has consistently been associated with higher mortality in patients with coronavirus disease 2019 (COVID-19).^1,2 Unfortunately, as shown by Cunningham et al³ in this issue of JAMA Internal Medicine, COVID-19 does not spare young people. Using a national all-payer hospital database, the investigators identified 3222 nonpregnant adults aged 18 to 34 years who were admitted to US hospitals for COVID-19. Morbidity was substantial: 21% required intensive care, and 2.7% died. Mortality was higher among those who had obesity, hypertension, and male sex, as has been noted in general adult populations.

“Combined with what we know about the greater risk of older persons, what does this study tell us about COVID-19 and young adults? First, 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. Second, obesity, hypertension, and male sex put patients of all ages at greater risk. As obesity and hypertension are preventable and treatable conditions, 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. Finally, the article by Cunningham et al³ establishes that COVID-19 is a life-threatening disease in people of all ages and that social distancing, facial coverings, and other approaches to prevent transmission are as important in young adults as in older persons.”

Three percent of adults, ages 18-34, who were hospitalized with COVID-19 died, but 21% required intensive care and 10% required mechanical ventilation, reported Scott Solomon, MD, of Brigham and Women’s Hospital in Boston, and colleagues.

“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,” wrote Katz, who is also the deputy editor of JAMA Internal Medicine.

Katz advocated for public health efforts to promote healthier eating and the importance of exercise in young people, and noted that young people should be adhering to public health interventions, such as face masks in public and social distancing, as much as older adults.