COVID-19 severity in young adults

Clinical Question

What do we know about the severity of disease among young people?

Key Findings

  • The US has fewer known cases in young people compared to Spain and China but more comparable levels to Italy
  • The US has comparable hospitalizations and number of cases in the ICU as Spain but significantly more ICU cases than Italy. The reason for this is unclear. Data from China for ICU admissions is also unreliable as the n for this study was small (41 patients).
  • Overall there are significantly fewer deaths in people ages 20–50 compared to the older population; data from the United States is showing that same trend; China is seeing a higher percent of total deaths in the younger population compared to other countries but this is still a much lower rate than infected persons in the older age ranges
  • As of March 16, 2020, 12% of US ICU cases consisted of patients between the ages of 20–44 years old. This age group also has the lowest admissions rate at 2-4%.
  • In France, those under 15 year old are presenting with pneumonia-like-symptoms, while 15–44 year olds are generally coming in with dyspnea or shortness of breath. All ages are equally coming for an isolated fever.

Summary of Information

Country

Percent of Total Cases

Percent of Hospitalizations

Percent of ICU Cases

Percent of Total Deaths

Italy

~25 (ages 19-50)[1][2]

No age breakdown

5.6 (age 15-44)

0.9 (ages 20-50)[2]

Spain

~33 (ages 15-49)[3]

18.3 (ages 15-49)[3]

11.5 (ages 15-49)[3]

0.7 (under age 40)[3]

China

~41 (ages 20-49)[4]

~49 (25-49)[5]

~54 (25-49)[5]

6.2 (ages 20-50)[2][4]

United States

29 (ages 20-44) [6]

20 (ages 20-44)[6]

12 (ages 20-44)[6]

0.1-0.2 (ages 20-44)[6]

Author Information

Authors: Danielle Urman MS1, Eulanca Liu MS3/PhD, Claire Conklin MS1, Elli Novatcheva MS3, UC San Diego School of Medicine
Completed on: March 28, 2020
Last updated on: Not yet updated

Reviewed by: Gary Smithson MD
Reviewed on: April 14, 2020

This summary was written as part of the CoRESPOND Earth 2.0 COVID-19 Rapid Response at UC San Diego. For more information about the project, please visit http://earth2-covid.ucsd.edu

References

  1. Italy: coronavirus cases by age 2020. Statista. https://www.statista.com/statistics/1103023/coronavirus-cases-distribution-by-age-group-italy/. Accessed March 26, 2020.
  2. Livingston E, Bucher K. Coronavirus Disease 2019 (COVID-19) in Italy. JAMA. 2020.  [PMID:32181795]
  3. Informe sobre la situación de COVID-19 en España. March 2020. https://www.isciii.es/QueHacemos/Servicios/VigilanciaSaludPublicaRENAVE/En.... Accessed March 26, 2020.
  4. Epidemiology Working Group for NCIP Epidemic Response, Chinese Center for Disease Control and Prevention. [The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China]. Zhonghua Liu Xing Bing Xue Za Zhi. 2020;41(2):145-151.  [PMID:32064853]
  5. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.  [PMID:31986264]
  6. CDC COVID-19 Response Team. Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) - United States, February 12-March 16, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(12):343-346.  [PMID:32214079]
Last updated: July 1, 2020