OBJECTIVES

The impact of COVID-19 on young adults is not well understood. The aim of this study was to identify factors associated with hospital utilization of young adult patients with COVID-19.

METHODS

Young adult patients (ages 18-24 years) diagnosed with COVID-19 between December 2019 and August 2020 were identified in the IBM® Explorys® database. Positive infection was determined via the Systematized Nomenclature of Medicine-Clinical Terms (SNOMED-CT) codes. Chi-square test, univariate, and multivariate logistic regression were employed to evaluate the association between key risk factors, including sociodemographics, and hospital admissions to the emergency department (ED), inpatient units, and intensive care unit (ICUs).

RESULTS

6648 young adult patients (mean 21.9 years, 59.6% female) with confirmed COVID-19 were identified. Forty-nine percent were Caucasian, 34% African American, 0.8% Asian, 8.9% Hispanic and 3.6% Other Race. Common symptoms included cough (25.6%), fever (15%), headache (10.6%), loss of smell (6.4%), loss of taste (6.2%), nausea (5.5%), and fatigue (4.6%). Among these, 910 (13.7%) were seen in the ED; 184 (2.8%) inpatient admission, and 23 (0.3%), ICU admission. Multivariate logistic regression suggested that both African American (OR=2.38, 95% CI: [1.63-3.53]) and Other Race (OR=4.99, 95% CI: [2.62-9.08]) patients were significantly associated with increased odds of hospitalization (OR=4.99, 95% CI: [2.79-5.70]). Cardiovascular disease (OR=4.01, 95% CI: [2.79 - 5.70]) and obesity (OR=3.03, 95% CI: [2.14 - 4.34]) were associated with the increased odds of hospitalization. Obesity was also associated with increased odds of ED visits (OR=1.45 95% CI: [1.24-1.69]). African American, Hispanic and Other Race had increased odds of ED visits (OR=2.24, 95% CI: [1.91-2.64]; OR=1.34, 95% CI: [1.01-1.76]; OR=3.48, 95% CI: [2.51-4.77], respectively).

CONCLUSIONS

Young adult patients typically have milder COVID-19 symptoms, yet 16% required emergency department or hospital care. Cardiovascular disease, obesity and race/ethnicity were important risk factors. Additional research is needed to better understand disease severity among young adults.